Fulminant Liver Failure

Fulminant liver failure (also known as acute liver failure) is a term used to describe a sudden impairment of liver function. Unlike chronic liver failure, which develops over months or years, people experiencing abrupt failure can show symptoms in only a few days or weeks. Acute liver failure typically affects people who have no previous history of liver disease.


Patients who experience fulminant liver failure may need a liver transplant and can be referred to the Comprehensive Liver Disease & Transplant Center at Tampa General Hospital’s Transplant Institute.

What Causes Fulminant Liver Failure?

One of the most common causes of fulminant liver failure is an overdose of acetaminophen (a drug also known as Tylenol or other brand names). An overdose can occur over several days if someone repeatedly exceeds the recommended dosage of the drug, or it can happen due to a single, very large dose.

Other, less common causes include:

  • Exposure to toxins
  • Infection by a virus like hepatitis A, B and (more rarely) C
  • Certain genetic disorders
  • Cancer that begins in or spreads to the liver
  • Vascular diseases that affect the veins in the liver
  • Metabolic diseases

What Are the Symptoms of Fulminant Liver Failure?

Fulminant liver failure may be difficult to identify early in its progression because its first symptoms are non-specific. For example, a patient may experience nausea, vomiting, loss of appetite or fatigue when their liver starts to fail.

Other, more distinguishable symptoms can show up later, including:

  • Yellowing of the skin and whites of the eyes (jaundice)
  • Ascites, or the accumulation of fluid in the abdomen
  • Edema, or the accumulation of fluid in the legs and ankles
  • Encephalitis, or the swelling and irritation of the brain
  • Easy bruising
  • Dark-colored urine
  • Light-colored bowel movements

How Is Fulminant Liver Failure Diagnosed?

Because acute liver failure happens so suddenly, it needs to be promptly addressed and diagnosed. Various tests and procedures can be used to diagnose fulminant liver failure, including:

  • Blood tests
  • Imaging tests
  • Examination of liver tissue with a biopsy

How Is Fulminant Liver Failure Treated at TGH?

Treatment will depend on the cause of the fulminant liver failure, as well as any complications that arise from it. For example, patients who have overdosed or been accidentally poisoned may be given medications to help eliminate the toxin causing liver damage.

If the liver damage cannot be improved or reversed through these means, a liver transplant may be the best course of action.

The Liver Transplant Program at the Comprehensive Liver Disease & Transplant Center at TGH is one of the busiest in the nation, and we treat some of the most complex cases of fulminant liver failure. In addition, we have a shorter-than-average time to transplant and above-average survival rates, according to Scientific Registry of Transplant Recipients data

Become a Patient

To become a patient in our Liver Transplant Program, you, your physician, or another hospital must fill out a referral form or call 813-844-8686. To speak to a transplant coordinator, call 813-844-7137.

Click here to learn more about our liver transplant process.