Liver Disease and Transplant: Q&A with Dr. Andrew Cameron

Liver Disease and Transplant: Q&A with Dr. Andrew Cameron


(light music)>>Liver transplant is
considered when a patient has end stage liver disease or cirrhosis. Cirrhosis in the United
States is most commonly caused by hepatitis C virus
infection or alcohol use, but there are other conditions that could also cause cirrhosis; auto-immune conditions like
primary sclerosing cholangitis or primary biliary cirrhosis. There are even conditions
that effect little kids like biliary atresia that can cause the need for a liver transplant. (light music) Unfortunately when a patient
becomes sick with a bad liver there aren’t great medical options, there aren’t great medicines, and there certainly is
no dialysis for the liver so a liver transplant becomes
the only and best option. In terms of liver transplant, there are basically two options. The first is to get a liver
transplant from a person who has passed away and
decided to donate their organs. That’s a whole liver
from a deceased owner. The other option is to
get half of a liver, a partial liver transplant,
from a living donor. (light music) We know that a living
donor partial transplant has excellent results equal
to that for a whole graft. The advantage would be
that you don’t have to wait for your liver transplant
if you have a living donor. There are 7,000 Americans on the liver transplant wait list now and the wait can be years and that can be very
difficult for sick patients. If you’re lucky enough to have
an appropriate living donor, you don’t have to wait on the list. (light music) The most exciting development
over the last couple of years in liver transplant is the arrival of powerful new anti-hep C meds. Hepatitis C used to be a very
difficult disease to treat. The medicines weren’t very good
and they were pretty toxic. Maybe two years ago we have
discovered new anti-virals. They are pills that are taken
once a day for 12 weeks. They cure hepatitis C 98% of the time and they are very well tolerated. This has entirely changed the game for liver transplantation for hepatitis C. Now many patients have had hepatitis C often for 20 years without knowing it, so clearing the virus, while
it’s wonderful, good news, may not prevent their need
for a liver transplant, but if they get a liver
transplant and take these meds, hepatitis C will not come
back after a liver transplant and that’s a huge improvement
in terms of how the liver will work and how long it will last. (light music) The biggest risk is not
getting your liver transplant. We know that it is incredibly difficult for patients on the wait list. We know with mathematical certainty that if they need a liver transplant and they don’t get one
they will die waiting. Liver transplant itself
certainly has it’s own risks, but for example, the one year survival after liver transplant is over 90%, so if you get a liver transplant
the odds are very much in your favor that a year later and far beyond you’ll be alive and well. Specifically we always
worry about infection after a liver transplant
because you have to take meds so that you don’t reject your new liver, those cause immunosuppression. We worry about bleeding
during a liver transplant, but for the most part,
complications are very well handled and long term success is the
rule after a liver transplant. (light music) Patients with liver
disease are very complex and they benefit from a team approach. They don’t need just a surgeon, they need an entire team, a team with a hepatologist, a dietician, a pharmacist, a social
worker, a psychologist. We know that when patients have an entire team results are better. Our goal is not just to
perform a liver transplant, it’s to restore sick patient to their normal state of
health and well-being. To make sure that the
patient really thrives we know that we do best with
a multi-disciplinary approach. (light music)

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