Digestive health centre

Liver transplantation

The liver is the body's largest internal organ, weighing about three pounds (1.36 kilograms) in adults. It is located below the diaphragm on the right side of the abdomen.

The liver performs many complex functions, including:

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

When is a liver transplant needed?

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

Chronic hepatitis with cirrhosis
Primary biliary cirrhosis (a rare condition where the immune system inappropriately attacks and destroys the bile ducts, causing liver failure).
Sclerosing cholangitis (scarring and narrowing of the bile ducts inside and outside the liver, causing a back-up of bile in the liver which can lead to liver failure).
Biliary atresia (malformation of the bile ducts).
Alcoholism.
Wilson's disease (a rare inherited disease that involves abnormal deposition of copper throughout the body, including the liver).
Haemochromatosis (a common inherited disease where the body is overwhelmed with iron).
Alpha-1 antitrypsin deficiency (an abnormal accumulation of alpha-1 antitrypsin protein in the liver, resulting in cirrhosis).
Liver cancer.

How are candidates for liver transplant determined?

Evaluations by specialists from a range of fields are needed to determine if a liver transplant is appropriate. These include a review of your medical history and a variety of tests. Hospitals take an interdisciplinary approach when assessing and selecting candidates for liver transplantation. This interdisciplinary healthcare team may include the following professionals:

A liver specialist (hepatologist).
Transplant surgeons.
A transplant co-ordinator - usually a registered nurse who specialises in the care of liver-transplant patients (this person will be your main point of contact with the transplant team).
A social worker to discuss your support network of family and friends, employment history and financial needs.
A psychiatrist or psychiatric nurse to help you deal with issues that may arise with liver transplantation, such as anxiety and depression.
An anaesthetist to discuss potential anaesthesia risks.
A physiotherapist to educate patients about pre-operative exercises and post-operative rehabilitation.
A dietitian to ensure adequate nutrition before and after the transplant.
A dependency specialist to help people with a history of alcohol or drug misuse.
A financial counsellor to advise on issues such as lost work time after a transplant.