End stage liver disease is an irreversible condition that results from chronic liver disease and signals that liver failure is imminent. Chronic liver diseases including alcohol cirrhosis of the liver, viral hepatitis infections, liver cancers, autoimmune disorders and drug toxicity can lead to end stage liver disease. Because the only treatment for end stage liver disease is a liver transplant, according to the doctors at the Mayo Clinic, it is important to recognize the symptoms.
Jaundice
Jaundice, the yellowing of the skin or the whites of the eyes, is often the first sign of liver disease and one that continues through to end stage liver disease. Jaundice is caused by an increased level of bilirubin, a byproduct from the breakdown of red blood cells. Bilirubin is filtered through the liver and excreted in the bile. However, when the liver is not functioning properly the bilirubin remains in the blood, leading to a build-up.
Cholestasis
Cholestasis, reduced or stopped flow of bile, is a symptom of end stage liver disease. The inflammation of the liver can cause an obstruction of the bile ducts, reducing the flow of bile. This interferes with the liver's ability to filter the bilirubin from the blood. As the blood flows to the kidneys, the excess bilirubin may enter the urine, resulting in dark-colored urine.
Light colored, or gray, stools are another symptom of end stage liver disease that results from cholestasis. Because the bilirubin, which is a brownish-yellow pigment, is not filtered from the blood within the liver and added to the bile, the resulting stools are light-colored.
Encephalopathy
A liver in end stage liver disease has lost much of its functionality. One of the main functions of the liver is to filter the blood to remove toxins. When the liver fails to remove toxins, they build-up in the blood and can cause problems in other organs in the body. Liver encephalopathy, also known as hepatic encephalopathy, is a condition of reduced brain functions as a result of these toxins. Symptoms of liver encephalopathy include loss of consciousness, behavioral changes, impaired judgment, drowsiness, confusion and disorientation which can all eventually lead to coma. The National Institutes of Health reports that 80 percent of patients who enter coma will die.
Portal Hypertension
The vein that carries blood into the liver is called the portal vein. The inflammation caused by liver disease and the build-up of scar tissue in the liver can cause reduced blood flow into and within the liver. This results in portal hypertension, which is unusually high blood pressure in the portal vein. Portal hypertension can cause the blood to re-route through other blood vessels to by-pass the liver, therefore increasing their blood volume. This increase in volume can weaken the walls of these vessels and cause them to burst resulting in internal bleeding that can be fatal.
