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Liver Transplant

The liver performs many essential functions. It makes the factors that the blood needs for clotting, aids in digestion and breaks down toxic substances (including drugs and alcohol) in the blood. If your liver fails, a liver transplant – surgery to replace your diseased liver with a healthy liver from another person – can save your life. The liver is the second most commonly transplanted organ in the U.S., after the kidney.

The Transplant Center at Memorial Hermann Texas Medical Center is Houston’s leader in liver transplantation* and has the highest transplant rate in Texas. Since performing Houston’s first liver transplant in 1985, the Transplant Center has maintained the top liver program in Houston and one of the top three programs in Texas, based on liver transplant quality outcomes and time to transplantation.

The length of time a patient waits for a transplant can impact a patient’s long-term outcome. Our patients’ median wait for a liver transplant is 7.7 months, versus 5+ years at other Houston-area hospitals, and we have the lowest waitlist mortality rate in Houston1.

Liver Transplant Team

The multidisciplinary liver transplant team at the Transplant Center is led by nationally renowned transplant surgeon J. Steve Bynon, MD, FACS, Chief of Abdominal Transplantation and Director and Professor, Division of Immunology and Organ Transplantation at the McGovern Medical School at UTHealth. The liver transplant team is comprised of transplant hepatologists, transplant surgeons, transplant nurses, transplant anesthesiologists, transplant coordinators, financial counselors, social workers and dietitians.

Through our partnership with the Ertan Digestive Disease Center, we provide quality treatment for patients with liver disease. Our affiliation with McGovern Medical School allows us to offer clinical trials that further the scientific understanding of liver disease, as well as advanced treatment protocols that keep us at the cutting-edge of liver disease treatment.

Liver Conditions That May Require Transplant

The following are common diseases or conditions which may necessitate a liver transplant.

Infectious

  • Chronic hepatitis C is a long-lasting viral infection that occurs when the body is unable to fight off the hepatitis C virus, which is spread through contact with an infected person’s blood. About 75 to 85 percent of people with acute (severe and sudden in onset) hepatitis C will develop chronic hepatitis. Many people who have hepatitis C do not have symptoms and do not know they have the infection. Without treatment, chronic hepatitis C can cause chronic liver disease, cirrhosisliver failure or liver cancer.
  • Chronic hepatitis B is a long-lasting viral infection that occurs when the body is unable to fight off the hepatitis B virus, causing liver inflammation and damage. Hepatitis B is primarily spread through sexual contact or through injection drug use. Since doctors began recommending children receive the hepatitis B vaccine in 1991, the rate of new diagnoses in the U.S. has decreased 82 percent, according to the Centers for Disease Control and Prevention.

Alcohol-related

  • Alcoholic liver disease (ALD) is damage to the liver and its function due to long-term alcohol abuse, resulting in scarring and, ultimately, cirrhosis. ALD is more common in people between 40 and 50 years of age and is more prevalent in men, although women may develop ALD after less exposure to alcohol than men. Some people may have an inherited risk for the disease.

Cirrhosis

  • Cirrhosis is a condition in which the liver slowly deteriorates and is unable to function normally due to chronic injury. According to the National Institutes of Health, cirrhosis is the 12th leading cause of death in the U.S. and is more prevalent among men than women. Early-stage symptoms may include fatigue, abdominal swelling, tenderness and pain, lack of appetite and weight loss. Later-stage symptoms may include jaundice, darkened urine, bleeding/bruising, enlarged liver and spleen, swelling in the legs and abdomen, vomiting blood, itching, forgetfulness or confusion, tremors and other symptoms. The leading causes of cirrhosis are chronic hepatitis C, ALD and nonalcoholic steatohepatitis (NASH) (fat build-up in the liver, unrelated to alcohol).

Autoimmune

  • Autoimmune hepatitis occurs when the body’s immune system attacks its own liver cells, resulting in inflammation in the liver and, if left untreated, cirrhosis of the liver.  Researchers believe genetics, or inherited genes, may make some people more likely to develop autoimmune diseases. At least 70 percent of those with autoimmune hepatitis are female.
  • Primary biliary cholangitis (PBC) is an autoimmune disease in which the body’s immune system attacks the small bile ducts of the liver, leading to duct obstruction and bile spilling into the liver tissue. The progression of PBC can be slowed with agents that improve the flow of bile through the bile ducts. In some cases, PBC can lead to cirrhosis. It is more common in women.
  • Primary sclerosing cholangitis (PSC) is an autoimmune disease in which inflammation (cholangitis) causes scarring (sclerosis) in the bile ducts. Early symptoms may include fatigue and itching. Later symptoms may include upper abdominal pain, fever, chills, night sweats, enlarged liver or spleen, weight loss or jaundice. Although PSC can occur at any age, it is more prevalent in people in their 40s, is more common in men (60 percent) than women (40 percent), and often occurs in the presence of inflammatory bowel disease (IBD).

Metabolic disorders

  • Alpha1-antitrypsin deficiency is a genetic (inherited) disorder that can cause liver and lung disease in individuals of any age. Liver-related symptoms include unexplained liver disease or elevated liver enzymes, eyes and skin turning yellow (jaundice), swelling of the abdomen (ascites) or legs, and vomiting blood (from enlarged veins in the esophagus or stomach).
  • Tyrosinemia (or tyrosinaemia) is a genetic disorder in which the body lacks an enzyme necessary to break down the amino acid tyrosine. As a result, tyrosine and its byproducts accumulate to toxic levels, which can cause damage and death to cells in the liver, kidneys, nervous system and other organs. Symptoms typically appear shortly after birth and, depending on the type of the disease (acute or chronic), may include inability to gain weight, enlarged liver and spleen, abdominal swelling, jaundice, swelling of the legs, increased tendency to bleed, vomiting or diarrhea.
  • A glycogen storage disease is a metabolic disorder, either genetic or acquired, caused by enzyme deficiencies affecting either glycogen synthesis, glycogen breakdown or glycolysis (glucose breakdown), typically within muscles and/or liver cells. Symptoms can include slow growth, low muscle tone, heat intolerance, bruising, low blood sugar (hypoglycemia), enlarged liver, abdominal swelling and muscle pain and cramping during exercise.
  • Maple syrup urine disease (MSUD) is a genetic disorder in which the body is unable to process certain amino acids properly. The disorder’s name is derived from the distinctive sweet odor of affected infants’ urine. It is characterized by poor feeding, vomiting, lack of energy (lethargy), abnormal movements and delayed development. If left untreated, it can lead to seizures, coma and death.
  • Wilson’s Disease is a genetic disorder in which excessive amounts of copper accumulate in the body, especially in the liver, brain and eyes. Symptoms usually appear between the ages of 6 and 45 (but most often in teenage years) and include a combination of liver disease (especially in affected children and young adults) and neurological and psychiatric problems. Liver-related symptoms include jaundice, fatigue, loss of appetite and abdominal swelling.
  • Urea cycle deficiency is a genetic disorder that results in a deficiency of one of the six enzymes in the urea cycle – enzymes that are responsible for removing ammonia from the blood stream, resulting in elevated blood ammonia which, when reaching the brain, can cause irreversible brain damage, coma and/or death. Onset of symptoms can occur in infancy, childhood or adulthood and can include lack of appetite, growth failure, vomiting, lethargy, poor muscle tone, respiratory distress, developmental delays and psychiatric problems.

Other Liver Conditions

  • Acute liver failure (ALF)/Acute hepatic necrosis is a relatively uncommon condition characterized by the abrupt onset of severe liver failure. Symptoms may include malaise, fatigue, nausea, abdominal discomfort or jaundice. Onset of symptoms typically occurs within one to 14 days and may include nausea, weakness, fatigue and abdominal pain. Other organ failure, such as lung, kidney or bone marrow, may also be present. Causes can include acetaminophen poisoning (leading cause of AFL), viral infection (hepatitis), blockage of blood vessels to the liver, autoimmune diseases, genetic disorders (most commonly Wilson’s Disease in adults) or unknown causes.
  • Biliary atresia (BA) is a life-threatening condition affecting newborns characterized by absent or malformed bile ducts. Usually identified shortly after birth, it is the most common cause of liver failure and transplant in children.

The Organ Donation Process

Life-saving liver transplantation is made possible through the generous “gifts of life” by donors. While living, these individuals registered to become donors (upon their death), either when signing up for or renewing their driver’s licenses or through the DonateLifeTexas.org registry. If the deceased has not registered but is a candidate for donation, his or her next-of-kin can provide consent for donation on his or her behalf. Currently, 47 percent of Texans are registered donors, and there are over 100,000 individuals awaiting organ transplants in the U.S.

Upon a donor’s death, the donor’s organs and/or tissues are recovered by an organ procurement organization (OPO). The OPO serving the Greater Houston area is LifeGift. To learn more about the organ donation process, click here.

Liver Transplantation Process

Click here to read about the liver transplantation process, from the time a patient decides to consider liver transplantation through recovery from transplantation surgery.

Transplant Support Group

Transplantation can sometimes seem overwhelming for patients. The Transplant Center offers a transplant support group, run by our transplant social workers. The group meets monthly and includes patients who are waiting for a transplant as well as those who have already received a transplant. Adult family members, friends and caregivers are welcome and encouraged to come with the patient.

To learn more about our transplant support group, call (713) 704-5200.

Patient Stories 

Ezra ThumbnailDonate for Life: Ezra’s Story

Watch how a young boy suffering from acute liver failure was given a second chance through a life-saving liver transplant.

Watch the Video »

Getting Started

To find out more about liver transplantation or to schedule an appointment with an affiliated physician at the Transplant Center, please call (713) 704-5200.

If you are a physician and would like to refer a patient to the Transplant Center, click here

 

[1] Scientific Registry of Transplant Recipients (SRTR). Cohort: 01/01/2016 - 12/31/2016