Liver Education

We’ve learned a lot more about the liver than we really ever wanted to know. It obviously does a lot and you can’t live without one, for starters. I vary on how I feel about all the information out there – sometimes I find it fascinating, but the fact that it is Thather’s reality makes me cringe at the thought of these bad things happening inside his little body. Sometimes I just don’t care what is wrong with Thatcher’s liver...just fix it! Thank God there are great doctors out there that do know what is wrong...and can fix it!! I pray for these doctors everyday.

Below is some background information and other terms we’ve become all too familiar with. If you are like me, and close to our situation, you may find some of this information depressing. Feel free to skip ahead, but remember to stay positive...we’re going to get a healthy liver!! Also remember that thanks to the living donor option, Thatcher has not and will not have to experience many of the complications and symptoms of a failing liver!

The liver, the largest organ in the body, is essential in keeping the body functioning properly. It removes or neutralizes poisons from the blood, produces immune agents to control infection, and removes germs and bacteria from the blood. It makes proteins that regulate blood clotting and produces bile to help absorb fats and fat-soluble vitamins. You cannot live without a functioning liver.

Thatcher has biliary atresia, where his liver does not have the proper biliary system to drain the bile it produces. This causes the liver to become damaged from scarring, or cirrhotic. In cirrhosis of the liver, scar tissue replaces normal, healthy tissue, blocking the flow of blood through the organ and preventing it from working as it should. This is when a liver transplant becomes necessary.

Many people with cirrhosis have no symptoms in the early stages of the disease. However, as scar tissue replaces healthy cells, liver function starts to fail and a person may experience the following symptoms:

• exhaustion
• fatigue
• loss of appetite
• nausea
• weakness
• weight loss
• abdominal pain
• spider-like blood vessels (spider angiomas) that develop on the skin

As the disease progresses, complications may develop. In some people, these may be the first signs of the disease. Complications of Cirrhosis:

• Edema and ascites. When the liver loses its ability to make the protein albumin, water accumulates in the legs (edema) and abdomen (ascites).
• Bruising and bleeding. When the liver slows or stops production of the proteins needed for blood clotting, a person will bruise or bleed easily. The palms of the hands may be reddish and blotchy with palmar erythema.
• Jaundice. Jaundice is a yellowing of the skin and eyes that occurs when the diseased liver does not absorb enough bilirubin.
• Itching. Bile products deposited in the skin may cause intense itching.
• Gallstones. If cirrhosis prevents bile from reaching the gallbladder, gallstones may develop.
• Toxins in the blood or brain. A damaged liver cannot remove toxins from the blood, causing them to accumulate in the blood and eventually the brain. There, toxins can dull mental functioning and cause personality changes, coma, and even death. Signs of the buildup of toxins in the brain include neglect of personal appearance, unresponsiveness, forgetfulness, trouble concentrating, or changes in sleep habits.
• Sensitivity to medication. Cirrhosis slows the liver's ability to filter medications from the blood. Because the liver does not remove drugs from the blood at the usual rate, they act longer than expected and build up in the body. This causes a person to be more sensitive to medications and their side effects.
• Portal hypertension. Normally, blood from the intestines and spleen is carried to the liver through the portal vein. But cirrhosis slows the normal flow of blood through the portal vein, which increases the pressure inside it. This condition is called portal hypertension.
• Varices. When blood flow through the portal vein slows, blood from the intestines and spleen backs up into blood vessels in the stomach and esophagus. These blood vessels may become enlarged because they are not meant to carry this much blood. The enlarged blood vessels, called varices, have thin walls and carry high pressure, and thus are more likely to burst. If they do burst, the result is a serious bleeding problem in the upper stomach or esophagus that requires immediate medical attention.
• Insulin resistance and type 2 diabetes. Cirrhosis causes resistance to insulin. This hormone, produced by the pancreas, enables blood glucose to be used as energy by the cells of the body. If you have insulin resistance, your muscle, fat, and liver cells do not use insulin properly. The pancreas tries to keep up with the demand for insulin by producing more. Eventually, the pancreas cannot keep up with the body's need for insulin, and type 2 diabetes develops as excess glucose builds up in the bloodstream.
• Liver cancer. Hepatocellular carcinoma, a type of liver cancer commonly caused by cirrhosis, starts in the liver tissue itself. It has a high mortality rate.
• Problems in other organs. Cirrhosis can cause immune system dysfunction, leading to infection.
• Fluid in the abdomen (ascites) may become infected with bacteria normally present in the intestines. Cirrhosis can also lead to impotence, kidney dysfunction and failure, and osteoporosis.
  

(source: http://digestive.niddk.nih.gov/ddiseases/pubs/cirrhosis/ )