Q: Which specialist should I consult to treat liver diseases?
A: Liver diseases are treated by a hepatologist or a gastroenterologist. A liver transplant is performed by a liver transplant surgeon.
Q: Is there an entity such as a toxic hepatitis?
A: When the liver is exposed to certain harmful chemical substances, there is an inflammatory reaction called toxic hepatitis. It can be caused by alcohol, drugs like acetaminophen, and even some nutrients. The toxic hepatitis may occur in a matter of hours or may take months to develop. The inflammatory response may subside once the exposure to the drug ceases or may lead to permanent damage and scarring of the liver.
Q: How does the concept of live donor work in liver transplant?
A: Unlike kidneys where a person can donate one of his kidneys, a live liver donor donates a part of his liver to the recipient. The interesting thing is that the liver has a remarkable capacity for regeneration and it grows back to its original size in the donor and to the normal in the recipient as well.
Q: What are MELD and PELD scores?
A: MELD is Model End stage Liver Disease and PELD is Pediatric End stage Liver Disease.
The MELD score is used for persons above 12 years and PELD score is used for children below 12 years.
When a person is assigned to a waiting list for liver transplant, the MELD /PELD scores are calculated to determine how urgently the person needs the transplant i.e the probability of his dying within 90 days without a transplant.
The MELD score ranges between 6 to 40, and a higher score indicated more urgency.
Patients with acute liver failure likely to die within a week without a liver transplant are accorded the highest priority.
Q: Are there any contraindications to a liver transplant?
A: A person with liver failure might be considered unfit to undergo a liver transplant for the following reasons.
- Cancer that has spread outside the liver
- Alcohol or drug addiction
- AIDS infection
- Advanced heart or lung disease
- Presence of sepsis
- Absence of family support
- Inability to follow the treatment regimen
Q: What is hepatic encephalopathy?
A: Hepatic encephalopathy occurs in advanced liver disease with failure. The liver is unable to perform the function of removal of toxins, which accumulate in the blood as a result. These accumulated toxins e.g. ammonia affect brain function leading to drowsiness, confusion, alteration in personality and in severe cases, coma and death.
