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Tuesday, 30 July, 2002, 13:01 GMT 14:01 UK
Q&A: Liver transplants

As footballer George Best undergoes a liver transplant, BBC News Online examines why the operation is necessary for patients.

What does the liver do?

The liver is the largest organ in the body, and one of its most complex.

It performs more than 400 functions that are needed to keep the body healthy.

These include:

  • converting food into nutrients the body can use
  • storing fats, sugars, iron, and vitamins for later use by the body
  • making the proteins needed for normal blood clotting
  • removing or chemically changing drugs, alcohol, and other substances that may be harmful or toxic to the body

What causes liver disease?

As the liver is such a complicated organ, it can be affected by a wide range of disease.

Fortunately, most of these are rare.

Among the most common are: hepatitis, cirrhosis, cancer and alcohol-related disease.

What impact does alcohol abuse have?

One of the liver's basic functions is to break down alcohol.

However, years of alcohol abuse can cause tissue damage, leading to a condition called alcohol-induced liver disease (ALD).

Fatty liver, the most common form of ALD, is reversible with abstinence.

However, more serious ALD includes alcoholic hepatitis, characterized by persistent inflammation of the liver, and cirrhosis, characterized by progressive scarring of liver tissue.

Either condition can be fatal, and treatment options are limited.

What are the symptoms of liver disease?

The symptoms of liver disease include:

  • jaundice
  • severe itching
  • dark urine
  • mental confusion or coma
  • vomiting of blood
  • easy bruising and tendency to bleed

Is a transplant an option?

If the damage is severe enough, transplantation may be the only answer.

Liver transplants are considered only when there is a high risk of death from liver disease.

Most people who get liver transplants take three months to recover, but then go back to having a full and active life. The majority live for many years.

However, transplant patients have to take drugs for the rest of their lives to ensure their body does not reject the replacement organ.

Are there any complications?

As with any other surgical procedure, complications may arise after liver transplantation. There is a small risk of bleeding from the place where the donor and recipient blood vessels were sewn together.

A clot can form in the hepatic artery that can cause the liver to malfunction.

The bile ducts from the new liver are sewn to a bile duct of the recipient or a piece of intestine. This connection can leak and drain into the abdomen and cause an infection.

The immune system has to be suppressed after a transplant to avoid rejection. This means that the patient is at increased risk of infection.

Some transplant patients may also have trouble with diabetes, high blood pressure, high cholesterol and occasional infections.

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