Cirrhosis		Liver Transplantation
Cirrhosis (Primary Biliary); Cirrhosis of the Liver; Liver Cirrhosis		What I need to know about Liver Transplantation

Pictures

Micronodular cirrhosis developing in a transplanted liver with

From a 5 year old girl who received this liver about a year ago after fulminant hepatic failure She developed acute rejection within month of transplantation and attempts at preventing rejection were unsuccesful Histologically a typical cirrhosis was not present since regenerative nodules were lacking A re transplant was made

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This was a liver that was removed from a dead person who died as a result of cirrhosis of the liver note the darkened appearence and many nodules of scar tissue that have developed deforming

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In cirrhosis of the liver scar tissue replaces normal healthy tissue blocking the flow of blood through the organ and preventing it from working Cirrhosis is the eighth leading cause of

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for instance from gall stones is another important reason to develop cirrhosis of the liver The surface of the liver is knobley instead of shiny and smooth This can be seen on this image of a liver with cirrhosis from the anatomical department of Cornell University With end stage cirrhosis of the liver patients develop portal hypertension This is a condition where the

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calculated to estimate the probability of liver decompensation and patient survival Cox regression analysis was used to determine risk factors associated with decompensation and survival Results 69 patients 14 had biopsy proven cirrhosis after a median follow up period of 36 months

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resulting in fibrosis and degeneration of the hepatocytes Transplantation is the most effective treatment currently for PBC however the disease may recur after transplantation Fig 4 Note the lymphocyte infiltration and the absence of bile ducts Fig 5 A liver with macronodular cirrhosis

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5 have HBV Of the 8 with liver cirrhosis 27 with liver cirrhosis have Child Pugh B stage and 7 have Child Pugh C stage and 17 of these patients are Liver Transplant candidates Approximately 500 000 HIV infected in North America have HCV or HBV Of these 33 000 have liver cirrhosis and of these about 15 are liver transplant candidates Miro reports there are

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Fig 1 The path to liver disease and failure

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to alcohol abuse are Steatohepatitis fatty liver the accumulation of lipid within the hepatocytes accompanied with inflammation These two factors can lead to fibrosis and cirrhosis Fig 9 Alcoholic fatty liver note the deposition of lipids within the hepatocytes Alcohol abuse can also lead directly to cirrhosis the repeated exposure of the hepatocytes to toxin

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biliary cirrhosis liver transplantation is the definitive treatment p ANCA antibodies are characteristic for primary sclerosing cholangitis Passive Congestion of the Liver develops cor pulmonale with ascites and peripheral edema right sided cardiac decompensation leads to passive congestion of the liver the liver is slightly enlarged

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Heart Cardiomyopathy Liver Cirrhosis Failure Heart and Liver Transplantation

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Fatty Liver pre hepatic alcoholic liver disease Notice the yellow color and swollen appearance

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is performed under general anesthesia and is quite lengthy requiring three to four hours The anesthetized patient is face up and both arms are drawn away from the body Surgeons often usea To remove a portion of the liver the surgeon enters the patient s abdomen and frees the affected part of the liver from the connecting tissues B The artery to the liver and hepatic duct

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Alcohol abuse can also lead directly to cirrhosis the repeated exposure of the hepatocytes to toxin can lead directly to fibrosis and cirrhosis most frequently micronodular cirrhosis Fig 10 Micronodular cirrhosis of the liver Alcoholic hepatitis is when alcohol leads directly to hepatocyte injury and swelling accompanied by necrosis There is also infiltration by

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and the hepatocytes are destroyed This necrosis leads to cirrhosis and liver failure While viral hepatitis can recur after a liver transplant if often recurs at a much slower rate Fig 8 This bile duct shows the narrowing involved in primary sclerosing cholangitis

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have chronic liver disease which may progress to cirrhosis and hepatocellular carcinoma Chronic infection with HCV is one of the most important causes of chronic liver disease see Image 1 Currently chronic hepatitis C is the most common indication for orthotopic liver transplantation in the United States HCV is a spherical enveloped single stranded RNA virus

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Where Is The Liver Ways To Keep Your Liver Healthy

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smoothly over one another In cirrhosis too much of this fluid can build up between the two layers and this is called ascites This causes the abdomen to become very large Portal Hypertension In individuals without cirrhosis blood is carried to the liver by a major blood vessel called the portal vein If blood is unable to flow easily through the liver because of cirrhosis the

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Hepatitis C is a virus caused liver inflammation which may cause jaundice fever and cirrhosis The people most at risk for contracting and spreading hepatitis C are those who share needles

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Fig 2 Chart depicting occurence of liver disease patients recieving transplants in the US Click picture to view enlarged

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