Common Diseases That May Lead to Liver Transplantation
Hepatitis (viral, autoimmune and idiopapathic)
Primary sclerosing cholangitis
Acute hepatic necrosis
Portal hypertension
Metabolic diseases
Liver tumors
Liver Cirrhosis
Biliary atresia
Thursday, January 18, 2007
Fatty liver
General description
Fatty liver, also known as steatosis, is accumulation of fat in liver cells. Although the fat in the liver usually poses no harm, it can lead to inflammation of the liver (steatohepatitis). Fatty liver usually occurs with heavy alcohol consumption, diabetes mellitus, obesity, and poor diet. Certain drugs such as corticosteroids can also induce fatty liver.
Symptoms
Usually no symptoms.
Possible rise in some liver enzymes.
Pathophysiology
Exact mechanism is unknown.
Reversible
A patient has fatty liver when the fat increases the weight of the liver by 5%.
Defects in uptake, metabolism, or secretion of lipids in liver.
Histopathology
Presence of numerous large lipid vacuoles that compress and displace nucleus to the periphery of cells.
General description
Fatty liver, also known as steatosis, is accumulation of fat in liver cells. Although the fat in the liver usually poses no harm, it can lead to inflammation of the liver (steatohepatitis). Fatty liver usually occurs with heavy alcohol consumption, diabetes mellitus, obesity, and poor diet. Certain drugs such as corticosteroids can also induce fatty liver.
Symptoms
Usually no symptoms.
Possible rise in some liver enzymes.
Pathophysiology
Exact mechanism is unknown.
Reversible
A patient has fatty liver when the fat increases the weight of the liver by 5%.
Defects in uptake, metabolism, or secretion of lipids in liver.
Histopathology
Presence of numerous large lipid vacuoles that compress and displace nucleus to the periphery of cells.
Liver Cirrhosis
The liver is a large organ that sits in the right upper abdomen, just under the right lung. It is one of the body's most "intelligent" organs in that it performs so many different functions at the same time. The liver makes proteins, eliminates waste material from the body, produces cholesterol, stores and releases glucose energy and metabolizes many drugs used in medicine. It also produces bile that flows through bile ducts into the intestine where it helps to digest food. This remarkable organ also has the ability to regenerate itself if it is injured or partially removed. The liver receives blood from two different sources -- the heart and the intestine. All of this blood flows through the liver and returns to the heart. It is no wonder that the ancient Chinese viewed the liver, not the heart, as the center of the body.
What Is Liver Cirrhosis?
Many types of chronic injury to the liver can result in scar tissue. This scarring distorts the normal structure and regrowth of liver cells. The flow of blood through the liver from the intestine is blocked and the work done by the liver, such as processing drugs or producing proteins, is hindered.
What is Causes of Liver Cirrhosis?
Cirrhosis can be caused by many things, some known and others unknown:
Alcohol -- Using alcohol in excess is the most common cause of cirrhosis in the United States.
Chronic Viral Hepatitis -- Type B and Type C hepatitis, and perhaps other viruses, can infect and damage the liver over a prolonged time and eventually cause cirrhosis.
Chronic Bile Duct Blockage -- This condition can occur at birth (biliary atresia) or develop later in life (primary biliary cirrhosis). The cause of the latter remains unknown. When the bile ducts outside the liver become narrowed and blocked, the condition is called primary sclerosing cholangitis. This condition is often associated with chronic ulceration of the colon (colitis).
Abnormal Storage of Copper (Wilson's Disease) or Iron (Hemochromatosis) -- These metals are present in all body cells. When abnormal amounts of them accumulate in the liver, scarring and cirrhosis may develop.
Drugs and Toxins -- Prolonged exposure to certain chemicals or drugs can scar the liver.
Autoimmune Hepatitis -- This chronic inflammation occurs when the body's protective antibodies fail to recognize the liver as its own tissue. The antibodies injure the liver cells as though they were a foreign protein or bacteria.
Cystic Fibrosis and Alpha l-antitrypsin Deficiency -- These disorders are inherited.
What is the Signs and Symptoms of Liver Cirrhosis?
Cirrhosis takes years to develop. During this time, there are usually no symptoms, although fatigue, weakness and decreased appetite may occur and worsen with time. When cirrhosis is fully developed, a number of signs may be present:
Fluid retention in the legs and abdomen -- The liver produces a protein, called albumin, that holds fluid in blood vessels. When the blood level of albumen falls, fluid seeps out of the tissues into the legs and abdomen, causing edema (fluid accumulation) and swelling.
Jaundice -- The liver produces bile that normally flows into the intestine.With advanced cirrhosis, bile can back up into the blood, causing the skin and eyes to turn yellow and the urine to darken.
Intense Itching -- Certain types of cirrhosis, such as chronic bile duct blockage, can produce troublesome itching.
Gallstones -- Cirrhosis causes the abnormal metabolism of bile pigment. Because of this, gallstones develop twice as often in cirrhosis patients as in those without the disorder.
Coagulation Defects -- The liver makes certain proteins that help clot blood. When these proteins are deficient, excessive or prolonged bleeding happens.
Mental Function Change -- The liver processes toxins from the intestine. When these substances escape into the bloodstream, as occurs in severe cases of cirrhosis, a variety of changes in mental function can develop.
Esophageal Vein Bleeding -- In advanced cirrhosis, intestinal blood bypasses the liver and flows up and around the esophagus (the food tube) to the heart. The veins in the esophagus dilate (widen) and may rupture, causing slow or massive intestinal bleeding.
How can Diagnosis of Liver Cirrhosis?
The physician can always suspect cirrhosis from the patient's medical history and physical examination. In addition, certain blood tests and scans or ultrasound (sonography) can provide helpful information. To make a definite diagnosis, however, a liver biopsy (tissue sample) is required. This is performed by anesthetizing the skin of the right-lower chest and inserting a thin, needle into the liver. A core or specimen of tissue is removed and examined under a microscope.
What Is the Course of Liver Cirrhosis?
When cirrhosis is diagnosed, the patient and physician begin a plan of action designed to preserve the remaining liver cells and correct the complications mentioned above. By following this plan, most patients can lead long, productive lives.
Prevention of Liver Cirrhosis
Perhaps 90 percent of cirrhosis is caused by excessive alcohol consumption or hepatitis viruses. Of course, alcohol can be avoided. Alcohol consumption should always be limited to no more than 1 or 2 drinks per day. And type B hepatitis now has an effective vaccine against it. Vaccination against B hepatitis virus is safe and inexpensive. It should be taken especially by certain high-risk groups: all health care professionals, persons traveling to third world countries, homosexuals, intravenous drug users, and prostitutes.
What is Treatment of Liver Cirrhosis?
Often, the only required treatment for cirrhosis is removing the offending cause:
The alcoholic patient must permanently stop consuming alcohol.
When iron is being retained in the body, chronic removal of blood by vein eliminates large amounts of iron.
Cortisone medicine helps treat autoimmune hepatitis and cirrhosis.
Restricting salt and using fluid pills (diuretics ) reduce edema and abdominal swelling.
Toxins and injurious drugs must be avoided.
Decreasing dietary protein and using certain laxatives generally can prevent changes in mental function.
Bleeding veins in the esophagus can be injected with sclerosing (clotting) agents or closed with small rubber bands. Occasionally, surgery is necessary to prevent recurrent massive bleeding.
Ursodiol (Actigall) and other drugs have been helpful in treating primary biliary cirrhosis and primary sclerosing cholangitis.
Liver Transplant
Liver transplantation has progressed to the stage where it can now be considered as standard treatment for selected patients.
Summary
Cirrhosis of the liver is a common disorder that has many causes. With early diagnosis, much can be done to prevent serious complications. Various treatments are available, depending on the cause of the liver injury and its complications. Ongoing medical research promises major advances in treating cirrhosis in the future.
Related Diseases
Autoimmune Hepatitis Hepatitis B Hepatitis C Primary Biliary Cirrhosis Primary Sclerosing Cholangitis Fatty Liver Gallstones Hemorrhoids
Related Diets
Copper Restriction (Wilsons Disease) Sodium RestrictionLow Protein Low Cholesterol Osteoporosis Vegetarian
Related Procedures
Liver Biopsy Liver Transplant Upper GI Endoscopy (EGD)
The liver is a large organ that sits in the right upper abdomen, just under the right lung. It is one of the body's most "intelligent" organs in that it performs so many different functions at the same time. The liver makes proteins, eliminates waste material from the body, produces cholesterol, stores and releases glucose energy and metabolizes many drugs used in medicine. It also produces bile that flows through bile ducts into the intestine where it helps to digest food. This remarkable organ also has the ability to regenerate itself if it is injured or partially removed. The liver receives blood from two different sources -- the heart and the intestine. All of this blood flows through the liver and returns to the heart. It is no wonder that the ancient Chinese viewed the liver, not the heart, as the center of the body.
What Is Liver Cirrhosis?
Many types of chronic injury to the liver can result in scar tissue. This scarring distorts the normal structure and regrowth of liver cells. The flow of blood through the liver from the intestine is blocked and the work done by the liver, such as processing drugs or producing proteins, is hindered.
What is Causes of Liver Cirrhosis?
Cirrhosis can be caused by many things, some known and others unknown:
Alcohol -- Using alcohol in excess is the most common cause of cirrhosis in the United States.
Chronic Viral Hepatitis -- Type B and Type C hepatitis, and perhaps other viruses, can infect and damage the liver over a prolonged time and eventually cause cirrhosis.
Chronic Bile Duct Blockage -- This condition can occur at birth (biliary atresia) or develop later in life (primary biliary cirrhosis). The cause of the latter remains unknown. When the bile ducts outside the liver become narrowed and blocked, the condition is called primary sclerosing cholangitis. This condition is often associated with chronic ulceration of the colon (colitis).
Abnormal Storage of Copper (Wilson's Disease) or Iron (Hemochromatosis) -- These metals are present in all body cells. When abnormal amounts of them accumulate in the liver, scarring and cirrhosis may develop.
Drugs and Toxins -- Prolonged exposure to certain chemicals or drugs can scar the liver.
Autoimmune Hepatitis -- This chronic inflammation occurs when the body's protective antibodies fail to recognize the liver as its own tissue. The antibodies injure the liver cells as though they were a foreign protein or bacteria.
Cystic Fibrosis and Alpha l-antitrypsin Deficiency -- These disorders are inherited.
What is the Signs and Symptoms of Liver Cirrhosis?
Cirrhosis takes years to develop. During this time, there are usually no symptoms, although fatigue, weakness and decreased appetite may occur and worsen with time. When cirrhosis is fully developed, a number of signs may be present:
Fluid retention in the legs and abdomen -- The liver produces a protein, called albumin, that holds fluid in blood vessels. When the blood level of albumen falls, fluid seeps out of the tissues into the legs and abdomen, causing edema (fluid accumulation) and swelling.
Jaundice -- The liver produces bile that normally flows into the intestine.With advanced cirrhosis, bile can back up into the blood, causing the skin and eyes to turn yellow and the urine to darken.
Intense Itching -- Certain types of cirrhosis, such as chronic bile duct blockage, can produce troublesome itching.
Gallstones -- Cirrhosis causes the abnormal metabolism of bile pigment. Because of this, gallstones develop twice as often in cirrhosis patients as in those without the disorder.
Coagulation Defects -- The liver makes certain proteins that help clot blood. When these proteins are deficient, excessive or prolonged bleeding happens.
Mental Function Change -- The liver processes toxins from the intestine. When these substances escape into the bloodstream, as occurs in severe cases of cirrhosis, a variety of changes in mental function can develop.
Esophageal Vein Bleeding -- In advanced cirrhosis, intestinal blood bypasses the liver and flows up and around the esophagus (the food tube) to the heart. The veins in the esophagus dilate (widen) and may rupture, causing slow or massive intestinal bleeding.
How can Diagnosis of Liver Cirrhosis?
The physician can always suspect cirrhosis from the patient's medical history and physical examination. In addition, certain blood tests and scans or ultrasound (sonography) can provide helpful information. To make a definite diagnosis, however, a liver biopsy (tissue sample) is required. This is performed by anesthetizing the skin of the right-lower chest and inserting a thin, needle into the liver. A core or specimen of tissue is removed and examined under a microscope.
What Is the Course of Liver Cirrhosis?
When cirrhosis is diagnosed, the patient and physician begin a plan of action designed to preserve the remaining liver cells and correct the complications mentioned above. By following this plan, most patients can lead long, productive lives.
Prevention of Liver Cirrhosis
Perhaps 90 percent of cirrhosis is caused by excessive alcohol consumption or hepatitis viruses. Of course, alcohol can be avoided. Alcohol consumption should always be limited to no more than 1 or 2 drinks per day. And type B hepatitis now has an effective vaccine against it. Vaccination against B hepatitis virus is safe and inexpensive. It should be taken especially by certain high-risk groups: all health care professionals, persons traveling to third world countries, homosexuals, intravenous drug users, and prostitutes.
What is Treatment of Liver Cirrhosis?
Often, the only required treatment for cirrhosis is removing the offending cause:
The alcoholic patient must permanently stop consuming alcohol.
When iron is being retained in the body, chronic removal of blood by vein eliminates large amounts of iron.
Cortisone medicine helps treat autoimmune hepatitis and cirrhosis.
Restricting salt and using fluid pills (diuretics ) reduce edema and abdominal swelling.
Toxins and injurious drugs must be avoided.
Decreasing dietary protein and using certain laxatives generally can prevent changes in mental function.
Bleeding veins in the esophagus can be injected with sclerosing (clotting) agents or closed with small rubber bands. Occasionally, surgery is necessary to prevent recurrent massive bleeding.
Ursodiol (Actigall) and other drugs have been helpful in treating primary biliary cirrhosis and primary sclerosing cholangitis.
Liver Transplant
Liver transplantation has progressed to the stage where it can now be considered as standard treatment for selected patients.
Summary
Cirrhosis of the liver is a common disorder that has many causes. With early diagnosis, much can be done to prevent serious complications. Various treatments are available, depending on the cause of the liver injury and its complications. Ongoing medical research promises major advances in treating cirrhosis in the future.
Related Diseases
Autoimmune Hepatitis Hepatitis B Hepatitis C Primary Biliary Cirrhosis Primary Sclerosing Cholangitis Fatty Liver Gallstones Hemorrhoids
Related Diets
Copper Restriction (Wilsons Disease) Sodium RestrictionLow Protein Low Cholesterol Osteoporosis Vegetarian
Related Procedures
Liver Biopsy Liver Transplant Upper GI Endoscopy (EGD)
Patients Questions for Liver transplantation
What is a liver transplant?
A liver transplant is the replacement of your liver with one that has been donated by someone else. The donated liver comes from someone who has died. In the future, it may be more common for donated liver tissue to come from a living person, such as a family member. In this case, you receive only a part of the donor's liver.
When is a liver transplant considered?
Liver transplants are considered only when there is a high risk of death from liver disease. Usually, more than one doctor will help decide if you need a liver transplant
Being told you might need a liver transplant doesn't automatically mean that you are in danger of dying right away. It usually takes a long time to find a liver that is right for you. For this reason, your doctor might try to decide whether you need a liver transplant months or years before you actually must have one.
What might make your doctor think you need a liver transplant?
Your doctor might think about giving you a liver transplant if you have any of the following symptoms, and they don't go away with time
Yellow skin or eyes (jaundice)
Fluid in your legs (edema) or in your stomach (ascites)
Thinning of your muscles, especially in your face, neck and arms
Easy bruising or bleeding
Vomiting blood (hematemesis), or passing blood in your stool (melena)
Times when you can't concentrate or become easily confused
Changes in your liver tests that suggest your liver is failing
Can anyone get a liver transplant?
No. Getting a liver transplant is very stressful. Not everyone who needs a liver transplant can survive the major surgery involved. In other cases, your doctor might decide that the liver transplant probably won't work
If your doctor thinks you might need a liver transplant, then you should do everything you can to keep healthy and strong. Some of the things that might prevent you from getting a liver transplant include:
Continuing to use alcohol or illegal drugs
Being at high risk of using drugs or alcohol again after the surgery
Being unable to follow your doctor's instructions, like taking your medicine when you are supposed to
Having too little support from people at home to care for you after the operation
Having advanced cancer of the liver
Having another kind of cancer in the past 3 to 5 years
Having severe heart, lung or kidney disease
Having advanced HIV disease (AIDS)
Severe hardening of the arteries
What can you do to keep healthy before and after a liver transplant?
If you follow the suggestions below, you can improve your chances of getting a liver transplant and feeling healthy after it is done. Some of these suggestions might also keep you from needing a transplant for a longer time.
Do not use alcohol or illegal drugs. Get treatment for your substance abuse problem if you need it
Get treatment for any mental illness or behavioral problems
Make sure you follow your doctor's advice to try to treat your liver disease
Eat well-balanced, healthy meals. Lose weight, if your doctor tells you to
Get treated for any other health problems (diabetes, blood pressure, cholesterol, etc
Stop smoking or chewing tobacco
Talk to your doctor before you use any other prescription or over the counter medicine. Talk to your doctor before using any vitamins, supplements or natural or herbal remedies
What is life like after a liver transplant?
Most people who get liver transplants go back to having a full and active life. Most of them live for many years. If you have a liver transplant, some things will be different. You will have to take medicine every day to make sure that your body doesn't reject your new liver. You will have to see your doctor often, and learn to work well with all the people on your healthcare team. You might need to keep getting treated for your liver disease, or for alcohol or drug use. You might have some new problems. Some people who get transplants have trouble with diabetes, high blood pressure, high cholesterol and occasional infections. Your doctor can help you deal with these problems, if they occur
If you have HCV, will it come back in the new liver?
But new treatments for HCV may become available to prevent HCV from damaging your new liver as much as your old on
What is a liver transplant?
A liver transplant is the replacement of your liver with one that has been donated by someone else. The donated liver comes from someone who has died. In the future, it may be more common for donated liver tissue to come from a living person, such as a family member. In this case, you receive only a part of the donor's liver.
When is a liver transplant considered?
Liver transplants are considered only when there is a high risk of death from liver disease. Usually, more than one doctor will help decide if you need a liver transplant
Being told you might need a liver transplant doesn't automatically mean that you are in danger of dying right away. It usually takes a long time to find a liver that is right for you. For this reason, your doctor might try to decide whether you need a liver transplant months or years before you actually must have one.
What might make your doctor think you need a liver transplant?
Your doctor might think about giving you a liver transplant if you have any of the following symptoms, and they don't go away with time
Yellow skin or eyes (jaundice)
Fluid in your legs (edema) or in your stomach (ascites)
Thinning of your muscles, especially in your face, neck and arms
Easy bruising or bleeding
Vomiting blood (hematemesis), or passing blood in your stool (melena)
Times when you can't concentrate or become easily confused
Changes in your liver tests that suggest your liver is failing
Can anyone get a liver transplant?
No. Getting a liver transplant is very stressful. Not everyone who needs a liver transplant can survive the major surgery involved. In other cases, your doctor might decide that the liver transplant probably won't work
If your doctor thinks you might need a liver transplant, then you should do everything you can to keep healthy and strong. Some of the things that might prevent you from getting a liver transplant include:
Continuing to use alcohol or illegal drugs
Being at high risk of using drugs or alcohol again after the surgery
Being unable to follow your doctor's instructions, like taking your medicine when you are supposed to
Having too little support from people at home to care for you after the operation
Having advanced cancer of the liver
Having another kind of cancer in the past 3 to 5 years
Having severe heart, lung or kidney disease
Having advanced HIV disease (AIDS)
Severe hardening of the arteries
What can you do to keep healthy before and after a liver transplant?
If you follow the suggestions below, you can improve your chances of getting a liver transplant and feeling healthy after it is done. Some of these suggestions might also keep you from needing a transplant for a longer time.
Do not use alcohol or illegal drugs. Get treatment for your substance abuse problem if you need it
Get treatment for any mental illness or behavioral problems
Make sure you follow your doctor's advice to try to treat your liver disease
Eat well-balanced, healthy meals. Lose weight, if your doctor tells you to
Get treated for any other health problems (diabetes, blood pressure, cholesterol, etc
Stop smoking or chewing tobacco
Talk to your doctor before you use any other prescription or over the counter medicine. Talk to your doctor before using any vitamins, supplements or natural or herbal remedies
What is life like after a liver transplant?
Most people who get liver transplants go back to having a full and active life. Most of them live for many years. If you have a liver transplant, some things will be different. You will have to take medicine every day to make sure that your body doesn't reject your new liver. You will have to see your doctor often, and learn to work well with all the people on your healthcare team. You might need to keep getting treated for your liver disease, or for alcohol or drug use. You might have some new problems. Some people who get transplants have trouble with diabetes, high blood pressure, high cholesterol and occasional infections. Your doctor can help you deal with these problems, if they occur
If you have HCV, will it come back in the new liver?
But new treatments for HCV may become available to prevent HCV from damaging your new liver as much as your old on
Wednesday, January 17, 2007
Welcome
Hello, every body.
Welcome to my blog.
I'm Dr. Samy Habib.
Consultant of Liver Transplantation, Alexandria, Egypt.
Middle East Representative of Liver Transplant in China
I'm dealing with chineese medical authoroties now to facilitate liver transplantation for middle east patients in china.
Welcome to my blog.
I'm Dr. Samy Habib.
Consultant of Liver Transplantation, Alexandria, Egypt.
Middle East Representative of Liver Transplant in China
I'm dealing with chineese medical authoroties now to facilitate liver transplantation for middle east patients in china.
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