Worsening hepatic function is a well-known potential complication of chemoembolization and occurs in up to 58% of patients undergoing chemoembolization. Although liver function returns to baseline levels within 3–4 weeks in the majority of patients, fulminant liver failure and death occur with a reported frequency of ~2–10%. Poor performance status, portal vein obstruction, biliary obstruction, extensive tumor burden, and Child-Pugh status B or C are among factors predisposing to an increased risk of transient or fulminant hepatic failure, with Child-Pugh status being the most accurate. Unless the patient is a candidate for liver transplantation, treatment for hepatic failure is limited to supportive measures.
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