Liver failure can occur acutely (if onset of symptoms is in <26 weeks in a patient with a previously healthy liver) in which case it is known as acute liver failure. This can be further divided into hyperacute (7 days or less), acute (8-21 days) and subacute (4-26 weeks).

• Acute liver failure describes the rapid onset of hepatocellular dysfunction leading to a variety of systemic complications.
• Chronic liver failure is the onset of liver failure on a background of cirrhosis.

Causes

• paracetamol overdose (the most common cause in the UK)
• alcohol
• viral hepatitis (usually A or B)
• acute fatty liver of pregnancy

Other:

• Toxins (Amanita phalloides mushroom, carbon tetrachloride)
• Vascular (Budd-Chiari syndrome)
• Primary biliary cirrhosis
• Haemochromatosis
• Wilson's disease
• Autoimmune hepatitis
• Alpha-1 antitrypsin deficiency
• Non-alcoholic fatty liver disease
• Malignancy
• HELLP syndrome