Processing of bile and cholesterolLiverEncyclopedia Entry for Liver :Liver fluke infection - Clonorchis sinensis, Opisthorchis viverrini, O. felineus, Fasciola hepatica (liver flukes)Encyclopedia Entry for Liver :Liver biopsy. Most of the time, the test is done in the hospital. Before the test is done, you may be given a medicine to prevent pain or to calm you (sedative). The biopsy may be done through the abdominal wall: You will lie on your back with your right hand under your head. You need to stay as still as you can. The health care provider will find the correct spot for the biopsy needle to be inserted into the liver. This is often done by using ultrasound. The skin is cleaned, and numbing medicine is injected into the area using a small needle. A small cut is made, and the biopsy needle is inserted. You will be told to hold your breath while the biopsy is taken. This is to reduce the chance of damage to the lung or liver. The needle is removed quickly. Pressure will be applied to stop the bleeding. A bandage is placed over the insertion site. The procedure can also be done by inserting a needle into the jugular vein. If the procedure is performed this way, you will lie on your back. X-rays will be used to guide the provider to the vein. A special needle and catheter (thin tube) is used to take the biopsy sample. If you receive sedation for this test, you will need someone to drive you home.Tell your provider about: Bleeding problems Drug allergies Medicines you are taking including herbs, supplements, or medicines you bought without a prescription. Whether you are pregnant You must sign a consent form. Blood tests are sometimes done to test your blood's ability to clot. You will be told not to eat or drink anything for the 8 hours before the test. For infants and children: The preparation needed for a child depends on the child's age and maturity. Your child's provider will tell you what you can do to prepare your child for this test.You will feel a stinging pain when the anesthetic is injected. The biopsy needle may feel like deep pressure and dull pain. Some people feel this pain in the shoulder.The biopsy helps diagnose many liver diseases. The procedure also helps assess the stage (early, advanced) of liver disease. This is especially important in hepatitis B and C infection. The biopsy also helps detect: Cancer Infections The cause of abnormal levels of liver enzymes that have been found in blood tests The cause of an unexplained liver enlargement.The liver tissue is normal.The biopsy may reveal a number of liver diseases, including cirrhosis , hepatitis , or infections such as tuberculosis. It may also indicate cancer. This test also may be performed for: Alcoholic liver disease (fatty liver, hepatitis, or cirrhosis) Amebic liver abscess Autoimmune hepatitis Biliary atresia Chronic active hepatitis Chronic persistent hepatitis Disseminated coccidioidomycosis Hemochromatosis Hepatitis B Hepatitis C Hepatitis D Hepatocellular carcinoma Hodgkin lymphoma Non-alcoholic fatty liver disease Non-Hodgkin lymphoma Primary biliary cirrhosis Primary biliary cholangitis Pyogenic liver abscess Reye syndrome Sclerosing cholangitis Wilson disease.Risks may include: Collapsed lung Complications from the sedation Injury to the gallbladder or kidney Internal bleeding.Biopsy - liver; Percutaneous biopsy.Liver biopsy Liver biopsy.Berk PD, Korenblat KM. Approach to the patient with jaundice or abnormal liver tests.Encyclopedia Entry for Liver :Liver cancer - hepatocellular carcinoma. Hepatocellular carcinoma accounts for most liver cancers. This type of cancer occurs more often in men than women. It is usually diagnosed in people age 50 or older. Hepatocellular carcinoma is not the same as metastatic liver cancer , which starts in another organ (such as the breast or colon) and spreads to the liver. In most cases, the cause of liver cancer is long-term damage and scarring of the liver ( cirrhosis ). Cirrhosis may be caused by: Alcohol abuse Autoimmune diseases of the liver Hepatitis B or hepatitis C virus infection Inflammation of the liver that is long-term (chronic) Iron overload in the body ( hemochromatosis ) People with hepatitis B or C are at high risk of liver cancer, even if they do not develop cirrhosis.Symptoms of liver cancer may include any of the following: Abdominal pain or tenderness, especially in the upper-right part Easy bruising or bleeding Enlarged abdomen ( ascites ) Yellow skin or eyes ( jaundice ) Unexplained weight loss.The health care provider will perform a physical exam and ask about your symptoms. The physical exam may show an enlarged, tender liver or other signs of cirrhosis. If the provider suspects liver cancer, tests that may be ordered include: Abdominal CT scan Abdominal MRI scan Abdominal ultrasound Liver biopsy Liver function tests Serum alpha fetoprotein Some people who have a high chance of developing liver cancer may get regular blood tests and ultrasounds to see whether tumors are developing. To accurately diagnose hepatocellular carcinoma, a biopsy of the tumor must be done.Treatment depends on how advanced the cancer is. Surgery may be done if the tumor has not spread. Before surgery, the tumor may be treated with chemotherapy to reduce its size. This is done by delivering the medicine straight into the liver with a tube (catheter) or by giving it intravenously (by IV). Radiation treatments in the area of the cancer may also be helpful. But in people who have liver cirrhosis or other liver diseases, radiation is difficult to perform. Ablation is another method that may be used. Ablate means to destroy. Types of ablation include using: Radio waves or microwaves Ethanol (an alcohol) or acetic acid (vinegar) Extreme cold (cryoablation) A liver transplant may be recommended for certain people who have both cancer and cirrhosis. If the cancer can't be surgically removed or has spread outside the liver, there is usually no chance for long-term cure. Treatment instead focuses on improving and extending the person's life. Treatment in this case may use targeted therapy with drugs known as tyrosine kinase inhibitors that can be taken as pills.You can ease the stress of illness by joining a cancer support group. Sharing with others who have common experiences and problems can help you not feel alone.If the cancer can't be completely treated, the disease is usually fatal. But survival can vary, depending on how advanced the cancer is when diagnosed and how successful treatment is.Call your provider if you develop ongoing abdominal pain, especially if you have a history of liver disease.Preventive measures include: Preventing and treating viral hepatitis may help reduce your risk. Childhood vaccination against hepatitis B may reduce the risk of liver cancer in the future. Do not drink excessive amounts of alcohol. People with certain types of hemochromatosis (iron overload) may need to be screened for liver cancer. People who have hepatitis B or C or cirrhosis may be recommended for liver cancer screening.Primary liver cell carcinoma; Tumor - liver; Cancer - liver; Hepatoma.Digestive system Digestive system Liver biopsy Liver biopsy Hepatocellular cancer, CT scan Hepatocellular cancer, CT scan.Abou-Alfa GK, Jarnagin W, Lowery M, et al. Liver and bile duct cancer.Encyclopedia Entry for Liver :Liver disease - resources. Resources - liver disease.Cirrhosis of the liver Cirrhosis of the liver.Encyclopedia Entry for Liver :Liver disease. Liver fattening, CT scan Fatty liver, CT scan Liver with disproportional fattening, CT scan Liver with disproportional fattening, CT scan Cirrhosis of the liver Cirrhosis of the liver Liver Liver.Anstee QM, Jones DEJ. Liver and biliary tract disease.Encyclopedia Entry for Liver :Liver function tests. LFT.Liver function tests Liver function tests.Pincus MR, Abraham NZ. Interpreting laboratory results.Encyclopedia Entry for Liver :Liver metastases. Almost any cancer can spread to the liver. Cancers that can spread to the liver include: Breast cancer Colorectal cancer Esophageal cancer Lung cancer Melanoma Pancreatic cancer Stomach cancer The risk for cancer spreading to the liver depends on the location (site) of the original cancer. A liver metastasis may be present when the original (primary) cancer is diagnosed or it may occur months or years after the primary tumor is removed.In some cases, there are no symptoms. When symptoms occur, they may include: Decreased appetite Confusion Fever, sweating Jaundice (yellowing of the skin and whites of the eyes) Nausea Pain, often in the upper right part of the abdomen Weight loss.Tests that may be done to diagnose liver metastases include: CT scan of the abdomen Liver function tests Liver biopsy MRI of the abdomen PET scan Ultrasound of the abdomen.Treatment depends on: The primary cancer site How many liver tumors you have Whether the cancer has spread to other organs Your overall health Types of treatments that may be used are described below. SURGERY When the tumor is only in one or a few areas of the liver, the cancer may be removed with surgery. CHEMOTHERAPY When the cancer has spread to the liver and other organs, whole-body (systemic) chemotherapy is usually used. The type of chemotherapy used depends on the original type of cancer. When the cancer has only spread in the liver, systemic chemotherapy may still be used. Chemoembolization is a type of chemotherapy to one area. A thin tube called a catheter is inserted into an artery in the groin. The catheter is threaded into the artery in the liver. Cancer-killing medicine is sent through the catheter. Then another medicine is sent through the catheter to block blood flow to the part of the liver with the tumor. This 'starves' the cancer cells. OTHER TREATMENTS Alcohol (ethanol) injected into the liver tumor -- A needle is sent through the skin directly into the liver tumor. The alcohol kills cancer cells. Heat, using radio or microwave energy -- A large needle called a probe is placed into the center of the liver tumor. Energy is sent through thin wires called electrodes, which are attached to the probe. The cancer cells are heated and die. This method is called radiofrequency ablation when radio energy is used. It is called microwave ablation when microwave energy is used. Freezing, also called cryotherapy -- A probe is placed in contact with the tumor. A chemical is sent through the probe that causes ice crystals to form around the probe. The cancer cells are frozen and die. Radioactive beads -- These beads deliver radiation to kill the cancer cells and block the artery that goes to the tumor. This procedure is called radioembolization. It is done in much the same way as chemoembolization.How well you do depends on the location of the original cancer and how much it has spread to the liver or anywhere else. In rare cases, surgery to remove the liver tumors leads to a cure. This is usually only possible when there are a limited number of tumors in the liver. In most cases, cancer that has spread to the liver cannot be cured. People whose cancer has spread to the liver often die of their disease. However, treatments may help shrink tumors, improve life expectancy, and relieve symptoms.Complications are often the result of tumors spreading to a large area of the liver. They can include: Blockage of the flow of bile Decreased appetite Fever Liver failure (usually only in the late stages of disease) Pain Weight loss.Anyone who has had a type of cancer that can spread to the liver should be aware of the signs and symptoms listed above, and call the doctor if any of these develop.Early detection of some types of cancer may prevent the spread of these cancers to the liver.Metastases to the liver; Metastatic liver cancer; Liver cancer - metastatic; Colorectal cancer - liver metastases; Colon cancer - liver metastases; Esophageal cancer - liver metastases; Lung cancer - liver metastases; Melanoma - liver metastases.Liver biopsy Liver biopsy Hepatocellular cancer, CT scan Hepatocellular cancer, CT scan Liver metastases, CT scan Liver metastases, CT scan Digestive system organs Digestive system organs.National Comprehensive Cancer Network website. NCCN clinical practice guidelines in oncology (NCCN guidelines): hepatobiliary cancers. Version 1.2018. www.nccn.org/professionals/physician_gls/pdf/hepatobiliary.pdf. Updated February 14, 2018. Accessed: March 22, 2018. Sherman KL, Mahvi DM. Liver metastases.Encyclopedia Entry for Liver :Liver scan. The health care provider will inject a radioactive material called a radioisotope into one of your veins. After the liver has soaked up the material, you will be asked to lie on a table under the scanner. The scanner can tell where the radioactive material has gathered in the body. Images are displayed on a computer. You may be asked to remain still, or to change positions during the scan.You must sign a consent form. You will be asked to remove jewelry, dentures, and other metals that can affect the scanner's functions. You may need to wear a hospital gown.You will feel a sharp prick when the needle is inserted into your vein. You should not feel anything during the actual scan. If you have problems lying still or are very anxious, you may be given a mild medicine (sedative) to help you relax.The test can provide information about liver and spleen function. It is also used to help confirm other test results. The most common use for a liver scan is to diagnose a condition called benign focal nodular hyperplasia, or FNH, which causes a non-cancerous mass in the liver.The liver and spleen should look normal in size, shape, and location. The radioisotope is absorbed evenly.Abnormal results may indicate: Focal nodular hyperplasia or adenoma of the liver Abscess Budd-Chiari syndrome Infection Liver disease (such as cirrhosis or hepatitis ) Superior vena cava obstruction Splenic infarction (tissue death) Tumors.Radiation from any scan is always a slight concern. The level of radiation in this procedure is less than that of most x-rays. It is not considered to be enough to cause harm to the average person. Pregnant or nursing women should consult their provider before any exposure to radiation.Other tests may be needed to confirm the findings of this test. These may include: Abdominal ultrasound Abdominal CT scan Liver biopsy This test is used infrequently. Instead, MRI or CT scans are more often used to evaluate the liver and spleen.Technetium scan; Liver technetium sulfur colloid scan; Liver-spleen radionuclide scan; Nuclear scan - technetium; Nuclear scan - liver or spleen.Liver scan Liver scan.Lidofsky SD. Jaundice.Encyclopedia Entry for Liver :Liver spots. Liver spots are changes in skin color that occur in older skin. The coloring may be due to aging, exposure to the sun or other sources of ultraviolet light, or causes that are not known. Liver spots are very common after age 40. They occur most often on areas that have had the greatest sun exposure, such as the: Backs of the hands Face Forearms Forehead Shoulders.Liver spots appear as a patch or area of skin color change that is: Flat Light brown to black Painless.Your health care provider usually diagnoses the condition based on how your skin looks, especially if you are over 40 and have had a lot of sun exposure. You may need a skin biopsy to confirm the diagnosis if you have a liver spot that looks irregular.Most of the time, no treatment is needed. Talk to your provider about using bleaching lotions or creams. Most bleaching products use hydroquinone. This medicine is thought to be safe in the form used to lighten darkened skin areas. However, hydroquinone can cause blisters or skin reactions in sensitive people. Talk to your provider about other treatment options, including: Freezing ( cryotherapy ) Laser treatment Intense pulsed light.Liver spots are not dangerous to your health. They are permanent skin changes that affect how your skin looks.Call your provider if: You have liver spots and want them removed You develop any new symptoms, especially changes in the appearance of a liver spot.Protect your skin from the sun by taking the following steps: Cover your skin with clothing such as hats, long-sleeved shirts, long skirts, or pants. Use sunglasses to protect your eyes. Try to avoid the sun at midday, when sunlight is strongest. Use high-quality broad-spectrum sunscreens that have an SPF rating of at least 30. Apply sunscreen at least a half hour before you go out in the sun. Reapply it often. Use sunscreen in the winter, too.Sun-induced skin changes - liver spots; Senile or solar lentigines; Skin spots - aging; Age spots.Lentigo, solar on the back Lentigo, solar on the back Lentigo, solar with erythema on the arm Lentigo, solar with erythema on the arm.Habif TP. Light-related diseases and disorders of pigmentation.Encyclopedia Entry for Liver :Liver transplant. The donated liver may be from: A donor who has recently died and has not had liver injury. This type of donor is called a cadaver donor. Sometimes, a healthy person will donate part of his or her liver to a person with a diseased liver. For example, a parent may donate to a child. This kind of donor is called a living donor. The liver can regrow itself. Both people most often end up with fully working livers after a successful transplant. The donor liver is transported in a cooled salt-water (saline) solution that preserves the organ for up to 8 hours. The necessary tests can then be done to match the donor with the recipient. The new liver is removed from the donor through a surgical cut in the upper abdomen. It is placed into the person who needs the liver (called the recipient), and attached to the blood vessels and bile ducts. The operation may take up to 12 hours. The recipient will often need a large amount of blood through a transfusion.A healthy liver performs more than 400 jobs each day, including: Making bile, which is important in digestion Making proteins that help with blood clotting Removing or changing bacteria, medicines, and toxins in the blood Storing sugars, fats, iron, copper, and vitamins The most common reason for a liver transplant in children is biliary atresia. The most common reason for a liver transplant in adults is cirrhosis. Cirrhosis is scarring of the liver that prevents the liver from working well. It can worsen to liver failure. The most common causes of cirrhosis are: Long-term infection with hepatitis B or hepatitis C Long-term alcohol abuse Other illnesses that may cause cirrhosis and liver failure include: Autoimmune hepatitis Hepatic vein blood clot (thrombosis) Liver damage from poisoning or medicines Problems with the drainage system of the liver (the biliary tract), such as primary biliary cirrhosis or primary sclerosing cholangitis Metabolic disorders of copper or iron ( Wilson disease and hemochromatosis ) Fatty liver disease Liver transplant surgery is often not recommended for people who have: Certain infections, such as tuberculosis or osteomyelitis Difficulty taking medicines several times each day for the rest of their lives Heart or lung disease (or other life-threatening diseases) History of cancer Infections, such as hepatitis, that are considered to be active Smoking, alcohol or drug abuse, or other risky lifestyle habits.Risks for any anesthesia are: Problems breathing Reactions to medicines Risks for any surgery are: Bleeding Heart attack or stroke Infection Liver transplant surgery and management after surgery carry major risks. There is an increased risk of infection because you must take medicines that suppress the immune system to prevent transplant rejection. Signs of infection include: Diarrhea Drainage Fever Jaundice Redness Swelling Tenderness.Your health care provider will refer you to a transplant center. The transplant team will want to make sure that you are a good candidate for a liver transplant. You will make a few visits over several weeks or months. You will need to have blood drawn and x-rays taken. If you are the person getting the new liver, the following tests will be done before the procedure: Tissue and blood typing to make sure your body will not reject the donated liver Blood tests or skin tests to check for infection Heart tests such as an EKG , echocardiogram , or cardiac catheterization Tests to look for early cancer Tests to look at your liver, gallbladder, pancreas, small intestine, and the blood vessels around the liver Colonoscopy, depending on your age You may choose to look at one or more transplant centers to determine which is best for you: Ask the center how many transplants they perform every year, and their survival rates. Compare these numbers to those of other transplant centers. Ask what support groups they have available, and what travel and housing arrangements they offer. If the transplant team thinks you are a good candidate for a liver transplant, you will be put on a national waiting list. Your place on the waiting list is based on a number of factors. Key factors include the type of liver problems you have, how severe your disease is, and the likelihood that a transplant will be successful. The amount of time you spend on a waiting list is most often not a factor in how soon you get a liver, with the possible exception of children. While you are waiting for a liver, follow these steps: Follow any diet your transplant team recommends. Do not drink alcohol. Do not smoke. Keep your weight in the appropriate range. Follow the exercise program your provider recommends. Take all medicines prescribed for you. Report changes in your medicines and any new or worsening medical problems to the transplant team. Follow-up with your regular provider and transplant team at any appointments that have been made. Make sure the transplant team has your correct phone numbers, so they can contact you immediately if a liver becomes available. Make sure that, no matter where you are going, you can be contacted quickly and easily. Have everything ready ahead of time to go to the hospital.If you received a donated liver, you will likely need to stay in the hospital for a week or longer. After that, you will need to be closely followed up by a doctor for the rest of your life. You will have regular blood tests after the transplant. The recovery period is about 6 to 12 months. Your transplant team may ask you to stay close to the hospital for the first 3 months. You will need to have regular check-ups, with blood tests and x-rays for many years.People who receive a liver transplant may reject the new organ. This means that their immune system sees the new liver as a foreign substance and tries to destroy it. To avoid rejection, almost all transplant recipients must take medicines that suppress their immune response for the rest of their lives. This is called immunosuppressive therapy. Although the treatment helps prevent organ rejection, it also puts people at a higher risk for infection and cancer. If you take immunosuppressive medicine, you need to be regularly screened for cancer. The medicines may also cause high blood pressure and high cholesterol, and increase the risks for diabetes. A successful transplant requires close follow-up with your provider. You must always take your medicine as directed.Hepatic transplant; Transplant - liver; Orthotopic liver transplant; Liver failure - liver transplant; Cirrhosis - liver transplant.Donor liver attachment Donor liver attachment Liver transplant Liver transplant - series.Carrion AF, Martin P. Liver transplantation.