Abdominal Transplant and Liver Disease Clinic at Baylor St. Luke's Medical Center - Houston, TX

Hepatitis refers to the inflammation of the liver and has a variety of causes (bacterial and viral) and is communicable/infections. Diagnosing hepatitis involves a physical exam and liver function test, with possible blood tests and liver biopsy. Managing hepatitis varies by strand, if it’s chronic or acute, and may involve antiviral drugs. Vaccines are available for Hepatitis A and B.

If a diagnostic liver test displays abnormalities, a biochemical serum evaluation can provide more information, particularly the type of liver injury (hepatocellular vs. cholestatic). The evaluation of abnormal liver tests is particularly useful in asymptomatic cases, and can track patterns and severity, as well as likely causes, of liver disease.

Cirrhosis, or end-stage liver disease, often has a side effect of portal hypertension — high blood pressure due to restricted blood flow in the portal vein, the large blood vessel that takes blood from the heart to the liver. Managing cirrhosis with portal hypertension often requires surgery, such as the TIPS (transjugular intrahepatic portosystemic shunt) procedure.

A paracentesis, or abdominal tap, is a procedure that uses a needle or catheter to remove built-up fluid (ascites) from the peritoneal cavity of the abdomen for evaluation in a lab. A paracentesis can be used as a diagnostic tool for cancers or infection, or to treat painful swelling and other conditions by removing the excess fluid.

Treating alcohol-related and metabolic liver disease require lifestyle/behavioral changes. Liver diseases cause by excessive consumption of alcohol are fatty liver, alcoholic hepatitis, or cirrhosis (in order of severity), and all require abstaining from alcohol to treat. Metabolic liver disease is genetic, and is treated with strategic dietary changes and other interventions.

Treatment of Hepatitis C (a viral infection of the liver that causes liver disease and liver cancer) involves antiviral medications and, in severe cases, liver transplantation. Medications include chemotherapy-like injections, which can carry debilitating side effects, and, increasingly, with oral medications. The exact regimen of medication depends on the Hepatitis C genotype present.

A liver transplant is a surgery to replace a person’s diseased liver with all or part of a healthy liver from an organ donor. Liver transplantation is performed in cases of end-stage liver disease/chronic liver failure, which is caused by conditions such as cirrhosis, liver cancer, viral hepatitis, or hepatic necrosis.

Radiofrequency ablation (RFA), also known as rhizotomy, is a minimally invasive procedure that uses radiofrequency waves to burn specific nerve endings with the goal of reducing or stopping the transmission of pain signals to the brain.

Hepatobiliary surgery treats disorders of the liver, bile ducts, and pancreas, e.g., cancer, tumors, pancreatitis, organ failure, hepatitis C, advanced liver disease, and gallstones. Procedures may be open or laparoscopic, and most often involve removing the tumor and/or part or all of the affected tissue.

Paracentesis is a simple procedure in which a hollow needle or catheter is used to remove the excess fluid from the body. Abdominal paracentesis refers to the process of removing excess fluid from the abdominal cavity.

The evaluation and treatment of liver abnormalities and diseases is most effective when done early. Liver diagnostics include blood tests, imaging tests, and biopsies, and they check the levels of liver enzymes and other functionality. Treatment of liver disease may involve medication, lifestyle changes, and, in severe cases, surgery or transplants.

Treatment of chronic liver disease (cirrhosis) involves lifestyle changes and medication to slow the development of scar tissue in the liver and, in cases of end-stage liver disease/chronic liver failure (caused by conditions such as cirrhosis, liver cancer, viral hepatitis, or hepatic necrosis), surgery or transplants.

Treatment of co-occurring Hepatitis B and C, which cause liver disease, begins with the virus that is more dominant. Hepatitis B currently has no cure, but there are antiviral medications to manage it. Hepatitis C is treated either with chemotherapy-like injections, or with oral medications.

Treatment of liver mass and liver cancer typically involves a partial hepatectomy (partial liver resection) surgery to remove the tumor(s) and affected tissue to stop its spread. Because the liver is an essential organ, the remaining portion must be healthy enough to support the patient. Depending on severity and spread, a liver transplant may be necessary.