Severe Liver Disease

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Your liver is the largest organ inside your body. It is also one of the most important. The liver has many jobs, including changing food into energy and cleaning alcohol and poisons from the blood. Your liver also makes bile, a yellowish-green liquid that helps with digestion.

Signs and Symptoms of Liver Problems?

Some signs and symptoms of liver problems are:

• jaundice - yellowing of the skin and the whites of the eyes


• feeling tired or weak


• losing your appetite


• feeling sick to your stomach


• losing weight


• losing muscle


• itching


• bruising or bleeding easily


• bleeding in the stomach


• throwing up blood


• passing black stools


• having a swollen abdomen


• becoming forgetful or confused

You cannot live without a liver that works. If your liver stops working as it should, you may need a liver transplant.

Reasons for Needing a Liver Transplant

In adults, the most common reason for needing a liver transplant is cirrhosis. Cirrhosis can be caused by many different types of diseases that destroy healthy liver cells and replace them with scar tissue.

Some causes of cirrhosis are

• long-term infection with the hepatitis C virus


• drinking too much alcohol over time


• autoimmune liver diseases


• long-term infection with the hepatitis B virus


• the buildup of fat in the liver


• hereditary liver diseases

Your body’s natural defense system, called the immune system, keeps you healthy by fighting against things that can make you sick, such as bacteria and viruses. Autoimmune liver diseases occur when your immune system doesn’t recognize the liver as a part of your body and attacks it. Hereditary diseases are passed from parents to children through genes.

In children, the most common reason for needing a liver transplant is biliary atresia. In biliary atresia, bile ducts are missing, damaged, or blocked. Bile ducts are tubes that carry bile from the liver to the gallbladder and small intestine. When bile ducts are blocked, bile backs up in the liver and causes cirrhosis.

Other reasons for needing a liver transplant include

• sudden liver failure, called acute liver failure, most often caused by taking too much acetaminophen (Tylenol)


• liver cancers that have not spread outside the liver

Reasons for a Liver Transplant

Your doctor will decide whether you need to go to a liver transplant center to be evaluated by a liver transplant team. The team will include liver transplant surgeons; liver specialists, called hepatologists; nurses; social workers; and other health care professionals. The transplant team will examine you and run blood tests, x rays, and other tests to help decide whether you would benefit from a transplant.

The transplant team will also check to see if

• your heart, lungs, kidneys, and immune system are strong enough for surgery


• you are mentally and emotionally ready to have a transplant


• you have family members or friends who can care for you before and after the transplant

Even if you are approved for a transplant, you may choose not to have it. To help you decide, the transplant team will explain the

• patient selection process


• operation and recovery


• long-term demands of living with a liver transplant, such as taking medicines for the rest of your life

During your evaluation, and while waiting for a transplant, you should take care of your health. Your doctor will tell you what you can do to stay strong while you wait for a new liver.

Can anyone with Liver Problems get a Transplant?

Each transplant center has rules about who can have a liver transplant. You may not be able to have a transplant if you have

• cancer outside the liver


• serious heart or lung disease


• an alcohol or drug abuse problem


• a severe infection


• AIDS


• trouble following your doctor’s instructions


• no support system

How Long does it take to get a New Liver?

If you need a transplant, your name will be placed on a national waiting list kept by the United Network for Organ Sharing (UNOS). Your blood type, body size, and how urgently you need a new liver all play a role in when you will receive a liver. Those with the most urgent need for a liver to prevent death are at the top of the list. Many people have to wait a long time to get a new liver.

Where do the Livers for Transplants come from?

Most livers come from people who have just died. This type of donor is called a deceased donor. Sometimes a healthy living person will donate part of his or her liver to a patient, usually a family member. This type of donor is called a living donor. Both types of transplants usually have good results.

All donated livers and living donors are tested before transplant surgery. The testing makes sure the donor liver works as it should, matches your blood type, and is the right size, so it has the best chance of working in your body. Adults usually receive the entire liver from a deceased donor. Sometimes only a portion of a whole liver from a deceased donor is used to fit a smaller person. In some cases, a liver from a deceased donor is split into two parts. The smaller part may go to a child, and the larger part may go to an adult.

Health Insurance

You should check your health insurance policy to be sure it covers a liver transplant and prescription medicines. You will need many prescription medicines after the surgery and for the rest of your life.