Digestive Diseases: Liver Transplantation
The liver is the body's largest internal organ, weighing about 3 pounds in adults. It is located below the diaphragm on the right side of the abdomen.
The liver performs many complex functions in the body, including:
- Produces most proteins needed by the body.
- Metabolizes, or breaks down, nutrients from food to produce energy, when needed.
- Prevents shortages of nutrients by storing certain vitamins, minerals and sugar.
- Produces bile, a compound needed to digest fat and to absorb vitamins A, D, E and K.
- Produces most of the substances that regulate blood clotting.
- Helps your body fight infection by removing bacteria from the blood.
- Removes potentially toxic byproducts of certain medications.
When is a liver transplant needed?
Liver transplantation is considered when the liver no longer functions adequately (liver failure). Liver failure can occur suddenly (acute liver failure) as a result of infection or complications from certain medications or it can be the end result of a long-term problem. The following conditions may result in liver failure:
- Chronic hepatitis with cirrhosis.
- Primary biliary cirrhosis (a condition where the immune system inappropriately attacks and destroys the bile ducts causing liver failure).
- Sclerosing cholangitis (scarring and narrowing of the bile ducts inside and outside of the liver causing the backup of bile in the liver which can lead to liver failure).
- Biliary atresia (malformation of the bile ducts).
- Wilson's disease (a rare inherited disease with abnormal deposition of copper throughout the body, including the liver, causing it to fail).
- Hemochromatosis (a common inherited disease where the body is overwhelmed with iron).
- Alpha-1 antitrypsin deficiency (an abnormal accumulation of alpha-1 antitrypsin protein in the liver, resulting in cirrhosis).
- Liver cancer
How are candidates for liver transplant determined?
Evaluations by specialists from a variety of fields are needed to determine if a liver transplant is appropriate. The evaluation includes a review of your medical history and a variety of tests. Many healthcare facilities offer an interdisciplinary approach to evaluate and to select candidates for liver transplantation. This interdisciplinary healthcare team may include the following professionals:
- Liver specialist (hepatologist).
- Transplant surgeons
- Transplant coordinator, usually a registered nurse who specializes in the care of liver-transplant patients (this person will be your primary contact with the transplant team).
- Social worker to discuss your support network of family and friends, employment history, and financial needs.
- Psychiatrist to help you deal with issues, such as anxiety and depression, which may accompany the liver transplantation.
- Anesthesiologist to discuss potential anesthesia risks.
- Chemical dependency specialist to aid those with history of alcohol or drug abuse.
- Financial counselor to act as a liaison between a patient and his or her insurance companies.
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