PRESENTED BY:
BRIENNA HIRSCH
JENNIFER HAIAR
WHITNEY DUNN
http://www.methodsofhealing.com/files/2010/11/tip-for-a-healthy-liver.jpg
Think about this for a moment…
“On May 9, every year, someone is mourning the loss of their baby, who for some reason
was called from this life way too early. On May 9, every year, we remember the Gift of
Life that this family gave us when they made the difficult decision to donate their baby’s
organs—and we think of their grief; yet celebrate the life and 2nd chance that was given to
Brienna at the age of 19 months. If they could only see the smiles, and hear the music;
and know just how grateful we are that they looked beyond their own grief to help
another child.
“In 1992, we didn’t know if we’d ever get to see the day our baby would graduate from High
School, and tomorrow, 16 years later, on May 17, 2009, we will se her walk across the stage
to get her diploma as a graduate of Washington High School (WHS)…”
-Russ & Connie Hirsch (2009)
Pictures provided from:
Brienna Hirsch
 Liver failure or disease occurs when the liver
becomes damaged and is no longer able to function
the way it should.
 The most common diseases of the liver are Hepatitis
B and C.
 The liver is the second largest organ in your body. It
weighs about 3 pounds.
 The liver processes what you eat and drink into
energy and nutrients for your body, and also will
remove harmful substances from your blood stream.
Hepatitis B
 Hepatitis B is the inflammation and swelling
of the liver.
 It is caused by the hepatitis B virus.
 There are immunization injections to help
prevent hepatitis B. they are given in infancy
and adulthood.
 Hepatitis B is spread through the blood,
semen, body fluids, and vaginal secretions.
Hepatitis C
 Hepatitis C is caused by an infection with a virus.
 The liver stops working as it should due to
inflammation and swelling
 Will destroy the liver and cause cirrhosis
 Hepatitis C is one of the main needs for liver
transplants
 Up to 70% of people develop chronic liver disease
Cirrhosis
 Inflammation and scarring damage the
liver.
 Alcohol use and hepatitis are the main
causes of cirrhosis
 Liver transplants are common in
individuals whom develop cirrhosis.
Biliary Atresia
 A rare disease of the liver that affects newborn




infants
Occurs in about 1 in 10,000 infants
“The loss of the bile ducts that are responsible for
draining bile from the liver”
The liver stops working and Cirrhosis will result
Liver transplants are mandatory within the first 1-2
years of life!
**This is what Brienna was diagnosed with.
Signs and Symptoms of Liver Failure
 Pain
 Stomach pain
 Swelling
 Diarrhea
 Tenderness in the right
 Yellow eyes
upper quadrant
Jaundice color
Itching all over body
Loss of appetite, fever
and nausea
Feeling tired
 Weight loss




 Internal bleeding
 Dark yellow urine
Liver Failure Prevention
 Do not overdose on




 Do not handle blood or
acetaminophen (Tylenol)
Do not drink alcohol in
access or long term

Immunizations

Ingestion of wild
mushrooms

Proper diet
blood products unless
professionally trained.
Don’t share personal
toiletry items
Do not share needles
Use condoms when
having sex
When is Liver Transplant Needed?
 Chronic hepatitis B





and/or C
Bile duct disease
Autoimmune liver
disease
Primary liver cancer
Alcohol liver disease
Fatty liver disease
 Currently there are more
than 6,000 liver
transplants every year.
 Success rate is high!
About 7 to 8 people out
of 10 live full healthy
lives
Advance Directives
 It is always wise to have an advance directive
when dealing with organ transplant and
donation
 An advance directive provides instructions
for your personal medical choices and
decisions while you are in the hospital.
The Waitlist
 In order to undergo a liver transplant, a
patient must be put on the national
waiting list.
 The list is managed by the United
Network for Organ Sharing, or UNOS.
UNOS
 The United Network for Organ Sharing does the
following:



Collects and manages all data that pertain to the patient waiting list.
Organ donation and matching.
Transplantation occurring on the Nation’s Organ Transplant
Network, or OPTN.
 UNOS developed a scoring system called the Model for
End-Stage Liver Disease, or MELD.

Sickest patients are given priority for organ transplants.
 Candidates age eleven and younger are placed in
categories according to the Pediatric End-Stage Liver
Disease, or PELD, scoring system.
MELD
 MELD system involves a numerical scale:
 Ranges
from 6 (less ill) to 40 (gravely ill)
 Used for liver transplant candidates that are
twelve or older.
 Gives each candidate a number based on how
urgent he or she needs a liver transplant within
the next three months.
MELD
 The number is calculated by a formula using three
routine lab test results:

Bilirubin


INR (pro thrombin time)


Measures how effectively the liver excretes bile.
Measures the liver’s ability to make blood clotting factors.
Creatinine

Measures kidney function.
 Impaired kidney function is often associated with sever liver
disease.
MELD Exceptions
 There is only one priority exception to MELD.
 This priority is referred to as Status 1.
 Status 1 patients have a sudden and severe onset liver failure
and a life expectancy of hours to a few days without a
transplant.
 Less than 1% of liver transplant candidates fall into this
category.
Waitlist Statistics
 Currently about 17,000 people are waiting for a liver
transplant in the United States.
 The median national waiting time in 2006 was 321
days.


The patient’s median wait could be longer or shorter.
The wait time depends on how sick the patient is or where they
live.
Waitlist Statistics
 According to UNOS about 540 children in the United
States were waiting for a liver transplant in 2009:




56 in newborn to 1 year old age group
174 in the 1 to 5 year old age group
127 in the 6 to 10 year old age group
183 in the 11 to 17 year old age group
Where do transplanted organs come from?
 Most transplanted livers come from deceased organ
donors.

Organ donors are adults or children who have been declared
brain dead.
 When children receive a liver they may get a whole
liver or a segment of one.
 If an adult liver is available and is an appropriate
match for two children, or a child and adult, on the
waiting list, the donor liver can be divided into two
segments.

This situation is called a split liver transplant.
Where do transplanted organs come from?
 Living family members may also be able to donate a
section of their liver.

This situation is called a living-related transplant.
 Relatives who donate a portion of their liver can live
healthy lives with the remaining segment.

The segment of the liver will eventually grow to the original
size of the whole liver.

The liver is the only organ in the human body that can do this.
Other Information!
 Patients will be placed on a specific and detailed diet
before & after the transplant
 After the transplant, the patients are placed on
numerous anti-rejection drugs, vitamins, and other
prescribed medication that they will be required to
take for the rest of their life in order to prevent the
body from the rejecting the liver as a “foreign object”
 Routine doctor appointments will also be a
requirement after the transplant; eventually
spreading out over longer periods of time
Liver Transplant Agencies
 National Kidney Foundation

Hosts the U.S. & World Transplant Games
Similar to the Olympics with a plethora of sporting events to
participate in: swimming, triathlon, tennis, bowling, cycling, etc.
 Held every other year: 1 year the games are held somewhere in the
U.S. and the next year the games are held somewhere else outside
the U.S.


Ex: 2010 games were held in Madison, WI while the 2011 games will be
held this summer in Göteborg, Sweden
For any Transplant Recipient, Donor, Families of Transplant
Recipients/Donors, Doctors, Surgeons, Nurses, etc.
 Divided into teams by States or Regions in U.S. Games and by
Country in the World Games
 Ex: Team Upper Midwest, Team Arizona, etc. for U.S. Games
and Team USA for World Games

Liver Transplant Agencies
 American Liver Foundation
Our mission is to facilitate, advocate and promote
education, support and research for the prevention,
treatment and cure of liver disease.
 Provides information for the parents or families of the
recipients and donors in order to help them cope with the
process
 Explains the Transplant process and the before and after
requirements
 Gives other websites to visit so that families can research
the problem and the solution!

Other Liver Transplant Agencies
 American Association for the Study of Liver
Diseases

www.aasld.org
 Hepatitis Foundation International

www.hepfi.org
 National Digestive Diseases Information
Clearinghouse

www.digestive.niddk.nih.gov
 Organ Procurement and Transplantation
Network

http://optn.transplant.hrsa.gov
REFERENCES

Brand, E. (2009, September). Liver transplant program: the waiting list. Retrieved from
http://www.chop.edu/service/liver-transplant-program/evaluation/liver-transplant-waitinglist.html.

Smith, C. (1999). Center for liver disease and transplantation. Retrieved from
http://www.livermd.org/waiting.html.

National Digestive Diseases Information Clearinghouse, . (2006, July). Biliary atresia.
Retrieved from http://digestive.niddk.nih.gov/ddiseases/pubs/atresia/

National Kidney Foundation, Inc., . (2010). 2010 U.S. transplant games. Retrieved from
http://www.kidney.org/news/tgames2010/index.cfm

WebMD (2005-2011) Retrieved on April 10, 2011 from
www.webmd.com/hepatitis

WebMD (2005-2011) Retrieved on April 10, 2011 from
guides/organ-transplant-overview
http://www.webmd.com/a-to-z-

World Transplant Games Federation, . (2011, April 19). XVII World transplant games
2011. Retrieved from http://www.wtg2011.com/Default.aspx