The liver is considered in “failure” (also called hepatic insufficiency) when it can no longer function to produce bile, filter the blood, store vitamins, iron, glucose, break down hemoglobin, insulin, and destroy old red blood cells.

It is caused when a disease or a substance damages it, and typical symptoms include jaundice (yellowing of the skin and whites of the eyes), ascites (abdominal swelling), hepatic encephalopathy (confusion or drowsiness), and generally failing health. Most people also have general symptoms, such as fatigue, weakness, nausea, and loss of appetite. The patient may bleed and bruise more easily, and the breath may develop a musty and sweet odor.s

Physical examination and blood tests will help verify the diagnosis.

The failure can be acute or chronic. With acute failure, a patient can be near death in days, whereas chronic failure, conditions worsen gradually over months until an emergency occurs, like bloody vomit or stool.

Many times, the kidneys also malfunction along with the liver.