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Since the mid- to late-eighties, there has been enormous advances in the basic research of liver function and damage to the liver, as well as an explosion in basic science knowledge. Medical technology has also aided our knowledge of the liver. Different types of scans and various methods of invasive imaging have allowed scientists and physicians to view the organ as never before.
These advancements in understanding the liver have led to more effective treatments than were available in the past.
The treatment of last resort – the liver transplant – has progressed from the experimental stage prior to 1983 to that of standard therapy today. The one-year patient survival rate following a liver transplant is approximately 90%, with the five-year rate being around 80%.
The art of liver transplantation has progressed to the point where a portion of a liver from a parent can be placed into a child to regenerate and become fully functional.
As with other organs, however, there remains a shortage of livers available for transplant, especially for children. Aside from viral hepatitis, liver disease may be due to autoimmunity, disturbances in metabolism and adverse reactions to medications. One inherited disorder causes excess iron absorption by the body, leading to dangerous iron deposits in the vital organs, including the liver. This faulty gene comes from both parents. One in 20 people carry one faulty gene, meaning that one in 400 may be affected by the disorder.
Most liver diseases, however, can be controlled through medication or other simple means if detected early enough. More complex and advanced cases need to be seen by a liver specialist. The advantage of seeing a hepatologist (a physician specializing in liver disease) lies not only in his/her special training and experience, but also in the network of liver specialists to which this physician is in contact. Patients can benefit from the advantage of tapping into the collective knowledge of liver experts across the country.
As part of the Digestive Disease Center, MUSC maintains separate outpatient clinics for liver patients, a separate inpatient service, and a multidisciplinary team to evaluate patients for transplantation.
On the horizon, we see advancements in several areas, including the following:
- improved methods and medications to combat the body's rejection of transplanted organs, as well as drugs to treat viral hepatitis and other disorders. Also being tested are short-term artificial livers that can keep a patient alive until a donor organ can be found, or the patient's own liver recovers.
- gene therapy, where physicians will be able to implant healthy genes into the liver to replace defective ones, permitting the replacement of missing or defective liver functions.
- telemedicine, linking MUSC's specialists with patients and other physicians by way of video networks.