Liver transplant Health Dictionary

Liver Transplant: From 1 Different Sources


Replacement of a diseased liver with a healthy liver removed from a donor. Liver transplants are most successful in the treatment of advanced liver cirrhosis in people with chronic active hepatitis or primary biliary cirrhosis. People who have primary liver cancer are rarely considered for transplantation because there is a high risk that the tumour will recur.During this procedure, the liver, gallbladder, and portions of the connected blood and bile vessels are removed.

The donor organs and vessels are connected to the recipient’s vessels.

After the transplant, the recipient is monitored in an intensive care unit for a few days and remains in hospital for up to 4 weeks.

Health Source: BMA Medical Dictionary
Author: The British Medical Association

Liver

The liver is the largest gland in the body, serving numerous functions, chie?y involving various aspects of METABOLISM.

Form The liver is divided into four lobes, the greatest part being the right lobe, with a small left lobe, while the quadrate and caudate lobes are two small divisions on the back and undersurface. Around the middle of the undersurface, towards the back, a transverse ?ssure (the porta hepatis) is placed, by which the hepatic artery and portal vein carry blood into the liver, and the right and left hepatic ducts emerge, carrying o? the BILE formed in the liver to the GALL-BLADDER attached under the right lobe, where it is stored.

Position Occupying the right-hand upper part of the abdominal cavity, the liver is separated from the right lung by the DIAPHRAGM and the pleural membrane (see PLEURA). It rests on various abdominal organs, chie?y the right of the two KIDNEYS, the suprarenal gland (see ADRENAL GLANDS), the large INTESTINE, the DUODENUM and the STOMACH.

Vessels The blood supply di?ers from that of the rest of the body, in that the blood collected from the stomach and bowels into the PORTAL VEIN does not pass directly to the heart, but is ?rst distributed to the liver, where it breaks up into capillary vessels. As a result, some harmful substances are ?ltered from the bloodstream and destroyed, while various constituents of the food are stored in the liver for use in the body’s metabolic processes. The liver also receives the large hepatic artery from the coeliac axis. After circulating through capillaries, the blood from both sources is collected into the hepatic veins, which pass directly from the back surface of the liver into the inferior vena cava.

Minute structure The liver is enveloped in a capsule of ?brous tissue – Glisson’s capsule – from which strands run along the vessels and penetrate deep into the organ, binding it together. Subdivisions of the hepatic artery, portal vein, and bile duct lie alongside each other, ?nally forming the interlobular vessels,

which lie between the lobules of which the whole gland is built up. Each is about the size of a pin’s head and forms a complete secreting unit; the liver is built up of hundreds of thousands of such lobules. These contain small vessels, capillaries, or sinusoids, lined with stellate KUPFFER CELLS, which run into the centre of the lobule, where they empty into a small central vein. These lobular veins ultimately empty into the hepatic veins. Between these capillaries lie rows of large liver cells in which metabolic activity occurs. Fine bile capillaries collect the bile from the cells and discharge it into the bile ducts lying along the margins of the lobules. Liver cells are among the largest in the body, each containing one or two large round nuclei. The cells frequently contain droplets of fat or granules of GLYCOGEN – that is, animal starch.

Functions The liver is, in e?ect, a large chemical factory and the heat this produces contributes to the general warming of the body. The liver secretes bile, the chief constituents of which are the bile salts (sodium glycocholate and taurocholate), the bile pigments (BILIRUBIN and biliverdin), CHOLESTEROL, and LECITHIN. These bile salts are collected and formed in the liver and are eventually converted into the bile acids. The bile pigments are the iron-free and globin-free remnant of HAEMOGLOBIN, formed in the Kup?er cells of the liver. (They can also be formed in the spleen, lymph glands, bone marrow and connective tissues.) Bile therefore serves several purposes: it excretes pigment, the breakdown products of old red blood cells; the bile salts increase fat absorption and activate pancreatic lipase, thus aiding the digestion of fat; and bile is also necessary for the absorption of vitamins D and E.

The other important functions of the liver are as follows:

In the EMBRYO it forms red blood cells, while the adult liver stores vitamin B12, necessary for the proper functioning of the bone marrow in the manufacture of red cells.

It manufactures FIBRINOGEN, ALBUMINS and GLOBULIN from the blood.

It stores IRON and copper, necessary for the manufacture of red cells.

It produces HEPARIN, and – with the aid of vitamin K – PROTHROMBIN.

Its Kup?er cells form an important part of the RETICULO-ENDOTHELIAL SYSTEM, which breaks down red cells and probably manufactures ANTIBODIES.

Noxious products made in the intestine and absorbed into the blood are detoxicated in the liver.

It stores carbohydrate in the form of glycogen, maintaining a two-way process: glucose

glycogen.

CAROTENE, a plant pigment, is converted to vitamin A, and B vitamins are stored.

It splits up AMINO ACIDS and manufactures UREA and uric acids.

It plays an essential role in the storage and metabolism of FAT.... liver

Bone Marrow Transplant

The procedure by which malignant or defective bone marrow in a patient is replaced with normal bone marrow. Sometimes the patient’s own marrow is used (when the disease is in remission); after storage using tissue-freezing technique (cryopreservation) it is reinfused into the patient once the diseased marrow has been treated (autologous transplant). More commonly, a transplant uses marrow from a donor whose tissue has been matched for compatibility. The recipient’s marrow is destroyed with CYTOTOXIC drugs before transfusion. The recipient is initially nursed in an isolated environment to reduce the risk of infection.

Disorders that can be helped or even cured include certain types of LEUKAEMIA and many inherited disorders of the immune system (see IMMUNITY).... bone marrow transplant

Cod-liver Oil

Cod-liver oil is derived from the fresh liver of the cod (Gadus callarius). It is a rich source of vitamin D, used in the prevention and treatment of RICKETS, and of vitamin A. Human milk contains more than enough vitamin D for the breast-fed baby, provided the mother has a balanced diet with adequate exposure to sunlight, or is taking vitamin supplements during pregnancy and lactation if considered necessary. All baby foods in the UK contain added vitamins, and therefore supplementation is unnecessary until weaning begins, and the baby starts taking cow’s milk, which contains less vitamin D than human milk. (See APPENDIX 5: VITAMINS.)... cod-liver oil

Fetal Transplant

A procedure in which cells – for example, from the pancreas – are taken from an aborted FETUS and then transplanted into the malfunctioning organ (pancreas) of an individual with a disorder of that organ (in this case, diabetes). The cells from the fetus are intended to take over the function of the host’s diseased or damaged cells. Fetal brain cells have also been transplanted into brains of people suffering from PARKINSONISM. These treatments are at an experimental stage.... fetal transplant

Liver Fluke

Fasciola hepatica is a parasite infesting sheep and occasionally invading the bile ducts and liver of humans (see FASCIOLIASIS).... liver fluke

Liver Spots

A misnomer applied to the brown MACULES often seen on the backs of the hands of those chronically exposed to sunlight (see LENTIGO). They have no connection with any liver disorder.... liver spots

Liver – Abscess

May follow inflammation of the liver from a number of causes, the most common being a manifestation of amoebic dysentery. Through blood infection it may appear on the surface of the liver or other organs.

Symptoms: pain under the right lower rib which may be referred to the right shoulder or under shoulder blades.

Treatment. Official treatment is aspiration or opening-up the abscess followed by drainage. Whether or not this is necessary, alternative anti-bacterials such as Myrrh, Goldenseal, Echinacea and Blue Flag may be used with good effect.

Alternatives. Teas: Milk Thistle. Grape leaves. 1 heaped teaspoon to each cup of water, thrice daily. Decoctions: Echinacea, Blue Flag, Goldenseal, Parsley root. One heaped teaspoon to each cup water gently simmered 20 minutes. Half a cup thrice daily.

Tablets/capsules: Blue Flag, Echinacea. Goldenseal. Wild Yam. Devil’s Claw.

Tinctures. Formula. Fringe Tree 3; Meadowsweet 2; Goldenseal 1. One to two 5ml teaspoons, thrice daily.

Practitioner. Ipecacuanha contains emetine which is specific for liver abscess; at the same time it is effective as an anti-amoebic-dysentery agent. Where dysentery is treated with Ipecacuanha liver abscess is rare. Tincture Ipecacuanha BP (1973). Dose: 0.25-1ml.

Diet. Fat-free. Dandelion coffee. Vitamins B6, C and K. Lecithin.

Treatment by or in liaison with a general medical practitioner. ... liver – abscess

Transplantation

Transplantation of tissues or organs of the body are de?ned as an allotransplant, if from another person; an autotransplant, if from the patient him or herself – for example, a skin graft (see GRAFT; SKIN-GRAFTING); and a xenotransplant, if from an animal.

The pioneering success was achieved with transplantation of the kidney in the 1970s; this has been most successful when the transplanted kidney has come from an identical twin. Less successful have been live transplants from other blood relatives, while least successful have been transplants from other live donors and cadaver donors. The results, however, are steadily improving. Thus the one-year functional survival of kidneys transplanted from unrelated dead donors has risen from around 50 per cent to over 80 per cent, and survival rates of 80 per cent after three years are not uncommon. For a well-matched transplant from a live related donor, the survival rate after ?ve years is around 90 per cent. And, of course, if a transplanted kidney fails to function, the patient can always be switched on to some form of DIALYSIS. In the United Kingdom the supply of cadaveric (dead) kidneys for transplantation is only about half that necessary to meet the demand.

Other organs that have been transplanted with increasing success are the heart, the lungs, the liver, bone marrow, and the cornea of the eye. Heart, lung, liver and pancreas transplantations are now carried out in specialist centres. It is estimated that in the United Kingdom, approximately 200 patients a year between the ages of 15 and 55 would bene?t from a liver transplant if an adequate number of donors were available. More than 100 liver transplants are carried out annually in the United Kingdom and one-year-survival rates of up to 80 per cent have been achieved.

The major outstanding problem is how to prevent the recipient’s body from rejecting and destroying the transplanted organ. Such rejection is part of the normal protective mechanism of the body (see IMMUNITY). Good progress has been made in techniques of tissue-typing and immunosuppression to overcome the problem. Drugs are now available that can suppress the immune reactions of the recipient, which are responsible for the rejection of the transplanted organ. Notable among these are CICLOSPORIN A, which revolutionised the success rate, and TACROLIMUS, a macrolide immunosuppressant.

Another promising development is antilymphocytic serum (ALS), which reduces the activity of the lymphocytes (see LYMPHOCYTE) cells which play an important part in maintaining the integrity of the body against foreign bodies.

Donor cards are now available in all general practitioners’ surgeries and pharmacies but, of the millions of cards distributed since 1972, too few have been used. The reasons are complex but include the reluctance of the public and doctors to consider organ donation; poor organisation for recovery of donor kidneys; and worries about the diagnosis of death. A code of practice for procedures relating to the removal of organs for transplantation was produced in 1978, and this code has been revised in the light of further views expressed by the Conference of Medical Royal Colleges and Faculties of the United Kingdom on the Diagnosis of Brain Death. Under the Human Tissue Act 1961, only the person lawfully in possession of the body or his or her designate can authorise the removal of organs from a body. This authorisation may be given orally.

Patients who may become suitable donors after death are those who have suffered severe and irreversible brain damage – since such patients will be dependent upon arti?cial ventilation. Patients with malignant disease or systemic infection, and patients with renal disease, including chronic hypertension, are unsuitable.

If a patient carries a signed donor card or has otherwise recorded his or her wishes, there is no legal requirement to establish lack of objection on the part of relatives – although it is good practice to take account of the views of close relatives. If a relative objects, despite the known request by the patient, sta? will need to judge, according to the circumstances of the case, whether it is wise to proceed with organ removal. If a patient who has died is not known to have requested that his or her organs be removed for transplantation after death, the designated person may only authorise the removal if, having made such reasonable enquiry as may be practical, he or she has no reason to believe (a) that the deceased had expressed an objection to his or her body being so dealt with after death, or (b) that the surviving spouse or any surviving relative of the deceased objects to the body being so dealt with. Sta? will need to decide who is best quali?ed to approach the relatives. This should be someone with appropriate experience who is aware how much the relative already knows about the patient’s condition. Relatives should not normally be approached before death has occurred, but sometimes a relative approaches the hospital sta? and suggests some time in advance that the patient’s organs might be used for transplantation after death. The sta? of hospitals and organ exchange organisations must respect the wishes of the donor, the recipient and their families with respect to anonymity.

Relatives who enquire should be told that some post-mortem treatment of the donor’s body will be necessary if the organs are to be removed in good condition. It is ethical (see ETHICS) to maintain arti?cial ventilation and heartbeat until removal of organs has been completed. This is essential in the case of heart and liver transplants, and many doctors think it is desirable when removing kidneys. O?cial criteria have been issued in Britain to recognise when BRAIN-STEM DEATH has occurred. This is an important protection for patients and relatives when someone with a terminal condition

– usually as a result of an accident – is considered as a possible organ donor.... transplantation

Amoebic Liver Abscess (ala)

Abscess of the liver caused by Entamoeba histolytica and often containing socalled “anchovy sauce” fluid.... amoebic liver abscess (ala)

Blue Flag Tea For A Healthy Liver

Blue Flag tea has a long history in treating liver ailments: Native American tribes used to consume it for its hepatic properties. Blue Flag Tea description Blue flag is a perennial herb also known as the liver lily and the fleur-de-lis, native to North America. It has smooth spear-shaped leaves topped with a light bluish-purple flower. Blue flag plants grow in bunches and bloom during late June and early July. Blue Flag tea is the resulting beverage from brewing the abovementioned plant. Blue Flag Tea brewing To prepare Blue Flag tea, place 1 teaspoon of the dried roots in a cup of boiling water. Let it steep for 10 minutes. The tea can be consumed three times a day. Blue Flag Tea benefits Blue Flag has been successfully used to:
  • stimulate the liver and thus, it is helpful in the treatment of jaundice and hepatitis
  • fight impurities of the blood
  • fight against skin problems like acne and psoriasis
  • detoxify the body by increasing the production of bile, as well as frequency of urination
  • help treat indigestion
  • treat rheumatism
  • help in weight loss
Blue Flag tea can be an effective laxative, diuretic and as an emetic. It is also effective in reducing inflammation of the skin, decreasing the symptoms of skin infections. It is also good in treating burns, bruises and wounds. Blue Flag Tea side effects Until further studies are conducted, pregnant and nursing women should avoid intaking this type of tea. Blue Flag tea has proven its efficiency in dealing with severe liver-related diseases. Also, applied topically, it can treat skin problems, but not only.... blue flag tea for a healthy liver

Boldo Tea Is Benefic For The Liver

Boldo tea has a long medicinal history, according to recent archeological discoveries. It is a healthy choice for the liver, urinary tract and infections. Boldo Tea description Boldo is a tree found in the central region of Chile and near the Mediterranean. It is an evergreen shrub whose leaves are colored brown when dried and whose fruits are small green spheres. Apparently, boldo use dates back at least 10,000 years. Nowadays, people use this plant to aid digestion, cleanse the liver and increase bile production for gallbladder’s health. Boldo tea is the resulting beverage from brewing the abovementioned plant. Boldo Tea brewing To prepare Boldo tea:
  • Pour boiling water over 1 teaspoon of dried boldo leaves.
  • Let the mix infuse for about 10 to 15 minutes.
  • Drink it slowly.
Boldo tea can be drunk three times a day for short periods of time. Boldo Tea benefits Studies have shown that Boldo tea is efficient in:
  • treating urinary tract and bladder infections
  • helping in liver cleansing
  • helping alleviate heartburn
  • relieving discomfort in the gallbladder
  • helping treat mild stomach cramps
  • treating worm infections
  • helping in the treatment of cystitis
  • treating gonorrhea
Boldo Tea side effects Patients with severe liver or kidney disease or obstruction of the bile ducts are advised to avoid the use of Boldo tea. Pregnant and nursing women should not consume Boldo tea. Boldo tea is a medicinal beverage which proved its efficiency in dealing with liver cleansing and urinary tract infections. It is recommended to patients suffering from stomach cramps, but not only.... boldo tea is benefic for the liver

Bone Transplant

The insertion of a piece of bone from another site or from another person to ?ll a defect, provide supporting tissue, or encourage the growth of new bone.... bone transplant

Halibut-liver Oil

The oil expressed from fresh, or suitably preserved, halibut liver. It is a particularly rich source of vitamin A (30,000 international units per gram), and also contains vitamin D (2,300– 2,500 units per gram). It is available in capsules as a means of providing the two vitamins. (See APPENDIX 5: VITAMINS.)... halibut-liver oil

Bupleurum Tea: A Cure For The Liver

Bupleurum tea is largely known for its healing propertiesand its action against the growth and spreading of cancer cells. Bupleurum Tea description Bupleurum is a plant from the Apiaceae family, originating from Asia. The roots of Bupleurum are used in various healing mixtures throughout China and East Asia. Scientists have shown that this plant possesses anti-inflammatory constituents and may inhibit the growth of liver cancer cells. Both Japan and China medicinal industries use it in order to treat cancer and hepatitis. Bupleurum tea is the resulting beverage from brewing the abovementioned plant. Bupleurum Tea brewing Bupleurum tea can be prepared by combining dried and chopped bupleurum roots with hot water. After steeping the mixture for about 10 minutes, drink it slowly. Bupleurum herb can also be consumed as extracts and capsules. Buplerum Tea benefits Bupleurum tea has been successfully used to:
  • treat liver problems like hepatitis, cirrhosis and cancer
  • treat infections with fever
  • relieve chest congestion
  • treat indigestion
  • treat hemorrhoids
  • treat uterine and anal prolapse
  • treat diarrhea
  • help in overall efforts to treat HIV
Bupleurum Tea side effects Bupleurum tea is not recommended to pregnant and breastfeeding women. Bupleurum tea is a healthy beverage used efficiently to treat liver-related diseases. It has been also proven that this type of tea can fight free radicals, responsible for cancer cells growth, due to its content of antioxidants.... bupleurum tea: a cure for the liver

Heart-lung Transplant

An operation in which a patient’s diseased lungs and heart are removed and replaced with donor organs from someone who has been certi?ed as ‘brain dead’ (see BRAIN-STEM DEATH). As well as the technical diffculties of such an operation, rejection by the recipient’s tissues of donated heart and lungs has proved hard to overcome. Since the early 1990s, however, immunosuppressant drug therapy (see CICLOSPORIN; TRANSPLANTATION) has facilitated the regular use of this type of surgery. Even so, patients receiving transplanted hearts and lungs face substantial risks such as lung infection and airway obstruction as well as the long-term problems of transplant rejection.... heart-lung transplant

Human Organs Transplants Act

UK legislation that lays down the framework and rules governing organ transplantation. The UK Transplant Support Service Authority (UKTSSA), a special health authority set up in 1991, is responsible for administering the NHS Organ Donor Registry and the Act (see APPENDIX 7: STATUTORY ORGANISATIONS).... human organs transplants act

Peripheral-blood Stem-cell Transplants

These have almost completely replaced BONE MARROW TRANSPLANT, used to treat malignancies such as LEUKAEMIA and LYMPHOMA for the past 20 years. The high doses of CHEMOTHERAPY or RADIOTHERAPY used to treat these diseases destroy the bone marrow which contains stem cells from which all the blood cells derive. In 1989 stem cells were found in the blood during recovery from chemotherapy. By giving growth factors (cytokines), the number of stem cells in the blood increased for about three to four days. In a peripheral-blood stem-cell transplant, these cells can be separated from the peripheral blood, without a general anaesthetic. The cells taken by either method are then frozen and returned intravenously after the chemotherapy or radiotherapy is completed. Once transplanted, the stem cells usually take less than three weeks to repopulate the blood, compared to a month or more for a bone marrow transplant. This means that there is less risk of infection or bleeding during the recovery from the transplant. The whole procedure has a mortality risk of less than 5 per cent – half the risk of a bone marrow transplant.... peripheral-blood stem-cell transplants

Amoebic Liver Abscess

Usually contracted in a tropical country during foreign travel. Likely to be associated with amoebic dysentery by the organism Entamoeba histolytica from contaminated drinking water or decaying foods (uncooked vegetables), foods exposed to flies. Onset of the disease may not be apparent until years after original infection. It presents with tenderness over the liver. On palpation, liver area is tender and the diaphragm elevated.

Symptoms. Fever, sweating, constitutional upset.

Differential diagnosis: diverticulitis, Crohn’s disease, salmonella, carcinoma, bacillary dysentery.

Alte rnative s:– Blue Flag, Boneset, Burdock, Chaparral, Echinacea, Elecampane, Elder flowers, Eucalyptus, Fringe Tree, Milk Thistle, Marshmallow, Queen’s Delight, Thyme (garden), Wild Indigo, Wild Yam, Yarrow, Yellow Dock.

Tea. Combine: equal parts, Yarrow, Burdock leaves, Marshmallow leaves. 2 teaspoons to each cup boiling water: infuse 10-15 minutes; 1 cup freely.

Decoction. Echinacea 2; Fringe Tree bark 1; Yellow Dock root 1. 2 teaspoons to 2 cups water gently simmered 20 minutes. Half a cup freely.

Formula: Combine: Echinacea 2; Fringe Tree bark 1; Boneset 1; Goldenseal quarter. Dose: Liquid Extracts: 2-4ml. Tinctures: 4-8ml. Powders: 500mg (two 00 capsules, or one-third teaspoon). In water, honey, or cup of Fenugreek tea.

Cold puree. Pass Garlic corm through food blender. Eat with a spoon as much as tolerated. Blend with adjutants: carrots, raisins, apple. ... amoebic liver abscess

Little Liver Pills

For bilious headache, inactive liver, constipation.

Ingredients: Aloin gr. 1/10. Ipom resin gr. 1/10. Capsic gr. 1/50. Podoph. resin. gr. 1/10. Jalapin gr. 1/10. Olearesin. Ginger. gr. 1/70.

Dose: One or two pills at bedtime or after dinner.

Historical interest only. ... little liver pills

Liver – Hepatitis A

The most common cause of inflammation of the liver from a virus known as Hepatitis A. May be caught by eating shellfish contaminated by sewage or polluted water. Distinct from alcohol and drugs. The virus is ingested in the mouth, grown in the intestines and passes out of the body on defecation.

Treatment. Same as for acute infectious hepatitis. ... liver – hepatitis a

Liver – Hepatitis C

Paul Bergner describes 4 cases of patients with chronic hepatitis C successfully treated. All were given Milk Thistle, and prescribed an alternative tea: equal parts, Burdock, Dandelion, Barberry, Liquorice, Cinnamon and Fennel. Chologogue action is important in chronic liver disease. Not used in acute inflammation. All patients felt better within 2 weeks, and had liver function tests at 3-monthly intervals, showing a gradual decline in elevated values until normal or almost so. All patients became symptom-free. (Medical Herbalism, Vol 6, No 4) ... liver – hepatitis c

Organ Transplantation

See TRANSPLANTATION.... organ transplantation

Small-bowel Transplantantion

Before the advent of small-bowel transplants, long-term intravenous feeding (total parenteral nutrition or TPN) was the last option for patients with chronic intestinal failure. Most recipients are children, and small-bowel transplantation is currently reserved for patients unable to continue on long-term parenteral nutrition. The main constraints to small-bowel transplantation are the intensity of rejection (necessitating high levels of immunosuppression), and the lack of donors who are the same size as the recipient (a particular problem for children).... small-bowel transplantantion

Transplant Support Services Authority

In the UK, this NHS authority (UKTSSA) provides a 24-hour service for matching, allocating and distributing organs. It is also responsible for keeping the records of all patients awaiting transplants. Established in 1991, the authority allocates donor organs without favour, following protocols set by advisory groups. It also administers the Human Organ Transplant Act on behalf of the Department of Health. (See TRANSPLANTATION.)... transplant support services authority

Liver – Acute Yellow Atrophy

Necrosis. Fatal disease in which the substance of the liver is destroyed. Incidence is rare since the public has been alerted to the dangers of certain chemical toxins, fumes from synthetic glues, solvents, and poisonous fungi.

Symptoms: jaundice, delirium and convulsions.

As it is the work of the liver to neutralise incoming poisons it may suffer unfair wear and tear, alcohol and caffeine being common offenders.

Treatment for relief of symptoms only: same as for abscess of the liver.

Treatment by or in liaison with a general medical practitioner. ... liver – acute yellow atrophy

Liver Disease In The Tropics

ACUTE LIVER DISEASE The hepatitis viruses (A– F) are of paramount importance. Hepatitis E (HEV) often produces acute hepatic failure in pregnant women; extensive epidemics – transmitted by contaminated drinking-water supplies – have been documented. HBV, especially in association with HDV, also causes acute liver failure in infected patients in several tropical countries: however, the major importance of HBV is that the infection leads to chronic liver disease (see below). Other hepatotoxic viruses include the EPSTEIN BARR VIRUS, CYTOMEGALOVIRUS (CMV), the ?avivirus causing YELLOW FEVER, Marburg/Ebola viruses, etc. Acute liver disease also occurs in the presence of several acute bacterial infections, including Salmonella typhi, brucellosis, leptospirosis, syphilis, etc. The complex type of jaundice associated with acute systemic bacterial infection – especially pneumococcal PNEUMONIA and pyomiositis – assumes a major importance in many tropical countries, especially those in Africa and in Papua New Guinea. Of protozoan infections, plasmodium falciparum malaria, LEISHMANIASIS, and TOXOPLASMOSIS should be considered. Ascaris lumbricoides (the roundworm) can produce obstruction to the biliary system. CHRONIC LIVER DISEASE Long-term disease is dominated by sequelae of HBV and HCV infections (often acquired during the neonatal period), both of which can cause chronic active hepatitis, cirrhosis, and hepatocellular carcinoma (‘hepatoma’) – one of the world’s most common malignancies. Chronic liver disease is also caused by SCHISTOSOMIASIS (usually Schistosoma mansoni and S. japonicum), and acute and chronic alcohol ingestion. Furthermore, many local herbal remedies and also orthodox chemotherapeutic compounds (e.g. those used in tuberculosis and leprosy) can result in chronic liver disease. HAEMOSIDEROSIS is a major problem in southern Africa. Hepatocytes contain excessive iron – derived primarily from an excessive intake, often present in locally brewed beer; however, a genetic predisposition seems likely. Indian childhood cirrhosis – associated with an excess of copper – is a major problem in India and surrounding countries. Epidemiological evidence shows that much of the copper is derived from copper vessels used to store milk after weaning. Veno-occlusive disease was ?rst described in Jamaica and is caused by pyrrolyzidine alkaloids (present in bush-tea). Several HIV-associated ‘opportunistic’ infections can give rise to hepatic disease (see AIDS/HIV).

A localised (focal) form of liver disease in all tropical/subtropical countries results from invasive Entamoeba histolytica infection (amoebic liver ‘abscess’); serology and imaging techniques assist in diagnosis. Hydatidosis also causes localised liver disease; one or more cysts usually involve the right lobe of the liver. Serological tests and imaging techniques are of value in diagnosis. Whilst surgery formerly constituted the sole method of management, prolonged courses of albendazole and/or praziquantel have now been shown to be e?ective; however, surgical intervention is still required in some cases.

Hepato-biliary disease is also a problem in many tropical/subtropical countries. In southeast Asia, Clonorchis sinensis and Opisthorchis viverini infections cause chronic biliary-tract infection, complicated by adenocarcinoma of the biliary system. Praziquantel is e?ective chemotherapy before advanced disease ensues. Fasciola hepatica (the liver ?uke) is a further hepato-biliary helminthic infection; treatment is with bithionol or triclabendazole, praziquantel being relatively ine?ective.... liver disease in the tropics

Cancer – Liver

A primary lesion in the liver is rare. Usually invasion of carcinoma from the pancreas, gall bladder, stomach or intestines. Enlargement is rapid.

Symptoms. Jaundice. Ascites (excess fluid in the abdomen). Tenderness and enlargement of right upper abdomen; hobnail to the touch.

Alternatives: for possible relief of symptoms:–

Dandelion juice (fresh): 4 drachms (14ml) every 4 hours.

Wormwood tea freely.

Tea. Equal parts: Agrimony, Gotu Kola, Milk Thistle. Mix. 1 heaped teaspoon to each cup boiling water; infuse 5-10 minutes. 1 cup freely.

Decoction. Dandelion 2; Clivers 1; Liquorice 1; Blue Flag root half. Mix. 30g (1oz) to 500ml (1 pint) water gently simmered 20 minutes. Dose: half-1 cup 3 or more times daily.

Tablets/capsules. Blue Flag root, Goldenseal, Prickly Ash.

Formula. Dandelion 2; Milk Thistle 2; Fennel 1; Peppermint 1. Mix. Dose: Powders: 750mg (three 00 capsules or half a teaspoon). Liquid extracts: 1-2 teaspoons. Tinctures: 1-2 teaspoons. 3 or more times daily.

Biostrath artichoke formula.

Practitioner. Dandelion juice (fresh) 4oz; Wahoo bark Liquid extract 10 drops. Violet leaves Liquid extract 10.5ml. Tincture Goldenseal 10 drops. Dose: 2 teaspoons in water thrice daily. To each dose add 10 drops Liquid extract Oats (avena). (W. Burns-Lingard MNIMH)

Vinchristine. Success has been reported following use of the Periwinkle plant (Vinca rosea).

Greater Celandine has been regarded of value.

Chinese Herbalism. See: CANCER: CHINESE PRESCRIPTION. Also: Pulverised t’ien chihuang (Hypericum japonicum) 1 liang, mixed with rock sugar, with boiled water, 3 times daily. Also of value for cirrhosis.

Epsom’s salt Baths (hot): to encourage elimination of impurities through the skin. Diet. Limit fats. Protein diet to increase bile flow.

Treatment by a general medical practitioner or hospital oncologist. CANCER – LYMPH VESSELS. See: HODGKIN’S DISEASE. ... cancer – liver

Liver – Amoebic Hepatitis

Patients with amoebic dysentery may develop liver complications, usually by blood borne infection via the portal system. Small lesions coalesce to form abscesses capable of destroying liver cells.

Treatment: as for LIVER ABSCESS. ... liver – amoebic hepatitis

Liver Enlargement

From a number of causes ranging from persistent infections to chemical poisoning.

Formula. Fringe Tree bark 2ml; Black root 7ml; Echinacea 4ml; Distilled water to 4oz (120ml). Dose: teaspoon every two hours. (W.H. Black MD, Tecumseh, Oklahoma, USA)

Hypertrophy. Equal parts: tinctures Goldenseal and Fringe Tree. 15-60 drops in water before meals and at bedtime.

Diet. Low fat. Artichokes, Dandelion coffee, lecithin.

Supplements. Vitamin B6. ... liver enlargement

Corneal Transplant

See corneal graft.... corneal transplant

Liver Biopsy

A diagnostic test in which a small sample of tissue is removed from the liver, usually under local anaesthesia. The main function of this test is to diagnose liver diseases. (See also biopsy.)... liver biopsy

Liver, Diseases Of

The LIVER may be extensively diseased without any obviously serious symptoms, unless the circulation through it is impeded, the out?ow of BILE checked, or neighbouring organs implicated. JAUNDICE is a symptom of several liver disorders, and is discussed under its separate heading. ASCITES, which may be caused by interference with the circulation through the portal vein of the liver, as well as by other reasons, is also considered separately. The presence of gallstones is a complication of some diseases connected with the liver, and is treated under GALLBLADDER, DISEASES OF. For hydatid cyst of the liver, see TAENIASIS. Liver diseases in a tropical environment are dealt with later in this section.

In?ammation of the liver, or HEPATITIS, may occur as part of a generalised infection or may be a localised condition. Infectious hepatitis, which is the result of infection with a virus, is one of the most common forms. Many di?erent viruses can cause hepatitis, including that responsible for glandular fever (see MONONUCLEOSIS). Certain spirochaetes may also be the cause, particularly that responsible for LEPTOSPIROSIS, as can many drugs. Hepatitis may also occur if there is obstruction of the BILE DUCT, as by a gall-stone.

Cirrhosis of the liver A disorder caused by chronic damage to liver cells. The liver develops areas of ?brosis or scarring; in response, the remaining normal liver cells increase and form regeneration nodules. Those islands of normality, however, suffer from inadequate blood supply, thus adversely affecting liver function. Alcohol is the most common cause of cirrhosis in the United Kingdom and the USA, and the incidence of the disorder among women in the UK has recently risen sharply as a consequence of greater consumption of alcohol by young women in the latter decades of the 20th century. In Africa and many parts of Asia, infection with hepatitis B virus is a common cause. Certain drugs – for example, PARACETAMOL – may damage the liver if taken in excess. Unusual causes of cirrhosis include defects of the bile ducts, HAEMOCHROMATOSIS (raised iron absorption from the gut), CYSTIC FIBROSIS, cardiac cirrhosis (the result of heart failure causing circulatory congestion in the liver), and WILSON’S DISEASE (raised copper absorption).

Symptoms Some people with cirrhosis have no signs or symptoms and the disease may be diagnosed at a routine medical examination. Others may develop jaundice, OEDEMA (including ascites – ?uid in the abdomen), fever, confusion, HAEMATEMESIS (vomiting blood), loss of appetite and lethargy. On examination, cirrhotic patients often have an enlarged liver and/ or SPLEEN, and HYPERTENSION. Liver function tests, cholangiography (X-ray examination of the bile ducts) and biopsy of liver tissue will help to reach a diagnosis.

Treatment Nothing can be done to repair a cirrhosed organ, but the cause, if known, must be removed and further advance of the process thus prevented. In the case of the liver, a high-protein, high-carbohydrate, low-fat diet is given, supplemented by liver extract and vitamins B and K. The consumption of alcohol should be banned. In patients with liver failure and a poor prognosis, liver TRANSPLANTATION is worthwhile but only after careful consideration.

Abscess of the liver When an ABSCESS develops in the liver, it is usually a result of amoebic DYSENTERY, appearing sometimes late in the disease – even after the diarrhoea is cured (see below). It may also follow upon in?ammation of the liver due to other causes. In the case of an amoebic abscess, treatment consists of oral metronidazole.

Acute hepatic necrosis is a destructive and often fatal disease of the liver which is very rare. It may be due to chemical poisons, such as carbontetrachloride, chloroform, phosphorus and industrial solvents derived from benzene. It may also be the cause of death in cases of poisoning with fungi. Very occasionally, it may be a complication of acute infectious hepatitis.

Cancer of the liver is not uncommon, although it is rare for the disease to begin in the liver – the involvement of this organ being usually secondary to disease situated somewhere in the stomach or bowels. Cancer originating in the liver is more common in Asia and Africa. It usually arises in a ?brotic (or cirrhotic) liver and in carriers of the hepatitis B virus. There is great emaciation, which increases as the disease progresses. The liver is much enlarged, and its margin and surface are rough, being studded with hard cancer masses of varying size, which can often be felt through the abdominal wall. Pain may be present. Jaundice and oedema often appear.... liver, diseases of

Liver, Cirrhosis Of

See cirrhosis.... liver, cirrhosis of

Liver Function Tests

Tests of blood chemistry that can detect changes in the way the liver is making new substances and breaking down and/or excreting old ones.

The tests can also show whether liver cells are healthy or being damaged.... liver function tests

Liver Imaging

Techniques that produce images of the liver, gallbladder, bile ducts, and blood vessels supplying the liver, to aid the detection of disease.

Ultrasound scanning, CT scanning, and MRI are commonly used.

Radionuclide scanning may reveal cysts and tumours and show bile excretion.

X–ray techniques include cholangiography, cholecystography, and ERCP (endoscopic retrograde cholangiopancreatography).

In these procedures, a contrast medium, which is opaque to X-rays, is introduced to show abnormalities in the biliary system.

Angiography reveals the blood vessels in the liver.... liver imaging

Tea For Liver

Liver problems appear as a sign of weakness shown by your organism after a prolonged consumption of alcohol, drugs or medicines. The main characteristic of these affections is that they are due to system intoxication and need to be repaired as quickly as possible. The liver is the organ responsible for our molecular exhaustion. All the toxins in our body go straight to the liver in order to clear the blood and detoxify the entire mechanism. When the liver is not functioning well, the main symptoms are: fatigue, stress, vascular malfunction and irradiated pain from the liver area to the entire body. Unsolved liver problems may lead to kidney failure and then to pulmonary edema or other respiratory disorder. How Tea for Liver Works A Tea for Liver is a natural supplement that can calm your localized pain and bring relief to those suffering from this affection. The main ingredients of these teas are based on a great amount of nourishing substances that can reconstruct the damaged liver cells or at least increase their action. However, these teas are not recommended for severe liver problems. If the pain is unbearable, a tea is most likely to calm it for a while and then lose its positive effect on your body. If that is the case, you should see a doctor immediately. Efficient Tea for Liver When choosing a Tea for Liver, you must keep in mind the fact that it must be safe and nourishing. You don’t need a tea that is rich in volatile oils or other substances that slow the liver cells’ action. If you are not sure about your abilities to choose the right tea, here are some suggestions: - Green Tea – has all the necessary ingredients to sustain life. Also, its action includes nourishing the coronary system and the arteries, in order to enhance the blood flow through your organs - Black Tea – more powerful than the Green Tea, the Black Tea is very effective, but more dangerous. If you’re also on your period or menopause, it’s best not to take it: it may cause abdominal acidity and discomfort. - Yerba Mate Tea – or the new green tea, how the specialists are calling it. Yerba Mate Tea can be used as a cure in order to rejuvenate the liver, but also as a treatment in cases of low blood pressure or digestive tract infections. Pay attention, though: more than 2 cups of Yerba Mate Tea per day may lead to a series of nervous system complications and even death! Teas you should avoid If you are suffering from liver problems, it’s best to avoid taking a tea with an elevated level of vitamins or acids. Although vitamins get directly to your blood and none of them reaches the liver, they have a tendency to enhance your body’s action towards other affected areas. In other words, they make your antibodies be more preoccupied with a random scratch than with your liver problems. A Tea for Liver needs to be specialized in internal affections and only attract antibodies to the most important damages. Tea for Liver contraindications When taken properly, any Tea for Liver is safe. However, high dosage may lead to a number of complications, such as diarrhea, nausea and even death. If you’re not very sure about starting a treatment based on one of these teas, talk to a specialist in order to gather more information. If there’s nothing that could interfere with your treatment, choose a Tea for Liver and enjoy its wonderful benefits responsibly!... tea for liver

Liver – Acute Infectious Hepatitis

Inflammation of the liver from virus infection. As the commonest form of liver disorder, it is often without jaundice or marked liver symptoms apart from general malaise and abdominal discomfort, ‘Gippy tummy’, ‘chill on the liver’. For feverishness, add a diaphoretic.

Treatment. Bitter herbs keep the bile fluid and flowing.

Alternatives. Teas. Agrimony, Lemon Balm, Boldo, Bogbean, Centuary, Dandelion, Hyssop, Motherwort, Wormwood, Yarrow.

Maria Treben. Equal parts: Bedstraw, Agrimony, Woodruff. 2 teaspoons to cup boiling water.

Cold tea: 2 teaspoons Barberry bark to each cup cold water. Infuse overnight. Half-1 cup freely. Tablets/capsules: Blue Flag. Dandelion. Wild Yam. Liquorice.

Formula. Equal parts: Turkey Rhubarb, Dandelion, Meadowsweet. Dose: Liquid Extracts: 1-2 teaspoons. Tinctures: 2-3 teaspoons. Powders: 500mg (two 00 capsules or one-third teaspoon). 3-4 times daily. Alfred Vogel. Dandelion, Devil’s Claw, Artichoke.

Antonius Musa, physician to Emperor Augustus Caesar records: “Wood Betony preserves the liver and bodies of men from infectious diseases”.

Preventative: Garlic. (Old Chinese)

Milk Thistle: good responses observed.

General. Bedrest until motions are normal. Enema with any one of above herb teas.

Diet. Fat-free. Fasting period from 1-3 days on fruit juices and herb teas only. Artichokes. Dandelion coffee. Lecithin.

See: COCKROACH, The.

Treatment by or in liaison with a general medical practitioner. ... liver – acute infectious hepatitis

Renal Transplant

Another term for kidney transplant.... renal transplant

Acute Fatty Liver Of Pregnancy

a rare and life-threatening complication of pregnancy that usually presents in the third trimester with symptoms of nausea, vomiting, malaise, and abdominal pain. Liver function tests are abnormal and the features of *pre-eclampsia and often *HELLP syndrome are present. *Hepatic encephalopathy, *disseminated intravascular coagulation, and renal failure may develop, and the condition is associated with a high maternal and fetal mortality. Treatment involves a multidisciplinary approach, usually in an intensive care unit.... acute fatty liver of pregnancy

Fatty Liver

see nonalcoholic fatty liver disease; acute fatty liver of pregnancy.... fatty liver

Heterotopic Transplantation

see orthotopic transplantation.... heterotopic transplantation

Hobnail Liver

the liver of a patient with *cirrhosis, which has a knobbly appearance caused by regenerating nodules separated by bands of fibrous tissue.... hobnail liver

Islet Cell Transplantation

a new technique still under evaluation for curing type 1 *diabetes mellitus, which involves the injection of donated cells from the pancreatic *islets of Langerhans into the liver, where it is hoped they will seed and survive. The transplanted cells then take over insulin production from the recipient’s diseased pancreas.... islet cell transplantation

Nhs Blood And Transplant

(NHSBT) a *special health authority established in 2005 to provide a safe and reliable supply of blood, organs, stem cell services, and diagnostics to hospitals. NHSBT also provides specialist therapeutic apheresis services, which remove or replace a single component of blood (e.g. malignant white cells or low-density lipoprotein), at six sites in England.

NHS Blood and Transplant website... nhs blood and transplant

Orthotopic Transplantation

transplantation of a donor organ or tissue (usually the liver) into a recipient at the site where the recipient’s organ has been removed. In contrast, heterotopic transplantation involves the preservation of the recipient’s organ in its natural site and the addition of the donor organ at another site.... orthotopic transplantation

Renal Transplantation

see transplantation.... renal transplantation

Liver – Hepatitis, Chronic

Term referring to hepatitis where the condition is the result of acute attacks of more than six months duration.

Causes: alcohol excess, drugs (Paracetamol prescribed for those who cannot tolerate aspirin), autoimmune disease, toxaemia, environmental poisons. Clinically latent forms are common from carbon monoxide poisoning. May lead to cirrhosis.

Symptoms. Jaundice, nausea and vomiting, inertia.

Treatment. Bile must be kept moving.

Alternatives:– Decoction. Formula. Milk Thistle 2; Yellow Dock 1; Boldo 1. 1 heaped teaspoon to each cup water gently simmered 20 minutes. Half-1 cup thrice daily.

Formula. Barberry bark 1; German Chamomile 2. Dose: Liquid Extracts: 2 teaspoons. Tinctures: 2-3 teaspoons. Powders: 750mg (three capsules or half a teaspoon) thrice daily.

Tablets/capsules. Blue Flag root. Goldenseal.

Astragalus. Popular liver tonic in Chinese medicine. A liver protective in chemotherapy.

Diet. Fat-free. Dandelion coffee. Artichokes. Lecithin.

Supplements. B-vitamins, B12, Zinc.

Treatment by or in liaison with a general medical practitioner. ... liver – hepatitis, chronic

Liver – Hepatitis B

Regarded as more serious than Hepatitis A. A main symptom is a flu-like illness followed by jaundice. Transmitted sexually, blood transfusion or by infected blood as from contaminated needles used by drug abusers. It is the first human virus to be identified with cancer in man. High mortality rate.

Symptoms: nausea and vomiting, fever, dark urine, loss of appetite, skin irritation, yellow discoloration of the skin and whites of eyes, weakness and fatigue.

Treatment. Internal. Silymarin (active principle of Milk Thistle) has been used with good responses. (R.L. Devault & W. Rosenbrook, (1973), Antibiotic Journal, 26;532)

Wormwood tea. 1-2 teaspoons herb to each cup boiling water in a covered vessel. Infuse 10-15 minutes: 1 cup thrice daily.

Formula. Equal parts: Balmony, Valerian, Wild Yam. Dose: Liquid Extracts: 1-2 teaspoons. Tinctures: 1- 3 teaspoons. Powders: 750mg (three 00 capsules or half a teaspoon) thrice daily.

Astragalus. Popular liver protective used in Chinese medicine.

Phyllanthus amarus. Clinical trials on 78 carriers of the virus revealed that this plant effectively eliminated the virus from the body in 59 per cent of cases. Treatment consisted of 200mg dried powdered herb (whole plant minus the roots) in capsules, thrice daily for 30 days). (Thyagarajan, S.P., et al “Effect of Phyllanthus amarus on Chronic Carriers of Hepatitis B Virus.” The Lancet, Oct. 1988 2:764-766) External. Castor oil packs for two months.

Treatment by or in liaison with a general medical practitioner. ... liver – hepatitis b

Liver – Cirrhosis

A disease of the liver with hardened and fibrotic patches. Scar tissue obstructs the flow of blood through the liver, back pressure causing damage. As they wear out liver cells are not renewed.

Causes: damage from gall-stones, aftermath of infections, drugs; the commonest is alcohol. Usually made up of three factors: toxaemia (self-poisoning), poor nutrition, infective bacteria or virus.

Symptoms. Loss of appetite, dyspepsia, low grade fever, nosebleeds, lethargy, spidery blood vessels on face, muscular weakness, jaundice, loss of sex urge, redness of palms of hands, unable to lie on left side. Mechanical pressure may cause dropsy and ascites. Alcohol-induced cirrhosis correlates with low phospholipid levels.

Treatment. Bitter herbs are a daily necessity to keep the bile fluid and flowing. Among other agents, peripheral vaso-dilators are indicated. Regulate bowels.

Teas. Balmony, Milk Thistle, Boldo, Bogbean. Dandelion coffee. Barberry tea (cold water). Tablets/capsules. Calamus, Blue Flag, Wild Yam.

Formula. Wahoo 2; Wild Yam 1; Blue Flag root 1. Dose: Liquid Extracts: one 5ml teaspoon. Tinctures: two 5ml teaspoons. Powders: 500mg (two 00 capsules or one-third teaspoon). Thrice daily.

Milk Thistle (Silybum marianum). Based on its silymarin contents: 70-210mg, thrice daily.

Practitioner. For pain. Tincture Gelsemium: 5-10 drops in water when necessary.

Enema. Constipation may be severe for which warm water injection should be medicated with few drops Tincture Myrrh.

Diet. High protein, high starch, low fat. Reject alcohol. Accept: Dandelion coffee, artichokes, raw onion juice, turmeric as a table spice.

Lecithin. Soy-derived lecithin to antidote alcohol-induced cirrhosis. (Study: Bronx Veterans Affairs Medical Center & Mount Sinai Hospital School of Medicine, New York City)

Supplements. B-complex, B12, C (1g), K, Magnesium, Zinc.

Treatment by or in liaison with a general medical practitioner or gastro-enterologist. ... liver – cirrhosis

Liver – Congestion

Non-inflammatory simple passive congestion is usually secondary to congestive heart failure, injury, or other disorders.

Symptoms: headache, vomiting of bile, depression, furred tongue, poor appetite, lethargy, sometimes diarrhoea. Upper right abdomen tender to touch due to enlargement, pale complexion.

BHP (1983) recommends: Fringe Tree, Wahoo, Goldenseal, Blue Flag, Butternut bark, Boldo, Black root. Treatment. Treat the underlying cause, i.e. heart or chest troubles. Bitter herbs.

Alternatives:– Teas. Balmony, Bogbean, Centuary. 1 heaped teaspoon to each cup boiling water infused 15 minutes. Half-1 cup 3 or more times daily.

Decoction. Dandelion and Burdock roots. Mix. One teaspoon to large cup water simmered gently 20 minutes. Cup 2-3 times daily.

Tablets/capsules. Blue Flag, Goldenseal, Wild Yam.

Formula. Dandelion 2; Wahoo 1; Meadowsweet 1; Cinnamon 1. Dose: Liquid Extracts: 1-2 teaspoons. Tinctures: 1-3 teaspoons. Powders: 750mg (three 00 capsules or half a teaspoon) thrice daily.

Alfred Vogel recommends: Barberry bark, Centuary, Boldo, St John’s Wort, St Mary’s Thistle, Sarsaparilla.

Epsom salt baths (hot) to promote elimination of impurities through the skin.

Diet. Fat-free. Dandelion coffee. Artichokes. Lecithin. ... liver – congestion

Liver – Fatty

Destruction of normal liver cells and their replacement by fat.

Causes: obesity; environmental chemicals, toxins from fevers (influenza, etc).

Alternatives. Teas. Boldo, Clivers, Motherwort, Chaparral. One heaped teaspoon to each cup boiling water infused 15 minutes. 1 cup freely.

Tablets/capsules. Seaweed and Sarsaparilla.

Formula. Fringe Tree 2; Clivers 1; Bladderwrack (fucus) 1. Dose: Liquid Extracts: 1 teaspoon. Tinctures: 1-2 teaspoons. Powders: 750mg (three 00 capsules or half a teaspoon) thrice daily.

Cider Vinegar. 2-3 teaspoons to glass water. Drink freely.

Evening Primrose oil. 4 × 500mg capsules daily.

Diet. Fat-free. Dandelion coffee. Artichokes.

Supplementation. Vitamin B6. C. K. Zinc. Kelp. ... liver – fatty

Liver – Injuries

As bleeding cannot be ruled out, no time should be lost seeking hospital treatment.

An immediate surgical repair may be necessary. However, there are ways in which healing can be speeded and body defences sustained. The following promote healing: Fringe Tree being most relevant. To prevent infection it should be combined with Echinacea (anti-microbial).

Alternatives. Teas. Comfrey, Horsetail, Marigold, St John’s Wort, Plantain.

Decoction. Equal parts: Fringe Tree bark; Echinacea root. 1 heaped teaspoon to each large cup water simmered gently 20 minutes. Half-1 cup or as much as tolerated, every 2 hours.

Tinctures. Equal parts: Milk Thistle, Echinacea root. 20-60 drops in water every 2 hours.

Castor oil packs. Applied over liver area. ... liver – injuries

Hair Transplant

A cosmetic operation in which hairy sections of scalp are removed and transplanted to hairless areas to treat alopecia (baldness). There are several different techniques.

In strip grafting, a strip of skin and hair is taken from a donor site, usually at the back of the scalp or behind the ears. The removed hairs and their follicles are then inserted into numerous incisions made in a bald area, known as the recipient site. The procedure usually takes 60–90 minutes. The patient is given a mild sedative and anaesthetic on the donor and recipient sites. The donor site heals in about 5 days. Transplanted hairs fall out shortly afterwards, but new hairs grow from the follicles 3 weeks to 3 months later.

Other transplant techniques include punch grafting, in which a punch is used to remove small areas of bald scalp, which are replaced with areas of hairy scalp; flap grafting, in which flaps of hairy skin are lifted, rotated, and stitched to replace bald areas; and male pattern baldness reduction, which involves cutting out areas of bald skin and stretching surrounding areas of hair-bearing scalp to replace them.... hair transplant

Heart Transplant

Replacement of a patient’s damaged or diseased heart with a healthy heart taken from a donor at the time of death. Typically, transplant patients have advanced coronary artery disease or cardiomyopathy. During the operation, the function of the heart is taken over by a heart–lung machine.

Most of the diseased heart is removed, but the back walls of the atria (upper chambers) are left in place.

The ventricles (upper chambers) are then attached to the remaining areas of the recipient’s heart.

Once the immediate post-operative period is over, the outlook is good.

Patients face the long-term problems associated with other forms of transplant surgery.

(See also heart–lung transplant.)... heart transplant

Liver Cancer

A cancerous tumour in the liver. The tumour may be primary (originating within the liver) or secondary (having spread from elsewhere, often the stomach, pancreas, or large intestine). There are 2 main types of primary tumour: a hepatoma, which develops in the liver cells, and a cholangiocarcinoma, which arises from cells lining the bile ducts.The most common symptoms of any liver cancer are loss of appetite, weight loss, lethargy, and sometimes pain in the upper right abdomen.

The later stages of the disease are marked by jaundice and ascites (excess fluid in the abdomen).

Tumours are often detected by ultrasound scanning, and diagnosis may be confirmed by liver biopsy.

A hepatoma can sometimes be cured by complete removal.

In other cases, anticancer drugs can help to slow the progress of the disease.

It is usually not possible to cure secondary liver cancer, but anticancer drugs or, in some cases, removal of a solitary metastasis may be advised.... liver cancer

Liver Disease, Alcoholic

Damage to the liver caused by excessive alcohol consumption.

The longer consumption goes on, the more severe the damage.

The initial effect is the formation of fat globules between liver cells, a condition called fatty liver.

This is followed by alcoholic hepatitis, and damage then progresses to cirrhosis.

Alcohol-related liver disease increases the risk of developing liver cancer.

Liver function tests show a characteristic pattern of abnormalities, and liver biopsy may be needed to assess the severity of damage.

There is no particular treatment, but abstinence from alcohol prevents further damage.

Treatment for alcohol dependence may be required.... liver disease, alcoholic

Liver, Disorders Of

The liver is a common site of disease. The most significant liver conditions include alcohol-related disorders (see liver disease, alcoholic), hepatitis, and liver cancer. Disorders can also result from infection. Certain viruses cause hepatitis (see hepatitis, viral). Bacteria may spread up the biliary system to the liver, causing cholangitis or liver abscess. Parasitic diseases affecting the liver include schistosomiasis, liver fluke, and hydatid disease. Certain metabolic disorders, such as haemochromatosis and Wilson’s disease, may involve the liver. Other types of liver disorder include Budd–Chiari syndrome, in which the veins draining the liver become blocked. Occasionally, defects of liver structure are present at birth. Such defects principally affect the bile ducts; one example is biliary atresia, in which the bile ducts are absent. Because the liver breaks down drugs and toxins, damage to liver cells can also be caused through overdose or drug allergy. (See also jaundice; liver failure; portal hypertension.)... liver, disorders of

Liver Failure

Severe impairment of liver function that develops suddenly or at the final stages of a chronic liver disease. Because the liver breaks down toxins in the blood, liver failure causes the levels of the toxins to rise, affecting the functioning of other organs, particularly the brain. Liver failure may be acute or chronic. Symptoms of acute liver failure develop rapidly and include impaired memory, agitation, and confusion, followed by drowsiness. The functioning of other organs may become impaired, and the condition may lead to coma and death. Features of chronic liver failure develop much more gradually and include jaundice, itching, easy bruising and bleeding, a swollen abdomen due to accumulated fluid, red palms and, in males, gynaecomastia (enlarged breasts) and shrunken testes. Chronic liver failure may suddenly deteriorate into acute liver failure.

Acute liver failure requires urgent hospital care.

Although no treatment can repair damage that has already occurred in acute and chronic liver failure, certain measures, such as prescribing diuretic drugs to reduce abdominal swelling, may be taken to reduce the severity of symptoms.

Consumption of alcohol should cease in all cases.

The prognoses for sufferers of chronic liver failure vary depending on the cause, but some people survive for many years.

For acute liver failure, a liver transplant is necessary to increase the chances of survival.... liver failure

Transplant Surgery

Replacement of a diseased organ or tissue with a healthy, living substitute. The organ is usually taken from a person who has just died. Some kidneys are transplanted from a patient’s living relatives (see organ donation). The results of surgery have also been improved by testing for histocompatibility antigens and tissue-typing.

Rejection is a major problem. However, a combination of a corticosteroid drug and ciclosporin are given in order to suppress this response.

Every patient who undergoes an organ transplant operation must take immunosuppressant drugs indefinitely. (See also heart transplant; heart–lung transplant; liver transplant; kidney transplant.)... transplant surgery

Nonalcoholic Fatty Liver Disease

(NAFLD) a spectrum of conditions affecting the liver in the absence of excessive alcohol consumption. NAFLD is a common cause of referral for patients with abnormal liver function tests. Fatty liver is excessive fat accumulation in the liver seen as an area of brightness within the liver on ultrasound examination. Fatty liver does not lead to irreversible liver damage in the majority of cases. Nonalcoholic steatohepatitis (NASH) is inflammation of the liver associated with accumulation of fat. It is often linked to insulin resistance, diabetes, hypertension, obesity, and *metabolic syndrome. Treatment involves dietary modification, regular physical exercise, weight reduction, and management of underlying conditions (e.g. diabetes, hypertension, and hiperlipidaemia). NASH may predispose to *cirrhosis and may ultimately require liver transplantation.... nonalcoholic fatty liver disease



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