A liver transplant is an option when the liver can no longer perform vital functions and when the liver disease cannot be corrected in any other way. The Liver Transplant Program at UofL Health – Trager Transplant Center has reached almost 1,000 transplants with our first liver transplant on May 22, 1990. Choosing the right transplant program can play a crucial role in ensuring a long, healthy life after transplantation.
We have a multi-disciplinary team of transplant surgeons, hepatologists, transplant coordinators, psychiatrists, social workers, nutritionists and financial coordinators who work together to diagnose and manage liver diseases. Many patients in need of a liver transplant suffer from some form of liver cancer, often caused by cirrhosis and Hepatocellular Carcinoma (HCC).
Our team has built a world-class transplant center with access to the latest techniques and technologies. From the time we are introduced to potential liver transplant patients and their families, through their transition to life outside the hospital, our focus is on easing that journey for all involved.
Advanced Liver Disease
Most chronic liver failure is the result of cirrhosis, a condition in which scar tissue replaces healthy liver tissue resulting in the liver not being able to function correctly. The scarring process happens little by little over many years, until the liver hardens, in which the damage cannot be undone. Common causes of cirrhosis are alcohol related liver disease, hepatitis C, hepatitis B and D, nonalcoholic fatty liver disease, autoimmune hepatitis, inherited diseases, drugs, toxins and infections.
Conditions & Treatments
Alcohol Related Liver Disease
Alcohol related liver disease is caused by damage to the liver from years of drinking. The liver becomes swollen and inflamed, oftentimes causing cirrhosis. A liver transplant for someone with alcohol-associated liver disease means a second chance at life granted by the selfless generosity of a donor. The efforts of patient caregivers including family and friends, doctors, transplant coordinators, nurses, social workers, dietitians and addiction specialists are also critical. Sometimes the most difficult part of a liver transplant is helping the recipient to understand that they are worthy of a second chance and to let go of the guilt, shame and hopelessness associated with having a disease many perceive is self-inflicted.
Many people who struggle with alcohol related liver disease often do not feel that they should be considered or worthy of a liver transplantation. In this blog post, one of our transplant hepatologists, Loretta Jophlin, M.D., takes the time to explain why everyone deserves the opportunity to receive a liver transplant.
While there are a wide range of opinions and feelings about liver transplantation where alcohol was a causative factor, there are some facts about alcohol-associated liver disease that should be considered.
- Many people are drinking more than they know. It is increasingly common for alcohol labels to be inaccurate regarding alcohol percentage or alcohol by volume (ABV). With the increasing popularity of “high gravity beer,” beers served in growlers and boxed wines, it may be difficult to judge just how much alcohol one is drinking.
- Women, as they tend to weigh less and have a higher percentage of body fat, may be imbibing at levels that are dangerous when matching men drink for drink. The incidence of women with alcohol liver disease is currently outpacing men. Alternately, men tend to retain more iron in their bodies than women, a condition that can prime the liver for injury from alcohol.
- Other conditions which affect the liver including obesity, high cholesterol and diabetes, as well as genetic conditions like alpha-one antitrypsin heterozygosity or hemochromatosis, can also amplify the effect of alcohol on the liver.
For those who argue that alcohol liver disease is self-inflicted, we ask that you consider the above situations as well as the fact that liver transplantation is widely accepted for other conditions often perceived as self-inflicted including TYLENOL® overdose, metabolic/non-alcohol fatty liver disease (often driven in part by diet choices) and hepatitis C virus, an infection sometimes acquired from a history of IV drug use.
Hepatitis C infection is caused by a blood-borne virus. For some people, hepatitis C infection is a short-term illness. For 70-85% of people who become infected with the virus, a long-term, chronic illness occurs. Today, most people become infected with the hepatitis C virus by sharing needles or other equipment to inject drugs. Once diagnosed with hepatitis C, your health care provider can refer you to our UofL Health – Hep C Center. The longer people live with hepatitis C, the more likely they are to develop a life-threatening liver disease
Acute Hepatitis C
Acute hepatitis C is a short-term illness that may occur within the first six months of exposure to hepatitis C. Symptoms are typically absent or very mild. Some people are lucky and will clear the virus without any treatment at all. However since most cases do not include symptoms, roughly three out of four cases will progress into chronic hepatitis C.
Chronic Hepatitis C
Chronic hepatitis C is a long-term illness that occurs when the hepatitis C virus remains in a person’s body for an extended time. As it worsens, it can lead to serious medical conditions, such as cirrhosis (scarring of the liver), liver failure or liver cancer.
Hepatitis C Signs and Symptoms
Many people with hepatitis C do not experience symptoms and are unaware they are infected with the virus. In some cases, symptoms can take 30 years to develop. When symptoms do appear, they can include:
- Loss of appetite
- Abdominal pain
- Dark urine
- Gray-colored stool
- Joint pain
Kentucky leads the nation in hepatitis C infections. Chronic hepatitis C infection can lead to cirrhosis, liver cancer, liver failure, and death. Thankfully, it can be cured.
Since 2011, significant advances in the treatment of hepatitis C infections have paved the way for 99% cure rates regardless of duration of infection, fibrosis status, dialysis status, transplant, and/or HIV status.
The UofL Health – Hep C Center leads our area in providing compassionate care, advocacy, and access to curative hepatitis C treatments, liver assessment with Fibroscan, and world-class specialty pharmacy services. There is no longer a need to worry about liver biopsies, interferon side effects, or stigma. All hepatitis C infected patients benefit from referral, regardless of age, and active or recent drug/alcohol use.
Our other services include, in-office registration, vaccine services, narcan prescriptions and overdose training, hepatology specialists, in-office lab and validated parking in our hospital garage.
UofL Health – Hep C Center
550 S. Jackson Street, Third Floor
Louisville, KY 40202
Our Location & Doctors
Ashutosh Barve, M.D., Ph.D.
Matthew Cave, M.D.
Loretta Jophlin, M.D., Ph.D.
Transplant Hepatologist – Medical Director
Luis Marsano-Obando, M.D.
Craig McClain, M.D.
UofL Health – Trager Transplant Center
UofL Health – Jewish Hospital
220 Abraham Flexner Way, 3rd Floor
Louisville, KY 40202
Liver Referrals: 502-587-4358
UofL Physicians – Digestive & Liver Health
UofL Health – Chestnut Street Outpatient Center
401 E. Chestnut Street, Suite 310
Louisville, KY 40202
Could you be a candidate for a liver transplant? For an appointment with a liver transplant specialist, please fill out our contact form.
If you are a physician who would like to refer a patient, complete and fax the liver referral form to 502-587-4319.