Chronic hepatitis refers to a condition of hepatic inflammation, necrosis, and fibrosis that is present for at least 6 months. There are numerous causes of chronic hepatitis.
Wilson’s disease is a treatable, genetic disorder. The metabolic defect leads to progressive accumulation of copper in the liver, brain (particularly in the basal ganglia), cornea, and kidneys, causing severe functional impairment leading to irreversible damage.
Hemochromatosis refers to a group of disorders in which excessive iron absorption, either alone or in combination with parenteral iron loading, leads to a progressive increase in total body iron stores. Iron is deposited in the parenchymal cells of the liver, heart, pancreas, synovium, and skin, and the pituitary, thyroid, and adrenal glands. Parenchymal deposition of iron results in cellular damage and functional insufficiency of the involved organs.
Nonalcoholic fatty liver disease is a spectrum of liver diseases with histologic features of alcohol induced liver disease that occurs in individuals who do not consume significant quantities of alcohol. The spectrums of the liver diseases include hepatic steatosis (fatty liver); nonalcoholic steatohepatitis with histologic evidence of hepatitis, hepatocellular injury, necrosis and, fibrosis; and cirrhosis with eventual portal hypertension and other complications.
The association of alcohol abuse and liver damage has been known since the time of the ancient Greeks. The availability of alcoholic beverages, licensing laws, and economic, cultural, and environmental conditions all influence both per capita alcohol consumption and mortality from alcohol- related liver disease. Alcoholism is, in part, inherited, and aberrant alcohol-drinking behavior is genetically influenced.
Absorption, distribution, and elimination. In a healthy man, about 100 mg of ethanol per kilogram of body weight is eliminated in an hour. Heavy alcohol consumption for years may increase the rate of ethanol elimination up to 100%.
Liver transplantation is an effective and accepted therapy for a variety of chronic, irreversible liver diseases for which no other therapy has proved to be satisfactory. The liver can be transplanted as an extra (auxiliary) organ at another site or in the orthotopic location after the removal of the host liver.
The routine evaluation process involves a number of laboratory tests and x-ray studies. Additional studies are tailored to the individual patient after a thorough review of the patient’s records from the referring physician.
The liver filters both arterial and portal venous blood and thus is a major site for the spread of metastatic cancers, particularly those that originate in the abdomen. Metastatic liver tumors can develop after the primary tumor has been identified, or patients can present initially with the signs and symptoms of metastatic liver disease.
Technical (procedure-related) complications. The abdominal wall incision used by most transplant surgeons is a bilateral subcostal incision that is extended in the upper midline. The xiphoid process is excised.