Liver Disease May Necessitate Transplant

LEXINGTON, Ky. (Aug. 3, 2015) —Your liver processes all the nutrients the body requires. It produces bile, which helps the body absorb food and also eliminates potentially toxic substances. Damage to the liver can impair these and many other processes.

Cirrhosis is the scarring of the liver and is a result of various disorders that can damage the liver over time.  The damage and scarring caused by these disorders is often irreversible and may potentially lead to the need for a liver transplant. 

Many people don’t realize they have cirrhosis until it has significantly progressed.  There’s a misconception that cirrhosis is due to heavy alcohol use, but there are many other potential causes of cirrhosis, including:

·      Hepatitis B and hepatitis C

·      Non-alcoholic liver disease

·      Alcoholic liver disease

·      Primary biliary cirrhosis (destruction of the bile ducts) and primary sclerosing cholangitis (scarring of the bile ducts)

·      Autoimmune hepatitis (a condition where your immune system attacks your liver)

A person with liver disease may experience fatigue, jaundice, itching, easy bruising, fluid buildup in the abdomen and even poor memory or confusion due to high ammonia levels in the body. It's extremely important to see your doctor if you have any of these symptoms prior to the disease progressing further.

Though liver damage is irreversible, there are numerous medications that can be helpful in controlling some of the symptoms of liver disease if diagnosed in time. Your doctors may also perform endoscopic procedures to screen for abnormalities.

To help determine how sick your liver is and if you need a transplant, a MELD score is calculated using basic lab tests. A MELD score is used to determine your risk of mortality without a liver transplant and prioritizes people for liver transplant based on how sick they are.

Waiting times for a liver transplant vary greatly.  The higher the MELD score, the quicker you may be transplanted.  At each clinic visit prior to transplant, your labs will be checked for changes in your MELD score. If your score changes significantly, your position on the waitlist may change.

Once on the transplant list, you will be “on-call” for a new liver. You can be called in at any day or time to come in for a liver transplant. A liver transplant surgery usually takes 4-6 hours.

In general, people spend between 7 and 14 days in the hospital recovering from a liver transplant.  You will receive antirejection medications that you must take for the rest of your life to prevent your body from rejecting the liver.  After a few months of frequent check-ups, patients typically check in with their doctor on a yearly basis.

Following a successful liver transplant, patients are able to return to their normal everyday, healthy lives.  It is likely you have seen people who have had a liver transplant without even realizing they had a transplant.

Dr. Malay B. Shah is the Surgical Director of the Liver Transplant Program at UK HealthCare. 

This column appeared in the August 2, 2015 edition of the Lexington Herald-Leader.