End-Stage Liver Disease
The function of the liver is to filter blood coming from the digestive tract of any toxic chemicals and metabolize any drugs. When disease, lifestyle contributors or genetic predispositions overtax the liver, scar tissue (cirrhosis) forms. The resulting liver disease takes years to progress. When the liver's function is near failure, end-stage liver disease, also known as chronic liver failure, causes symptoms that include yellowing of the skin (jaundice), abdominal pain and swelling, change in appetite, dark urine, itchy skin and chronic fatigue.
When you contact Einstein for end-stage liver disease treatment, a nurse navigator will arrange your evaluations - by up to five physician specialists - to be performed at Einstein Medical Center. After your initial visit, any tests and follow-up appointments you need are scheduled for you. Your case is then examined and evaluated each week by your treatment team of physician specialists, nurses, social workers and others.
Diagnostic Testing & Treatment
Einstein’s compassionate, multidisciplinary team of physicians, nurses, behavioral health specialists, nutritionists and social workers will help manage your treatment and care.
Part of normal liver functionality is to excrete waste and excess fluids from the body. When scarring associated with cirrhosis inhibits that function, ascites, or fluid buildup, occurs. Abdominal paracentesis is the process of removing that fluid. During the procedure, a clinician inserts a needle into the peritoneal cavity to draw fluid out.
In the case of advanced liver disease, all treatments include lifestyle modifications like stopping alcohol usage, losing weight and adopting a healthy, low-sodium diet. These changes can stop progression of the disease in early stages and can affect the rate of progression, but they cannot reverse the damage once cirrhosis occurs. Lifestyle changes are critical to prevent complications after liver transplantation.
Advances in medication therapies have proven very successful in limiting damage caused by hepatitis B and C. Other medications that may be prescribed include those that control blood pressure, prevent internal bleeding and reduce toxins in the blood. Antibiotics are used to fight infection. After transplantation, immunosuppressants helps prevent the body from rejecting the donor organ.
Several nutritional therapies have been proven useful in managing complications of advanced liver disease. For example, a low-sodium diet will help reduce fluid buildup in the abdomen. To counter the effects of cirrhosis-related malnutrition, your care team may also prescribe nutritional supplements to strengthen the body until a transplant becomes available.
Radiofrequency ablation (RFA) is a minimally invasive therapy that uses image guidance to place a thin, needle-like probe directly into the tumor. High-energy radio waves are then passed through the probe, heating the tumor and destroying cancer cells.
Depending on the size, location and stage of your cancer; how your cancer responds to other types of therapy; and other factors, your doctors may recommend surgery to remove cancerous tumors. At Einstein, our highly experienced surgeons are experts in the most advanced, minimally invasive procedures.
Depending on the size of your tumor and other factors, your doctor may recommend surgical removal. Our surgeons use video-assisted techniques and the most minimally invasive procedures possible to remove the cancer without damaging healthy tissue. If there is enough healthy tissue left to restore function, your surgeon will perform a resection on your liver after the tumor is removed. If the cancer has spread to a large portion of your liver, you may require a liver transplant.
Transarterial chemoembolization is a targeted therapy in which a surgeon administers chemotherapy drugs directly into a tumor on the liver.
Also called selective internal radiation therapy, this procedure involves injecting radioactive microspheres directly into the arteries that supply blood to cancerous tumors in the liver. Those spheres travel into, and become embedded in, blood vessels, and cut off the tumor's blood supply.
The Center for Advanced Liver Disease and Transplantation at Einstein Healthcare Network provides compassionate, comprehensive treatment from a multidisciplinary team of nutritionists, behavioral health specialists, social workers, physicians and surgeons.
Learn more about Transplantation at Einstein
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