The liver is a highly complex organ in which many different metabolic processes take place. These include the metabolism of dietary carbohydrate, protein and fats, the storage of iron, the formation of hormones and blood coagulation factors and the removal of toxins from the bloodstream. Liver transplants are required when liver function has dropped to below 20% of normal. This can be a result of chronic liver failure, where liver function declines progressively, usually over a period of years, or acute liver failure. The main chronic diseases in adults are cirrhosis, alcohol-induced and non-alcoholic, and hepatitis. In children, the main cause is biliary atresia and other inherited anatomic and metabolic disorders. Acute liver failure is nonnally caused by viral hepatitis or toxic drugs. Acute liver failure is less common than chronic liver failure, but results in brain damage through inflammation and fluid accumulation in the brain, and in 75% of cases the patient dies within a few days of onset. In the few cases where the patient does survive, the liver appears to have an amazing ability to regenerate. Thus far, patients with liver disease are handicapped by the lack of satisfactory means of artificial support comparable to renal dialysis. The transplanted liver must function efficiently from the time of transplantation, or the patient may be lost. Despite these and other difficulties, the therapeutic power and appeal of liver transplantation has had a considerate impact in the treatment of liver failure. Almost all patients with nonneoplastic chronic liver disease can at least be considered for liver transplantation, and even some of those with malignant tumors may benefit. Acute liver disease was rarely suggested as a reason to consider liver transplantation until the mid 1980s, but now transplantation of patients with fulminant hepatitis is common. Patient survival of more than 20 years after liver transplantation has been achieved.

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J. Jeekel (Hans)
Erasmus University Rotterdam
Professor Michael van Vloten Fonds, Gastrostart Foundation
Erasmus MC: University Medical Center Rotterdam

Stockmann, H.B.A.C. (2001, April 11). Xeno Assistance of the Faling Liver. Erasmus University Rotterdam. Retrieved from