Hepatic ischemia is a condition in which the liver does not get enough blood or oxygen, causing injury to liver cells.

Low blood pressure from any condition can lead to hepatic ischemia. Such conditions may include:

• Abnormal heart rhythms
• Dehydration
• Heart failure
• Infection
• Severe bleeding

Other causes may include:

• Large blood clots in the main artery to the liver (hepatic artery) after a transplant
• Swelling of blood vessels (vasculitis)

If low blood pressure continues for a long time, you may feel weak and light-headed. However, the period of low blood pressure may be brief and produce no symptoms. Damage to the liver cells usually does not cause symptoms.

Blood levels of liver enzymes such as AST and ALT typically rise 1-3 days after the episode of low blood pressure. Levels of another enzyme in the blood, LDH, are also usually high.

Treatment depends on the cause of the low blood pressure. Low blood pressure must be treated so that the liver receives enough blood. The illness causing the problem must also be treated.

Patients generally recover if the illness causing hepatic ischemia can be treated. Death from liver failure due to hepatic ischemia is very rare.

Liver failure is a rare but life-threatening complication.

See your health care provider right away if you have persistent weakness or symptoms of shock or dehydration.

Quickly treating the causes of low blood pressure may prevent hepatic ischemia.

Jain R, Thiele D. Gastrointestinal and Hepatic Manifestations of Systemic Diseases. In: Feldman M, Friedman LS, Sleisenger MH, eds. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 8th ed. Philadelphia, Pa: Saunders Elsevier;2006:chap 34.