Liver Disease and Transplantation

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Liver Disease and Transplantation

Robert S. Brown, Jr., MD, MPH
Director
Center for Liver Disease and Transplantation
Columbia University Medical Center
In affiliation with NewYork-Presbyterian Hospital
Phone: 855-CUSURGE

Everyone has some risk for liver disease, and it's easy to get screened by obtaining a simple blood test. Your risk depends on your past history (including exposure to blood, drug or alcohol use). Unfortunately, chronic liver diseases are frequently asymptomatic in the early stages, when they are best treated.

About Liver Disease
Hepatitis, a word meaning literally inflammation of the liver, refers to a group of conditions. Most are caused by one of many viruses. Hepatitis can also be inherited (congenital hepatitis) or brought on by excess alcohol consumption, obesity, diabetes and other factors. Most cases of liver failure are due to undetected hepatitis C, whose causes include sharing needles, blood transmission, sexual transmission, and transfusions prior to 1991.

Cirrhosis, scarring of the liver caused by injury over a period of time, is a consequence of chronic hepatitis, excessive alcohol use, and other less common causes including infections, drug toxins, and inherited diseases. Cirrhosis due to alcoholism is the second most common cause of chronic liver failure leading to transplantation.

About Liver Transplantation
When the liver stops working efficiently due to advanced liver disease, a transplant may become necessary. After a liver transplant, in which a damaged liver is replaced with a healthy one, the patient is able to lead a fairly normal life, although they must take medication for the rest of their lives to prevent their body from rejecting the transplanted liver. A liver can be transplanted from either a living or a deceased donor.

Living Donor Liver Transplantation
Living donor transplantation enables the patient to obtain a transplant right away and avoid the waiting time required for a deceased donor liver—during which the patient might become sicker, weaker, or die. In this procedure, a healthy adult donor undergoes an operation to remove part of his or her liver, which is implanted into the recipient. The donor's liver regenerates to full size in both people within weeks. A living donor may be a family member, spouse, or friend.

The Waiting List
Those who are to receive a deceased-donor organ are registered with the United Network for Organ Sharing (UNOS), the agency that maintains the national database of all individuals waiting for a deceased-donor organ. Waiting times vary depending on severity of illness, blood type, and overall demand. When it is determined that a potential donor cannot survive and his or her family chooses to donate the organs for transplantation, the liver is made available for transplantation. UNOS matches the donor and recipient and allocates that "gift of life" to the patient at the top of the waiting list.

If you or a loved one have liver disease, our team recommends making contact with a multidisciplinary liver care center that can meet medical management needs, provide appropriate counseling, and follow patients through a transplant, should one become necessary.

Quality of Life Interventions from the Columbia University Department of Surgery