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What is liver disease and transplant?

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About liver disease and transplant

The liver acts like the chemical factory for our body. Whatever we eat and drink has to pass through the liver, and it’s the only organ that can provide fuel to our body when we haven’t eaten in awhile. We cannot survive without a working liver: It’s as important as our heart or lungs.

There are many different types of liver disorders that affect the liver in different ways, ranging from inflammation to build-up of bile to accumulation of fat in liver cells. Liver disease can damage this vital organ and eventually lead to liver failure and the need for a liver transplant.

What causes liver disease?

Liver disease can strike children for a wide variety of reasons. The most common cause of pediatric liver disease is obesity.

Babies may inherit liver disease, despite having healthy parents. Congenital problems in which the bile ducts don’t develop normally also can cause liver problems in babies. In addition, infections — including hepatitis A, B and C — and drug reactions may lead to childhood liver disorders.

How often does liver disease occur?

Congenital liver disease affects one in 2,500 children. Fatty liver disease is becoming more and more common due to the childhood obesity epidemic, affecting up to 10 percent of children. Between 400 and 500 children in the United States receive a liver transplant each year.

How does liver disease develop?

Some children are born with liver disease while others develop it later. Different liver disorders progress at different rates.

What are the symptoms of liver disease?

Symptoms vary but can include:

  • Jaundice
  • Fatigue
  • Low-grade fevers
  • Unexplained itching
  • Diarrhea
  • Distended abdomen
  • Poor weight gain

Who is at risk of developing this condition?

Children who are obese are at greater risk of developing liver disease. It can also be associated with a variety of genetic conditions, including hemochromatosis and alpha-1 antitrypsin deficiency. Children who have been adopted from parts of the world with higher rates of Hepatitis B or who have been exposed to drug use also face higher risk.

Why is liver disease a concern?

Although different liver disorders progress at different rates, liver disease can be life-threatening once it advances to liver failure. The liver is a vital organ.

How is liver disease diagnosed/evaluated?

Your child’s doctor will first review your child’s medical history and examine your child for signs of jaundice and an enlarged liver and spleen. Blood tests will show how your child’s liver is functioning. The doctor may also order an abdominal ultrasound to get a better look at the liver and sometimes do a biopsy to get samples of liver tissue that can be analyzed in the lab.

What is the treatment for liver disease?

Treatment varies by liver disorder, but it can include dietary management, nutritional supplementation, medications and surgery. To meet your child’s nutritional needs, the doctor may recommend one or more of the following:

  • Dietary management of obesity
  • High doses of vitamins
  • Special formulas to improve fat absorption
  • Dietary restrictions for ascites or encephalopathy
  • Special diets for metabolic liver diseases
  • Gastrostomy tube feeding
  • Intravenous nutrition

Chronic or acute liver failure or severe metabolic disorders may require a liver transplant.

What happens after treatment?

Some patients recover completely while others will continue to need ongoing care.

When should you contact a physician?

Talk to your pediatrician if your child seems inexplicably sick and isn’t getting better. Fatigue, frequent low-grade fevers, unexplained itching, jaundice, poor weight gain and a distended abdomen can all be signs of liver disease.

What is the long-term outlook for liver disease?

The outlook varies with the type of liver disorder, but the majority of pediatric liver disease cases can be successfully managed. Progressive liver disorders slowly get worse and may eventually require a liver transplant.

How do I live with liver disease?

Liver disease will affect your child’s life in significant ways. This condition can lead to decreased energy levels, decreased bone strength, poor growth and bleeding in the GI tract, and you may need to make lifestyle changes as a result.

For more information about this condition, visit the Children’s Liver Association for Support Services.

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