Liver Transplantation

At NewYork-Presbyterian/Weill Cornell Medicine, we have a deep commitment to compassionate personal care and clinical innovation. Our physicians and surgeons have a great deal of expertise but we offer an experience where the doctors take the time to explain conditions, procedures, treatments and alternatives. Liver disease and surgery can be frightening and confusing. Our entire team is here to ensure that you are confident that you are getting the best care in the world. 
     
Liver transplantation surgically replaces a failing or diseased liver with one that is normal and healthy. At this time, transplantation is the only cure for liver insufficiency or liver failure because no device or machine reliably performs all of the functions of the liver. The liver is a vital organ, meaning that one cannot live without it. The liver serves many critical functions including metabolism of drugs and toxins, removing degradation products of normal body metabolism (for example clearance of ammonia and bilirubin from the blood), and synthesis of many important proteins and enzymes (such as factors necessary for blood to clot). 

People who require liver transplants typically have one of the following conditions: 

• Acute Liver Failure-occurs when a previously healthy liver suffers massive injury resulting in clinical signs and symptoms of liver insufficiency. The hallmark of this condition is the development of confusion (encephalopathy) within eight weeks after the onset of yellowing of the skin (jaundice). Confusion occurs because toxins typically metabolized by the liver accumulate. Unlike patients with chronic liver disease, who can survive weeks to months to years while awaiting liver transplantation, patients with acute liver failure may die within days if not transplanted. 
  
  
• Chronic Liver Failure- the liver has a remarkable ability to repair itself in response to injury. Nevertheless, repeated injury and repair, typically over many years and even decades, scars the liver permanently. The end stage of scarring is termed cirrhosis and corresponds to the point where the liver can no longer repair itself. Although medications can decrease the symptoms caused by the liver failure, liver transplantation represents the only permanent cure. 
       
• Liver Cancer- for patients with both early-stage hepatocellular carcinoma and cirrhosis who cannot undergo resection (removal), the latest advancement in treatment is liver transplantation. In a small percentage of patients, the liver function is normal and surgical removal of the tumor is possible with good long-term results, and this is always the first choice for treatment.  Unfortunately, however, most patients have associated liver disease (that is, cirrhosis) from a long-term condition like hepatitis C or fatty liver disease, and this damage is known to lead to liver cancer.