Partridge Family actor and “I Think I Love You” singer David Cassidy died Tuesday from organ failure at age 67 in Florida. “David died surrounded by those he loved, with joy in his heart and free from the pain that had gripped him for so long. Thank you for the abundance and support you have shown him these many years,” his family said in a statement to People.
Cassidy had been hospitalized the previous week for liver and kidney failure and was in need of a liver transplant. He had previously spoken publicly about his struggle with alcoholism, and, more recently, had revealed he was battling dementia too. Very few details have been released about Cassidy's death, and it's not known what role alcohol may have played, if any.
So what causes liver failure? It depends on which type a person has. A person can have acute liver failure, which develops suddenly after, say, ingesting toxic substances or contracting an aggressive virus, says Scott Friedman, MD, chief of liver diseases at Mount Sinai Health System in New York City. Or they can have chronic liver failure, which is the result of a long-term injury or illness like hepatitis B or C, metabolic diseases like iron overload, or alcohol abuse, Dr. Friedman says.
Someone with acute liver failure may make a full recovery, but “in chronic liver failure, there’s no chance for spontaneous improvement, so really the only option is liver transplantation,” he explains.
It takes time to reach that state, however; inflammation leads to progressive scarring of the liver. “At the time of liver failure from chronic injury, the biggest problem becomes the large amount of scarring, which chokes the blood flow to the liver, accelerating the loss of function," says Dr. Friedman.
Many people might not know they have damage to their liver until it’s quite extensive. As scarring worsens, symptoms might include swelling in the legs, bruising and bleeding easily, and gallstones, according to the American Liver Foundation (ALF). Once the liver begins failing, a person is unable to clear waste products. They may experience a buildup of ammonia in their body, fluid in the abdomen, or ruptured blood vessels in the esophagus, Dr. Friedman explains. “Those are three major hallmarks of liver failure,” he says, and they signal the need for a liver transplant.
Without a transplant, liver failure can lead to the destruction of other organs, typically starting with the kidneys, says Dr. Friedman. Kidney failure occurs when the kidneys are damaged and not working properly, which contributes to a buildup of waste products in the body that the kidneys would typically remove, according to the National Institute of Diabetes and Digestive and Kidney Diseases.
Some people with kidney failure can be treated with dialysis, a process that filters waste products for the kidneys. Others may need a kidney transplant, which replaces one or both diseased kidneys with healthy ones. The damage can also extend to other organs. “In very sick patients, ultimately, liver failure can lead to multi-organ failure,” says Dr. Friedman, and the more organs that fail, the poorer the prognosis becomes, he explains.
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Though Dr. Friedman did not treat the singer and actor, he says that alcohol abuse can also contribute to memory problems. Before revealing his dementia diagnosis, Cassidy struggled to remember the lyrics to some of his most famous songs on stage. His grandfather and mother both lived with dementia at the end of their lives, Cassidy told People in February 2017. “I was in denial, but a part of me always knew this was coming,” he said of his own experience with the condition.