A
​​Ablation - Where doctors use heat to destroy tumors, usually smaller than 4cm across, that started in the liver (primary liver cancer). The two types of thermal ablation for liver cancer are: radiofrequency ablation (RFA) and microwave ablation (MWA). (see Hepatocellular carcinoma)
Acute - Sudden and severe.
​Acute hepatic necrosis - When tissue in the liver dies. Possible reasons include acute infections and reactions to drugs, medicines, or toxins.
​Acute kidney injury (AKI) - A sudden episode of kidney failure or kidney damage that happens within a few hours or a few days. AKI causes a build-up of waste products in your blood and makes it hard for your kidneys to keep the right balance of fluid in your body. A common complication of decompensated cirrhosis and portal hypertension. Dialysis may be needed to help replace kidney function until your kidneys recover. (see Decompensated cirrhosis, Dialysis, Portal hypertension)
Acute liver failure - Develops rapidly, typically over days to a few weeks. The liver suddenly begins to lose its ability to function, often after an overdose of medicine or poisoning. In the U.S., the most common cause is taking too much acetaminophen (Tylenol and others).
Addiction - A chronic, relapsing, treatable medical disease involving complex interactions among genetics, brain circuits, environment, and an individual's life experiences. Characterized by using substances or engaging in behavior that becomes compulsive and continues despite harmful consequences.
Advance directive - A document stating your medical wishes in the event you can't speak for yourself. An advance directive can guide medical decisions made by your health care providers. It can also provide direction for your loved ones and ensure your medical wishes are followed.
Alagille syndrome - An inherited condition in which bile builds up in the liver because there are too few bile ducts to drain the bile. This results in liver damage.
Alanine aminotransferase (ALT) and Aspartate aminotransferase (AST) - Enzymes produced mainly in the liver. Vital indicators of liver function on blood tests.
Albumin - A protein made in the liver that assists in maintaining blood volume in the arteries and veins. If the liver is damaged, then the albumin can drop to very low levels, which may cause fluid to leak into the tissues from the blood vessels, resulting in edema or swelling. (see Ascites, Edema)
Alcohol-related liver disease (ARLD/ALD) - Damage to the liver and its function due to alcohol abuse. Alcoholic liver disease occurs after years of heavy drinking. Over time, scarring and cirrhosis can occur. Some people may have an inherited risk for the disease. (see Cirrhosis)
Alcohol use disorder (AUD) - A medical condition characterized by an impaired ability to stop or control alcohol use despite adverse social, occupational, or health consequences. It encompasses the conditions that some people refer to as alcohol abuse, alcohol dependence, alcohol addiction and alcoholism. The most common form of substance use disorder (SUD) in the United States, fueled by widespread access and social acceptance of alcohol consumption.
Alkaline phosphatase (ALP/ALK-PHOS) - An enzyme produced in the bile ducts and elsewhere in the body.
Alpha-1 antitrypsin deficiency - A condition in which the body does not make enough of AAT, a protein that protects the lungs and liver from damage. The condition can lead to chronic obstructive pulmonary disease (COPD) and liver disease (cirrhosis). The most common genetic cause of chronic liver disease among children. (see Chronic liver disease)
Ammonia - A waste product that your intestines make when they digest protein. Your liver is responsible for transforming ammonia into urea. If your liver is damaged or diseased, it may not be able to properly process ammonia, which then leads to ammonia buildup in your blood and brain. (see Hepatic encephalopathy)
Angiogram - A test using X-rays to see blood vessels and detect blockages or other problems in the vessels. It can be used to see the blood vessels which supply the liver. A dye (contrast) is injected into the blood vessel to make the blood flow visible on an X-ray.
Anticoagulants - Sometimes called "blood thinners", a family of medications that prevent your blood from clotting too easily. They can breakdown existing clots or prevent clots from forming in the first place.
Ascites - A large, abnormal accumulation of fluid in the abdomen that can occur due to cirrhosis, liver cancer and liver failure. Abdominal pain, discomfort and difficulty breathing may occur when too much fluid accumulates in the abdomen or moves up to the space around the lungs. Symptoms include: swollen stomach, hands, ankles, feet, face- 'bloating'. (see Distension, Portal hypertension)
Atresia - Blocked, destroyed, or missing. (see Biliary atresia)
Autoimmune hepatitis (AIH) - Liver inflammation that occurs when the immune system attacks the liver. Cause is unknown. When treated early, can often be controlled with medications that suppress the immune system. In rare cases, a liver transplant may be needed.
A1C (hemoglobin A1C) test - A blood test used to measure average blood sugar (glucose) levels over the past two to three months. One of the commonly used tests to diagnose diabetes.
​
B
Banding - A treatment for esophageal varices that are at risk of bursting. Surgical elastic bands are placed around the varices during an endoscopy. (see Varices)
Benign liver tumors - Abnormal growths or masses. When a tumor is not a cancer, it is called benign. There are three main types of benign liver tumors: (1) adenomas, (2) hemangiomas, and (3) focal nodular hyperplasia (FNH). Most benign liver tumors do not have symptoms and are found incidentally on an ultrasound, CT scan or MRI. If the mass grows and pushes on other organs, it can cause upper abdominal pain, particularly on the right side. Can also cause a sense of fullness after eating. Most tumors can be monitored with imaging studies. Surgery requires removing the tumor completely, called a liver resection.
Bile - A green/yellow fluid that is made and released by the liver and stored in the gallbladder. Bile helps with digestion. It breaks down fats into fatty acids, which can be taken into the body by the digestive tract.
Bile ducts - A series of thin tubes that go from the liver to the small intestine, which allow a fluid called bile to travel from the liver and gallbladder into the small intestine, where it helps digest fats.
Biliary atresia - A condition in infants in which the bile ducts outside and inside the liver are scarred and blocked. Bile can't flow into the intestine, so bile builds up in the liver and damages it. The damage leads to scarring, loss of liver tissue and function and cirrhosis. Most common reason for a liver transplant in children. (see Cirrhosis)
Biliary tract - The system of tubes which carry bile from the liver and gallbladder and drain into the intestine.
Bilirubin - The yellow pigment in bile that is made during the breakdown of red blood cells. Bilirubin passes through the liver and is eventually excreted out of the body. Higher than usual levels of bilirubin may indicate different types of liver or bile duct problems. (see Jaundice)
Biopsy (liver) - A procedure to remove a small sample of liver tissue, so it can be examined for signs of damage or disease.
Budd-chiari syndrome (BCS) - A condition in which the hepatic veins are blocked or narrowed by a clot (mass 0f blood cells). This blockage causes blood to back up into the liver and as a result, the liver grows larger. The spleen may also grow larger.
C
Cannula - A short, soft, narrow plastic tube temporarily put into a vein so medicines, fluids, blood etc. can be given intravenously (IV) as needed.
CellCept® (Mycophenolate mofetil) - A prescription medicine to prevent rejection (anti-rejection medication) in people who have received a kidney, heart or liver transplant. (see Mycophenolate mofetil, Immunosuppressed, Rejection)
Central venous catheter (CVC) - A thin, flexible tube inserted into a vein, usually below the right collarbone and guided (threaded) into a large vein above the right side of the heart called the superior vena cava. It is used to give intravenous fluids, blood transfusions, chemotherapy, dialysis and other drugs. The catheter is also used for taking blood samples. It may stay in place for weeks or months and helps avoid the need for repeated needle sticks. A peripherally inserted central catheter (PICC) is one type of central venous catheter. (see Dialysis)
Cholangiocarcinoma - Cancer of the bile ducts. (see Bile ducts)
Cholangiogram - The injection of dye into the bile ducts, either directly or through a T-tube, to see if bile is flowing into the intestine. (see T-tube)
Cholangitis - Inflammation or infection of bile ducts which can cause poor bile flow from the liver and liver damage.
Cholestasis - Reduction or blockage of bile flow.
Chronic - An illness or condition which lasts over a period of time.
Chronic hepatitis - Inflammation of the liver that lasts over a period of time. Liver cells may be destroyed by the inflammation. (see Hepatitis)
Chronic kidney disease (CKD) - A condition characterized by a gradual loss of kidney function over time. Medications help manage symptoms. In advanced stages, filtering the blood with a machine (dialysis) or a kidney transplant may be needed. (see Dialysis)
Chronic liver disease (CLD) - A progressive deterioration of liver function over a period of months to years. Also called end-stage liver disease (ESLD). The most common causes are viral infections (hepatitis), long-term alcohol abuse, genetic (inherited) disorders, or liver cancer. (see Cirrhosis, Hepatitis, Hepatocellular carcinoma)
Cirrhosis - A chronic scarring and degeneration of the liver cells. Many different diseases can cause cirrhosis. Cirrhosis of the liver has four stages: (1) Inflammation, (2) Fibrosis, (3) Cirrhosis, and (4) Liver failure.
Coagulopathy - Refers to any condition where the blood cannot clot properly.
CT/CAT scan (Computerized axial tomography) - A three-dimensionaI X-ray picture of the internal organs used to detect a mass, an abscess, tissue damage, or bleeding in the body.
Corticosteroids (Steroids) - Anti-inflammatory medicine. Following liver transplantation, standard treatment to prevent rejection generally involves a combination of corticosteroids and immunosuppressant medications. (see Prednisone, Cellcept/Mycophenolate mofetil, Prograf/Tacrolimus, Rejection)
Cotrimoxazole (Bactrim DS, Septra DS) - An important medication prescribed post-transplant to prevent dangerous infection.
Creatinine - A chemical waste product of creatine, an amino acid made by the liver and stored in the liver. Elevation in creatinine can indicate the presence of either an acute kidney injury (AKI) or chronic kidney disease (CKD). Acute kidney injury is a common complication after liver transplantation. Patients with cirrhosis typically have decreased creatinine levels, due to liver disease, muscle wasting and malnutrition. (see Acute kidney injury, Chronic kidney disease)
Cyclosporine - An immunosuppressive medication used to prevent organ rejection after a kidney, heart or liver transplant. Also used to treat severe psoriasis or severe rheumatoid arthritis. (see Immunosuppressed, Rejection)
Cystic - Relating to the gallbladder.
​
D
Decompensated cirrhosis - An acute deterioration in liver function in a patient with cirrhosis, characterized by jaundice, ascites, hepatic encephalopathy, hepatorenal syndrome, or variceal hemorrhage. (see Ascites, Cirrhosis, Hepatic encephalopathy, Hepatorenal syndrome, Jaundice, Varices)
DEXA exam - A bone density test that can gauge your risk of osteoporosis. Liver disease is associated with bone loss.
Diabetes - A chronic health condition that affects how your body turns food into energy. There are three main types: Type 1, Type 2, and Gestational diabetes (diabetes while pregnant). Diabetes raises your risk of non-alcoholic fatty liver disease (NAFLD). (see NAFLD, NASH)
Dialysis (Hemodialysis) - A procedure that involves diverting blood to a machine to be cleaned. This is to remove waste products and excess fluid from the blood when the kidneys stop working properly. Often used as a treatment in patients with liver failure. (see Acute kidney injury, Hepatorenal syndrome)
Distension - Expansion or enlargement. For example, ascites causes abdominal distension and weight gain.
Duct - A tube which fluid can pass through from one part of the body to another, e.g. bile ducts.
E
Echocardiogram (Echo) - A test that uses high frequency sound waves to create a moving picture of the heart and determine how effectively the heart is pumping.
Edema - A condition in which the body retains too much fluid in the tissues, especially in the hands, legs, ankles and feet. A symptom associated with advanced liver disease. (see Cirrhosis)
Electrocardiogram (ECG) - Records the electrical activity of the heart.
Encephalopathy - Changes in the brain seen in advanced liver disease and liver failure, due to the buildup of ammonia (toxins) in the blood and brain. Can cause confusion, tiredness, irritability, changes in behavior, coordination, speech, thinking ability and consciousness. If left untreated, can lead to coma and death. (see Ammonia, Hepatic encephalopathy)
End-stage liver disease (ESLD) - When the liver is damaged beyond repair due to chronic liver disease or acute liver failure. Most often, the result of cirrhosis, a condition in which scar tissue replaces healthy liver tissue until the liver cannot function adequately. Patients with abnormal liver function who develop ascites, vericeal hemorrhage, hepatic encephalopathy, or renal impairment are considered to have end-stage liver disease.
Endoscopic retrograde cholangiopancreatography (ERCP) - An endoscopic procedure used to identify the presence of tumors, stones, or narrowing in the biliary and pancreatic ducts.
Endoscopy - A small, telescope-like instrument that can be inserted into the esophagus, stomach and part of the small intestine. Used to look at the upper end of the digestive system. Inserted through the mouth and down the esophagus (food pipe).
Evaluation process (liver transplant) - Transplant centers in the United States evaluate the suitability of potential transplant candidates using listing criteria developed by transplant programs. The transplant evaluation process involves reviewing medical history, verifying health insurance benefits, social support, diagnostic tests, blood work, imaging scans, radiology, consults and exams. Most assessments are done on an outpatient basis, customized to each patient's medical condition. The process takes several days, depending on which tests and screenings are needed. If the transplant team determines you are a candidate for transplant, they will add you to the UNOS national waiting list. (see Transplant waiting list, UNOS)
Exception scores (points) - A separately assigned score that may be an option for liver transplant candidates whose medical circumstances require special attention, where a MELD score does not accurately predict their short-term transplant need. To qualify for a standard exception, the liver transplant program needs to document that the patient's medical condition meets criteria outlined in OPTN policy. (see Model for end-stage liver disease (MELD score), Organ procurement and transplantation network (OPTN), Transplant waiting list)
F
Fibrosis - Thickening or scarring of tissue that replaces normal tissue. Fibrosis is the second stage of cirrhosis. Some fibrosis may be treatable and reversible. (see Cirrhosis)
Fluconazole (Diflucan) - A medication prescribed to prevent dangerous infection after liver transplantation.
G
Gabapentin - A medicine prescribed to treat nerve pain associated with liver disease. (see Peripheral neuropathy)
Gallbladder - A small, pear-shaped organ in your upper right abdomen, that stores and releases bile to help your digestive system break down fats. During liver transplant surgery, the gallbladder attached to the donor liver will be detached to prevent gallstones from forming and causing problems with your new liver, and your gallbladder will also be removed. (see Liver transplant)
Gallstones - Pebble-like objects formed by bile that can cause severe pain and may pass into the common bile duct and cause cholangitis or obstructive jaundice. (see Cholangitis, Obstructive jaundice)
Gastroenterology - The study of the digestive system and its disorders. A gastroenterologist (also called a GI doctor) specializes in treating and preventing diseases in the gastrointestinal or digestive tract.
General anesthesia - A method of medically inducing unconsciousness during surgery. Medicine is either inhaled through a breathing mask or given through an intravenous (IV) line.
Glomerular filtration rate (GFR) - A test used to check how well the kidneys are functioning.
Graft - An organ, tissue, or cells used for transplantation.
Gynecomastia - A condition of overdevelopment or enlargement of the breast tissue in men. Medically attributed to hormonal imbalance, especially of estrogen, due to the poor functioning of the liver. Condition can result from cirrhosis, hormonal imbalance, or certain medications. (see Cirrhosis)
H
Hemochromatosis - A hereditary disorder in which extra iron builds up in the body to harmful levels. The liver is the organ most affected by hemochromatosis. Without treatment, cirrhosis is a major complication of iron overload. (see Cirrhosis)
Hepatic - Referring to the liver.
Hepatic artery - A soft, oxygenated blood vessel that supplies oxygen-rich blood to the liver, duodenum (first part of the small intestine immediately beyond the stomach) and pancreas.
Hepatic encephalopathy (HE) - A reversible complication brought on by advanced liver disease and liver failure. When the liver doesn't function properly, toxins (ammonia) build up in the blood. These toxins can travel to the brain and affect brain function, mood, behavior, speech and coordination. Treatments can remove the toxins and alleviate the debilitating symptoms. As liver disease progresses, 'ammonia brain' (HE) may worsen and become less treatable. Some people with advanced HE lose consciousness and go into a hepatic coma. If left untreated, HE can lead to coma and death. (see Lactulose, Rifaximin)
Hepatic veins - Blood vessels that carry low-oxygen blood from the liver back to the heart.
Hepatitis - Inflammation of the liver. Liver inflammation can be caused by several viruses, chemicals, drugs, alcohol, certain genetic disorders, or an overactive immune system that mistakingly attacks the liver, called Autoimmune hepatitis (AIH).
Hepatitis A (HAV) - One of several viral infections that can affect your liver. Causes acute liver inflammation and symptoms can last for several months, but eventually goes away without treatment. Transmission is mostly by fecal-to-oral route.
Hepatitis B (HBV) - Viral infection spread through bodily fluids. Most people only have a brief, acute infection, which causes inflammation of the liver. For some people, it becomes chronic, which can cause serious long-term damage to the liver. Hepatitis B is preventable with a vaccine, but has no cure.
Hepatitis C (HCV) - A virus that causes chronic liver inflammation and long-term damage. Transmission commonly occurs through infected needles. Treatable with new antiviral medications, but many people don't know they're infected. May not have symptoms until liver disease progresses to liver failure. (see Liver failure)
Hepatitis D (HDV) - Occurs among people infected with the Hepatitis B virus. Transmission requires contact with infectious blood. At-risk populations include intravenous drug users and people who have received multiple blood transfusions. There are few treatments specifically for Hepatitis D. Management focuses on supportive care.
Hepatitis E (HEV) - Mainly transmitted through drinking water contaminated with fecal matter. In rare cases, it may progress to acute liver failure. Usually resolves on its own within 4-6 weeks. Treatment includes rehydration, rest, and supportive care.
Hepatocellular carcinoma (HCC) - The most common type of primary liver cancer. Primary liver cancer is a disease in which malignant (cancer) cells form in the tissues of the liver. Occurs most often in people with chronic liver diseases, such as cirrhosis caused by hepatitis B or hepatitis C infection. Treatment will depend on the size and location, how well the liver is functioning and overall health.
Hepatology - The study, prevention, diagnosis and management of diseases that affect the liver, gallbladder and pancreas. Hepatologists are medical doctors who diagnose, treat and manage conditions associated with the liver, gallbladder, bile ducts and pancreas.
Hepatorenal syndrome (HRS) - A unique type of acute kidney injury (AKI) and a life-threatening complication of advanced liver disease that affects your kidney function. It comes on suddenly, without any previous kidney disease or changes to the kidneys themselves. Kidneys may be healthy, but they lose the ability to function because their blood supply has been compromised. Requires urgent medical intervention. (see Acute kidney injury, Dialysis)
HIDA scan - A test that helps measure general liver function and determines whether there are any blockages of the bile ducts. During the test, a special dye (contrast) is injected into an arm vein to track its progress through the liver, bile ducts, gallbladder and pancreas.
Hypo/hypertension - Low/high blood pressure. Hypotension is a well-known complication in patients with cirrhosis, mainly stemming from portal hypertension. (see Portal hypertension)
I
Immune response - The body's attempt to protect itself from bacteria, viruses and other materials that appear foreign to the body, such as a transplanted liver. Anti-rejection (immunosuppressive) medications are used to try to control the body's immune response to a transplanted liver.
Immunosuppressed (Immunocompromised) - Having a weakened immune system. People who are immunocompromised have a reduced ability to fight infections and other diseases. After transplant, immunosuppressant (anti-rejection) medications are taken for life, to prevent rejection of the new organ. These anti-rejection medications lower the body's immune system by making it less active. (see CellCept/Mycophenolate mofetil, Prograf/Tacrolimus)
Inflammation - In the early stages of liver disease, the liver will become swollen or inflamed as the body's natural response to injury. Liver inflammation can also occur when there are more toxins in the blood than the liver is able to manage. Inflammation is the first stage of cirrhosis.
INR (International normalised ratio) - A type of calculation based on Prothrombin time (PT) test results. A PT/INR test helps diagnose the cause of bleeding or clotting disorders. Also checks to see if a medicine that prevents blood clots is working the way it should. (see Prothrombin time (PT) test)
Intubated - Process where a healthcare provider inserts a tube through a person's mouth or nose, then down into their trachea (airway/windpipe). The tube keeps the trachea open so that air can get through. The tube connects to a machine that delivers air or oxygen. Patients with end-stage liver disease (ESLD) have an increased risk of prolonged intubation, and increased ventilator-related infection.
J
Jackson-pratt (JP) drain - May be placed during transplant surgery into the abdominal cavity to collect fluids. This drain is attached to a bag or bulb outside the body. Once drainage is minimal, it is usually removed before discharge from the hospital.
Jaundice - A yellowing of the skin and/or whites of the eyes, membranes and body secretions caused by increased levels of bilirubin. Jaundice occurs when a diseased liver doesn't remove enough bilirubin from the blood. (see Bilirubin, Cirrhosis)
L
Lactulose - A medication prescribed by doctors to reduce the amount of ammonia in the blood of patients with advanced liver disease. (see Hepatic encephalopathy)
Lasix® (furosemide) - A water pill (diuretic) sometimes used in combination with Spironolactone to manage ascites in cirrhosis patients. (see Ascites, Cirrhosis, Spironolactone)
Liver failure - Occurs either suddenly (acute), or gradually (chronic)- also called end-stage liver disease (ESLD). Acute liver failure can be caused by hepatitis; it can also be caused by taking too much acetaminophen, Autoimmune disease, and Wilson disease. Sometimes the cause is unknown. Chronic liver failure progresses over months, years, or decades. In many cases, chronic liver failure results from cirrhosis. Liver failure happens when large parts of the liver become damaged beyond repair and the liver can't function properly anymore. Treatment can help but this condition can't be cured. Treatment options may include medications, dietary changes, or a liver transplant. (see Cirrhosis)
Liver transplant - A complex surgery that removes a diseased liver that no longer functions properly and replaces it with a healthy liver from a deceased donor, or a portion of a healthy liver from a living donor. A life-saving gift.
Living donor - A healthy living person who donates a part of their liver to someone whose liver is no longer functioning properly. The donor's remaining liver regenerates to its original size within a couple months, and the transplanted liver section grows into a normal sized, fully functioning liver in the recipient. Living donor liver transplants may be an option for some patients. Discuss with your hepatologist and transplant coordinator.
M
Magnesium - An essential mineral that plays a major role in muscle function, the nervous system and energy production. Patients with cirrhosis usually have low magnesium levels. It's also common for liver transplant recipients to experience low magnesium levels, due to taking certain anti-rejection medications. Magnesium supplements may be prescribed.
Magnetic resonance imaging (MRI) - A noninvasive scan of the body using a large magnet and radio waves to produce detailed images of internal structures in the body, including: organs, bones, muscles and blood vessels.
Metabolic associated fatty liver disease (MAFLD) - An umbrella term, formally known as NAFLD, for conditions caused by the build-up of extra fat in the liver that is not caused by alcohol intake.
Metabolic dysfunction-associated steatohepatitis (MASH) - A chronic, often considered "silent", progressive, and potentially life-threatening liver disease. Caused by a build-up of excess fat in the liver (steatosis), MASH is characterized by liver inflammation and ballooning, with or without fibrosis. Formally known as NASH.
Malnutrition - A common finding in end-stage liver disease (ESLD), leading to a loss of muscle mass, bone loss and an increase in frailty.
Model for end-stage liver disease (MELD score) - Helps determine how urgently a patient needs a liver transplant within the next three months. Score ranges from 6 to 40, based on blood tests that show how well your body is functioning. Your score may go up or down over time as your liver disease either worsens or improves. Your score may be recalculated a number of times while you are on the transplant waiting list. The sicker a patient is, the higher the MELD score. Although, a significant number of patients are sicker than what their MELD score can represent. Therefore, patients with a low MELD score should still be considered for a liver transplant. Approval of MELD exception points may be appropriate in some cases. (see Exception scores)
Multiple listing - Involves registering at two or more transplant hospitals. Since candidates at hospitals local to the donor hospital are often considered ahead of those who are more distant, multiple listing may increase your chances or receiving a local organ offer. Many factors affect how long you might wait for a transplant. OPTN policy allows multiple listing, however, it will still be up to the individual hospital to decide whether to accept you as a candidate. Ask the transplant team how they handle such requests. (see Transplant candidate, Transplant waiting list)
Multivisceral transplant (MVT) - When the liver, small intestine, and other abdominal organs (for example, the stomach and pancreas) are transplanted at the same time.
Mycophenolate mofetil - Generic for CellCept®, a prescription medicine for people who have had a kidney, heart or liver transplant. Can help prevent rejection of the transplanted organ. After transplant, you may take several of these anti-rejection medications to keep your immune system from rejecting the transplanted organ. (see CellCept, Immunosuppressed, Rejection).
N
Naltrexone - A medication to treat both alcohol use disorder (AUD) and opioid use disorder (OUD), to help achieve abstinence and decrease cravings.
Nasogastric tube (NG tube) - A special tube that carries food and medicine to the stomach through the nose.
Nephrology - The branch of medicine that concerns the study of the kidneys, preservation of kidney health and the treatment of kidney diseases. A nephrologist is a medical doctor who specializes in diagnosing and treating kidney conditions.
Non-alcoholic fatty liver disease (NAFLD) - Now known as MAFLD, an umbrella term that encompasses the entire spectrum of fatty liver disease.
Non-alcoholic steatohepatitis (NASH) - Now known as MASH, defined as the liver manifestation of a metabolic disorder. The most severe form of non-alcoholic liver disease (NAFLD), but its symptoms are often silent, making it difficult to diagnose. NASH is heavily influenced by lifestyle (e.g., chronic excessive calorie intake, sedentary activity) and is distinct from other fatty liver diseases caused by alcohol abuse or medication side effects.
O
Obstructive jaundice - A specific type of jaundice, where symptoms develop due to a narrowed or blocked bile duct, preventing the normal drainage of bile from the bloodstream into the intestines. (see Jaundice)
Opioid use disorder (OUD) - A complex illness characterized by compulsive use of opioid drugs even when the person wants to stop, or when using the drugs negatively affects the person's physical and emotional well-being. Use of legally prescribed or illegal opioid medications may lead to an opioid use disorder. OUD is a public health crisis in the United States.
Organ donation - The process of surgically removing an organ or tissue from one person (the donor) and placing it into another person (the recipient). Transplantation is necessary because the recipient's organ has failed, or has been damaged by disease or injury and is beyond repair. One deceased donor can save up to eight lives.
Organ procurement and transplantation network (OPTN) - The OPTN helps create and define organ allocation and distribution policies that make the best use of donated organs. This process involves continuously evaluating new advances and discoveries so policies can be adapted to best serve patients waiting for transplants. All transplant programs and organ procurement organizations throughout the country are OPTN members and are obligated to follow the policies the OPTN creates for allocating organs. (see UNOS (United network for organ sharing)).
P
Pantoprazole (Protonix) - Often prescribed to patients with cirrhosis to prevent and treat upper gastrointestinal ulceration and bleeding. Commonly prescribed to liver transplant recipients as well, to treat gastrointestinal side effects, like heartburn, that are common under immunosuppressive therapy. (see Banding, Mycophenolate mofetil, Portal hypertension, Varices)
Paracentesis - A procedure that uses a hollow needle or plastic tube (catheter) to remove fluid from the abdominal cavity or belly. The fluid buildup (ascites) is caused by cirrhosis. (see Ascites, Cirrhosis)
Peripheral neuropathy (Neuropathy) - Symptoms include numbness or tingling in the hands and feet, often associated with advanced liver disease.
Petechiae - Small spots of blood leakage in the skin or membranes, often seen with poor clotting.
PEth blood test - Measures the level of phosphatidylethanol, a direct alcohol biomarker which is found in human blood following alcohol consumption.
Phlebotomist - A medical professional who is trained to draw blood.
Platelets - The cells that circulate within our blood and bind together when they recognize damaged blood vessels. Platelets can be low in people with liver disease.
Polymerase chain reaction (PCR) test - A test used to detect if a virus is present in the blood.
Portal gastropathy - Abnormal blood vessels in the stomach caused by portal hypertension. Enlarged veins (vascular ectasia) in the stomach and the esophagus (food pipe) are called varices. These blood vessels are more likely to burst due to thin walls and higher pressure. If they burst, severe, life-threatening bleeding can happen. Seek medical attention immediately. (see Portal hypertension, Varices)
Portal hypertension - High blood pressure in the veins of the liver caused by the damage and hardening of the liver around the veins. This high blood pressure forces blood to be rerouted to other veins so it can return to the heart. Cirrhosis is the most common cause of portal hypertension. Symptoms include: ascites, gastrointestinal bleeding marked by black, tarry stool or blood in stool, vomiting of blood due to rupture and hemorrhage from varices, low platelet count, low white blood cell count, low blood oxygen. (see Ascites, Varices)
Portal vein - Also called hepatic portal vein. An important blood vessel that delivers blood to the liver from the intestines, stomach, spleen and pancreas.
Prednisolone - A corticosteroid (cortisone-like medicine or steroid) used to treat a wide range of health problems, including many types of inflammatory liver diseases, such as autoimmune hepatitis.
Prednisone - Classified as a steroid, used to treat inflammatory liver diseases and to prevent rejection following liver transplantation. Used in combination with other medications. Can cause weight gain and blood sugar to increase. Can also cause confusion, mood disturbances and psychosis, which improves with dose reduction or discontinuation. Patients are gradually tapered off of Prednisone as liver function improves. (see Corticosteroids, SEROquel)
Primary biliary cholangitis (PBC) - A chronic and progressive condition that causes inflammation and, eventually, the destruction of the bile ducts that run through your liver. Bile backs up, causing liver damage. Medication can delay and sometimes prevent it. (see Bile, Cirrhosis)
Primary sclerosing cholangitis (PSC) - Commonly associated with ulcerative colitis. Condition is characterized by decrease in size of the bile ducts due to inflammation and fibrosis. (see Fibrosis, Cirrhosis)
Prograf® (Tacrolimus) - A prescription medicine used with other medications to help prevent rejection in people who have received a liver, kidney, heart, or lung transplant. Prograf/Tacrolimus suppresses your immune system to prevent your body from rejecting the transplanted organ. (see Immunosuppressed, Rejection)
Propranolol - Belongs to a group of medicines called beta blockers, used to reduce the chance of variceal bleeding in patients with cirrhosis. (see Portal hypertension, Varices)
Prothrombin time (PT) test - Measures how long it takes for a clot to form in a blood sample. An INR is a type of calculation based on PT test results. (see INR)
Pruritis - The medical term for itch/itchiness, a common symptom of liver disease. May be caused by high levels of bilirubin.
Pulmonary - Relating to the lungs.
Pulse oximeter - A device usually placed on the fingertip to measure the oxygen level (oxygen saturation) of the blood.
R
Rejection - The body's attempt to protect itself from foreign tissues, such as a new liver. Anti-rejection or immunosuppressive medications are used to prevent this. (see Cellcept/Mycophenolate mofetil, Prograf/Tacrolimus)
Renal - Refers to the kidneys.
Respiratory - Refers to breathing.
Rifaximin (Xifaxan®) - An antibiotic prescribed to stop bacterial growth. As a result, the body produces fewer toxins. Used to treat HE in patients with advanced liver disease. (see Hepatic encephalopathy, Lactulose)
Rounds - When the medical team visits each inpatient as a group to review the patient's status and care plan.
S
Sclerotherapy - A treatment of varicose (swollen) veins by injecting chemicals that cause hardening and clotting of the veins. Often done to prevent bleeding from the vessels into the esophagus or stomach. (see Varices)
Sengstaken-blakemore tube (Blakemore tube) - A medical device used in emergency medicine to manage upper gastrointestinal bleeding due to esophageal varices. (see Varices)
Sepsis - Severe infection in the bloodstream. A life-threatening medical emergency.
SEROquel (QUEtiapine) - Often prescribed to treat steroid-induced mania following liver transplantation. Has mood-stabilizing properties, as well as sedative properties. Additionally, may be administered in hospital as needed to treat aggression and agitation in patients with end-stage liver disease. (see Cirrhosis, Hepatic encephalopathy, Prednisone)
Spider angiomas - A collection of blood vessels under the surface of your skin that resembles a spider. Angiomas are red to purple marks on your skin. Multiple angiomas could be a sign of an underlying condition. Prevalence of spider angiomas is highest among patients with cirrhosis.
Spironolactone - A diuretic used to treat fluid buildup (ascites) and water retention (edema) and lower portal pressure in cirrhosis. (see Ascites, Cirrhosis, Lasix, Portal hypertension)
Spleen - An organ located on the upper left side of the abdomen that helps fight infection by filtering the blood.
Spontaneous bacterial peritonitis (SBP) - A term used to describe acute infection of ascites. Primarily occurs in patients with advanced cirrhosis. (see Ascites, Cirrhosis)
Status 1A - When patients have acute (sudden and severe) liver failure and are not likely to live more than a few days without a liver transplant. Must meet UNOS diagnostic criteria.
Status 7 - When potential transplant recipients on the transplant waitlist are listed "temporarily inactive". Potential recipients may be listed inactive for various reasons, including but not limited to: a change in one's current health, needing further tests, incomplete financial/insurance arrangements, non-compliant with medical instructions or follow-up, or travel. (see Transplant waiting list)
Steatotic liver disease (SLD) - Involves having excess fat in your liver. Metabolic conditions and heavy alcohol use are risk factors. Depending on the type of SLD, the fat buildup may not cause problems, or it may lead to liver damage. Often, you can prevent or even reverse SLD with medications and lifestyle changes.
Stress test - Involves walking on a treadmill or receiving medication to see how your heart works when it is working harder than normal. This will assist your physicians in deciding if your heart is strong enough for transplant surgery.
Substance use disorder (SUD) - A complex condition that involves a problematic pattern of substance use. It can range from mild to severe (addiction). SUD is treatable. It’s important to seek help as soon as possible if you think you, or your loved one, is developing SUD.
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T
Tacrolimus (Prograf) - Tacrolimus is an immunosuppressive medication that is taken to prevent organ rejection after transplant. Tacrolimus affects creatinine levels and kidney function, and can cause blood sugar to increase. Blood work is checked regularly to adjust the dosage for liver transplant recipients, if necessary. (see Immunosuppressed, Prograf, Rejection)
Thrombosis - The formation of a blood clot (partial or complete) within blood vessels, whether venous or arterial- venous vessels carry blood that is low in oxygen toward the heart, arterial vessels contain oxygenated blood away from the heart.
TIPS procedure (Transjugular intrahepatic portosystemic shunt) - A procedure performed by an interventional radiologist (IR) that uses image guidance to create new connections between two blood vessels in the liver. Involves inserting a metal mesh stent (tube) to connect the portal vein to one of the hepatic veins. This new pathway helps relieve the pressure of blood flowing through the diseased liver and can help stop bleeding and fluid buildup (ascites). When the liver is very damaged and there are blockages, blood cannot flow through it very easily. A TIPS procedure may be necessary. Development of Hepatic encephalopathy is the most common complication related to the procedure. (see Hepatic encephalopathy (HE), Portal hypertension, Varices)
TPN (Total parenteral nutrition) - When the IV administered nutrition is the only source of nutrition the patient is receiving. Indicated when there is impaired gastrointestinal function.
Transfusion - A medical procedure in which donated blood or blood products (plasma) are provided through a narrow tube placed within a vein in your arm. Your blood will be tested before a transfusion to determine your blood type (A, B, AB, O and whether your blood is Rh positive or Rh negative). Donated blood must be compatible with your blood type.
Transplant candidate - If you have a condition leading to organ failure, your doctor may recommend you for an organ transplant. A transplant hospital must evaluate and accept you for a transplant before you can be considered a transplant candidate. Each hospital uses its own criteria to decide whether or not to accept someone as a transplant candidate.
Transplant waiting list - A national list of all the people in the United States who need an organ transplant. If the hospital's transplant team decides you are a candidate for transplant, you are added to the UNOS national waiting list. Most transplant candidates usually wait for some length of time because there are not enough organs for all who need them. Donor organs are distributed locally first and if no match is found, they are offered regionally, then nationally, until a recipient is found. Criteria for matching donor organs with recipients includes medical urgency, blood type and size, genetic makeup, time on the waiting list, and proximity between the donor and recipient. (see Model for end-stage liver disease (MELD score), UNOS (United network for organ sharing))
T-tube - A small, soft tube that is temporarily inserted into the large bile duct to allow it to heal after liver transplant surgery without scarring and bile blockage.
U
Ultrasound - The use of sound waves to produce an image of the inside of the body. Often used to detect masses or abscesses, or to determine bile duct size and blood flow in the liver veins.
UNOS (United network for organ sharing) - A non-profit, scientific and educational organization that manages the only Organ Procurement and Transplantation Network (OPTN) in the United States, established by the U.S. Congress in 1984 by Gene A. Pierce, founder of UNOS. (see Organ procurement and transplantation network (OPTN))
Ursodiol (Actigall) - Used to treat cholestatic (slowing of bile flow) forms of liver disease including primary biliary cirrhosis (PBC). Also prescribed to help increase bile flow and reduce liver enzymes during the first weeks post-liver transplantation.
V
ValGANciclovir (Valcyte) - An effective antiviral medication prescribed for the prevention of CMV (Cytomegalovirus) disease in liver transplant recipients.
Varices - Swollen blood vessels often found in the stomach, esophagus and intestines when there is high pressure in the liver veins. Esophageal varices occur most often in people with cirrhosis or scarring of the liver. Usually there are no symptoms. People may experience bloating, difficulty swallowing, blood in stool or dark, tarry stool from digested blood. (see Banding, Portal hypertension)
W
Wilson disease - A rare inherited disorder that prevents the body from removing extra copper, causing copper to build up in the liver, brain, eyes and other organs. Wilson disease is typically treated with dietary changes and medications. Without treatment, high copper levels can cause life-threatening organ damage. A liver transplant may be necessary if other treatments are not effective or if liver failure occurs.