Can morphine in a esld patient cause hepatic coma, renal failure and ultimately death?

In high doses: Depends on the dose. Because morphine is metabolized through the liver, it can accumulate and lead to obtundation on its own because of the overdose, the patient can then lose control of their airway and die without help. Renal failure as a consequence of lower BP resulting from the drug is possible, but less likely.

No: Hepatic coma is from the buildup of toxins not being processed by the damaged liver...Which can poison the kidneys...And eventually result in death. Morphine or other narcotics may be given to an esld patient to reduce their discomfort as they are passing.