Liver Transplantation

Liver transplantation is reserved for patients with advanced and irreversible liver disease. Patients with complications related to chronic hepatitis or cirrhosis should be referred to medical centers specializing in liver transplantation for evaluation. This should be done before the onset of terminal liver disease. Transplantation can dramatically prolong and improve quality of life for patients in advanced stages of this disease, which would otherwise be untreatable. Hepatitis C is the leading indication for liver transplantation in the United States. If possible, treatment with interferon and ribavirin to reduce or eliminate the virus prior to transplantation is optimal. Although transplantation cures the cirrhosis, the hepatitis C infection persists, and reinfection of the new liver is universal.

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Patients who are deemed to be good candidates for a transplant are placed on a waiting list and scored by severity of disease. The donated liver may come either from a living person, who provides a piece of his own liver (in both parties, the divided liver grows to normal size again within a short time), or from a cadaver. The operation itself may take as long as 12 hours and requires antirejection drugs afterward to prevent the patient's immune system from attacking the unfamiliar tissue.