Liver Transplant for Liver Disease and Failure
Froedtert & the Medical College of Wisconsin’s Liver Transplant Program began in 1983 when we performed Wisconsin’s first liver transplant. Since then, we have performed more than 600 liver transplants. With more than two decades of experience, we provide superior care for liver transplant patients.
Superior Liver Transplant Patient Survival
Our program has a strong multidisciplinary approach, relying on the expertise of physicians in a wide range of specialties. Patients with liver failure often have other underlying conditions, such as diabetes, hypertension, lipid disorders, osteoporosis and more. We are able to care for the whole patient because of the breadth of specialties and resources available at Froedtert & the Medical College of Wisconsin.
Our program continues to maintain superior one year patient survival. Reports for the one-year and three-year survival rates for liver transplant patients show our liver transplant patient survival compared to the US national average and centers in our region. To compare survival rates of liver transplants across the country, go to the website for the Scientific Registry of Transplant Recipients.
Because we are a leading academic medical center, Froedtert & the Medical College of Wisconsin hepatologists and other physicians are better able to recognize and treat complications of cirrhosis and other liver diseases, which means patients undergo transplant surgery in overall better health.
Froedtert & the Medical College of Wisconsin also offer a strong team of dedicated support professionals. Our hepatologists and transplant surgeons are assisted by experienced transplant nurses, social workers, psychologists, dietitians and more.
End-Stage Liver Disease Program
Our End-Stage Liver Disease Program, together with our Transplant Program, is led by nationally recognized physicians, many of who have been named to the “Best Doctors in America®” list. Our dedicated support staff, including nurses and physicians assistants, specializes in caring for patients with end-stage liver disease and in transplant programs.
Excellent end-stage care is vital to a successful transplant program. By offering the best care for end-stage liver disease patients, we can help some avoid transplantation while ensuring that those who need a transplant are in the best possible health at the time of transplant.
Dedicated Clinic and Follow-up Care
Because transplant patients need to take anti-rejection medications for the rest of their lives, we have a dedicated Transplant Clinic that provides a central place for questions, check-ups and other resources. Surgeons, hepatologists, endocrinologists, infectious disease experts and others are available to give our patients the best care that meets the diversity of needs they may face.
We also have post-transplant coordinators who work with our patients to coordinate every aspect of their follow-up care. By drawing on the strengths of physicians in a variety of fields, we can take care of little problems early before they become big problems. Having a dedicated clinic with an experienced staff and a central location gives patients a familiar place where their unique needs are well understood. Clinic hours accommodate patients’ schedules, and patients may come to the clinic without an appointment if they’re not feeling well.
Causes of Liver Failure
There are many causes of liver disease that can lead to liver failure and the need for a transplant. The most common causes that we see at Froedtert & the Medical College of Wisconsin are:
- Hepatitis C — Its progression is slow, often taking decades to cause damage. There was no test for Hepatitis C until 1992, and many people receiving transplants today were infected in the 1970s. It’s estimated that almost 2 percent of the general population has Hepatitis C, and most don’t know it yet. It’s important to note that not everyone with Hepatitis C will require a liver transplant.
- Excessive use of alcohol leading to cirrhosis of the liver — All patients, as part of our effort to care for the whole patient, undergo a psychological exam to make sure they understand the ramifications of their disease and the risks of transplantation. To be a candidate for transplantation, patients undergo a very careful psychosocial evaluation and are required to abstain from alcohol for at least six months. In addition, participation in a relapse prevention program is necessary.
- Non-alcoholic fatty liver disease — This disease causes damage similar to that caused by alcohol abuse, but it occurs in patients who don’t drink to excess but are overweight or have diabetes. It is by far the most prevalent liver disease in the United States, but only a small percentage of people with this condition progress to the most severe form where they need a transplant.
- Bile duct diseases — These affect the “plumbing” of your liver. Bile ducts carry bile, which aids in digestion, from the liver to the gallbladder and then to the small intestine. Some bile duct diseases can cause severe liver damage (examples include primary biliary cirrhosis and primary sclerosing cholangitis).
- Acute liver failure — The first four conditions above are all chronic diseases. Acute liver failure comes on quickly and without warning. Several things can cause acute liver failure including all viral infections and certain medications (most notably, acetaminophen). Patients with acute liver failure will typically either recover completely or require a transplant within a week or two. These patients will go to the top of the transplant list because of the severity of their condition. Many of our acute liver failure patients have been referred to us from other hospitals in the region. Because of our multidisciplinary approach and our extensive experience with liver disease, we are able to help many of these patients recover without a transplant. We do everything possible to support these patients through their condition. At the same time, we are able to determine when their only option is a liver transplant.
Liver Transplantation for Liver Malignancies
Another common indication for liver transplantation is liver cancer. While there are different kinds of liver cancer, transplantation of the liver is done for hepatocellular carcinoma (HCC), the most common primary liver cancer.
Patients who receive a liver transplant for early HCC enjoy excellent survival in the short and long term. The care of patients with HCC is very complex and involves several measures to treat and keep the tumor within the transplant criteria. Our multidisciplinary program offers all the expertise necessary to achieve this goal. Our hepatologists aggressively try to control the underlying liver disease well so that the cancer progression is slowed down. For example treating hepatitis C or B is always considered and done for appropriate patients.
Our interventional radiologists are highly experienced in using different methods to treat liver cancer so that the tumor is brought back into the transplant criteria if it was larger at the start or to keep the tumor within the transplant criteria for those that were initially small. Our surgeons would also consider surgically removing the tumor if possible. But for patients who can not undergo resection, liver transplantation is an available excellent option.
We also perform liver transplantation for other less common liver cancers that meet certain criteria. Our multidisciplinary team carefully reviews the details of each case for cancers such as cholangiocarcinoma or metastatic neuroendocrine tumors, to determine if liver transplantation is the best option to help the patient.
We are here to help international patients arrange for their care at Froedtert Hospital in Milwaukee, Wisconsin.