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Liver Transplantation

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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:

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  • Makes most proteins needed by the body
  • Metabolizes, or breaks down, nutrients from food to make energy, when needed
  • Prevents shortages of nutrients by storing certain vitamins, minerals, and sugar
  • Makes bile, a compound needed to digest fat and to absorb vitamins A, D, E, and K
  • Makes most of the substances that regulate blood clotting
  • Helps the body fight infection by removing bacteria from the blood
  • Removes potentially toxic byproducts of certain medications

When Is a Liver Transplant Needed?

A liver transplant is considered when the liver no longer functions adequately (liver failure). Liver failure can happen suddenly (acute liver failure) as a result of infection or complications from certain medications, for example. Liver failure can also be the end result of a long-term problem. The following conditions may result in chronic liver failure:

  • Chronic hepatitis with cirrhosis.
  • Primary biliary cirrhosis (a rare condition where the immune system inappropriately attacks and destroys the bile ducts)
  • Sclerosing cholangitis (scarring and narrowing of the bile ducts inside and outside of the liver, causing the backup of bile in the liver)
  • Biliary atresia (a rare disease of the liver that affects newborns)
  • Alcoholism
  • Wilson's disease (a rare inherited disease with abnormal levels of copper throughout the body, including the liver)
  • Hemochromatosis (a common inherited disease where the body has too much iron)
  • Alpha-1 antitrypsin deficiency (an abnormal buildup of alpha-1 antitrypsin protein in the liver, resulting in cirrhosis)
  • Liver cancer

How Are Candidates for Liver Transplant Selected?

Specialists from a variety of fields are needed to determine if a liver transplant is appropriate. Many health care facilities assemble a team of such specialists to evaluate (review your medical history, do tests) and choose candidates for a liver transplant. The 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 a liver transplant
  • 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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