What is the liver and where is it located in the body?

Your liver is the largest organ in your body and is probably one of the most complex organs. It is necessary for life and growth. It is located in the upper right side of your abdomen, protected by your rib cage. Your liver helps your body to:

• Convert food into stored energy and to regulate the release of the energy when needed.
• Absorb vitamins (including vitamins A, E, D and K).
• Get rid of wastes, including ammonia and other end products of natural metabolism.
• Process and remove drugs, alcohol and other substances that may be harmful to your body.
• Produce bile, a greenish-yellow fluid that carries away waste products and aids in the absorption of fats and vitamins.
• Manufacture important proteins needed to nourish your body, fight infections and provide normal blood clotting.
• Maintain hormone balance.
• Maintain strong bones.

What diseases affect the liver?

• Your liver condition may be caused by one of the following diseases or conditions:
• Hepatitis B or C
• PBC (Primary Biliary Cirrhosis)
• PSC (Primary Sclerosing Cholangitits)
• Alcoholic Cirrhosis
• Cryptogenic Cirrhosis       
• Budd-Chiari Syndrome
• Venocclusive Disease
• Hepato Cellular Carcinoma
• Fulminant Hepatic Failure
• Wilson's Disease
• Hemochromatosis
• Polycystic Liver Disease
• Drug Induced Hepatic Failure
• Alpha-1-Antitrypsin Deficiency
• Biliary Atresia
• Various Inborn Errors of Metabolism

What are some of the symptoms of liver disease?

People who have liver disease may have some of the following symptoms. If you have any of these symptoms and have not already discussed them with your doctor, it is important to do so immediately .

• Yellow discoloration of the skin and eyes called jaundice
• Itching from the build up of bile salts in the skin
• Loss of muscle and strength in your arms and legs
• Tea-colored urine
• Gray or clay-colored stools
• Mental confusion, sleep disturbance or coma
• Abnormal accumulation of fluid in the abdomen (ascites)
• Tendency to bleed and bruise easily
• Vomiting blood or passing stools that are bloody or tar-black
• Abdominal pain or fullness
• Loss of energy

Are there liver disease symptoms that I need to address immediately with my doctor?

If you experience any of the following symptoms you should report them immediately to your doctor:

• Fever over 101 degrees Fahrenheit
• Trouble breathing
• Increased tiredness
• Bleeding (This includes vomit that is brown (like coffee grounds), a nosebleed, blood in your urine or stool that is black.)
• Any fall or injury that could cause internal bleeding
• Confusion or dizziness
• Severe abdominal pain
• Decreased urination over 24 hours
• Inability to eat for a period of more than 24 hours

What is end stage liver disease?

End stage liver disease is the final stage of liver failure. It includes symptoms like yellowing of the skin (jaundice), itching, dark colored urine, gray or clay colored stools, ascites (fluid collection in the abdomen), encephalopathy (mental confusion), coma, easy bruising, intestinal bleeding and fatigue. In general, people who qualify for liver transplantation have end stage liver disease.

What is the treatment for liver disease?

Treatment options for liver disease will depend upon your health condition. Sometimes liver disease may best be treated by medical interventions.

Severe liver disease may require medical and surgical intervention. For example, you may benefit from surgical intervention such as a shunt procedure.

If you are a candidate for liver transplantation, the physicians (hepatologist/transplant surgeon) will conduct a thorough medical evaluation to determine if a cadaveric liver transplant or a living related liver donor transplant is the best option for you. During the evaluation, we carefully look at your overall medical condition and we make sure that you meet specific criteria.

Your physicians will always discuss your condition and options with you and your family so together we can decide what will benefit you the most. It is a team effort.

What is a liver transplant?

During a liver transplant, your diseased liver is removed and replaced with a healthy liver. Follow-up care after transplantation includes taking medications to prevent rejection, frequent doctor's appointments and laboratory testing including blood tests. In spite of the need for follow-up care and many medications, it is possible for liver transplant recipients to return to an active lifestyle.

What is a living related donor transplant?

During a living related donor transplant, the diseased liver is removed and replaced with a partial liver (usually the right lobe) from a living person. Both lobes of the liver in the donor and the recipient grow back to their normal size within three months. Living related transplantation evolved from the need for more donors to meet the needs of increased number of potential recipients. Donors must meet specific criteria before being considered. This criteria includes: being between the ages of 18 and 55; having a compatible blood type with the recipient; and having no medical problems that would increase the risk of surgery. The donor must also undergo blood testing, various procedures and an evaluation by a social worker. The average length of stay for the donor is about seven to ten days.

How do I find out if I am a candidate for a liver transplant?

Liver transplant evaluation includes a number of laboratory tests, X-rays and specialty consults. This will give a thorough picture of your overall health to ensure that you are able to undergo transplant surgery and that a liver transplant is the best treatment for you.

Most of the time, the tests are completed on an outpatient basis. However, if there are other health concerns, you could be hospitalized for the tests. The entire evaluation process takes about two to four weeks. Prior to any testing, you will be informed of special instructions.

What if I qualify for a liver transplant?

Once your diagnostic work has been completed, the physician (hepatologist/transplant surgeon) will determine if you have end stage liver disease that requires a liver transplant. This will be discussed with you and your family. If you do require a liver transplant, and you are in agreement with this treatment plan, your medical information will be presented to The University Hospital Liver Transplant Multidisciplinary Team Committee for approval. This team includes physicians, nurses, a social worker, a dietitian, physical therapist, ethicist and financial counselor.

Is the Multidisciplinary Team the same team that will take care of me?

Your transplant treatment team includes liver transplant surgeons, gastroenterologists/hepatologists, nurses, transplant assistants, a social worker, dietitian, financial counselor, physical and occupational therapists, your primary care physician, you and your family. The medical members of this team are some of the same clinicians on The University Hospital Liver Transplant Multidisciplinary Team Committee.

What about the cost?

Most insurance companies cover many of the costs related to organ transplantation. The specific amount of coverage varies according to your health plan. The University Hospital's transplant program is approved by Medicare and Medicaid. This approval is based on the high standards of care we provide and the high success rate of our program.

As part of our program, a financial counselor will meet with you to discuss your insurance plan and potential costs of transplant surgery. This occurs during the pre-transplant and evaluation period. At that time, the financial counselor and social worker will work with you and your insurance company to insure the maximum coverage for care. You are responsible for all co-payments.