It’s important to love your liver. It performs hundreds of tasks that are vital to life, from storing energy and fighting infection, to getting rid of waste products and toxins from the body. We look at its role, the causes of damage and some of the more common liver-related conditions.
Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose
Currently, patients with non-alcoholic fatty liver disease are encouraged to alter their lifestyles, but the focus has been on weight loss through dietary changes. But when patients were encouraged to be active for at least 150 minutes per week, they showed improvements in liver enzymes and other metabolic indices, which were not connected to weight loss.
Introduction:Your liver helps fight infections and cleans your blood. It also helps digest food and stores energy for when you need it. You cannot live without a liver that works.
If your liver fails, your doctor may put you on a waiting list for a liver transplant. Doctors do liver transplants when other treatments cannot keep a damaged liver working.
Liver transplantation or hepatic transplantation is the replacement of a diseased liver with a healthy liver allograft. The most commonly used technique is orthotopic transplantation, in which the native liver is removed and the donor organ is placed in the same anatomic location as the original liver. Liver transplantation nowadays is a well accepted treatment option for end-stage liver disease and acute liver failure.
During a liver transplantation, the surgeon removes the diseased liver and replaces it with a healthy one. Most transplant livers come from a donor who has died. Sometimes a healthy person donates part of his or her liver for a specific patient. In this case the donor is called a living donor. The most common reason for transplantation in adults is cirrhosis. This is a disease in which healthy liver cells are killed and replaced with scar tissue. The most common reason in children is biliary atresia, a disease of the bile ducts.
People who have transplants must take drugs for the rest of their lives to keep their bodies from rejecting their new livers.
Liver transplantation is usually done when other medical treatment cannot keep a damaged liver functioning.
The first human liver transplant was performed in 1963 by a surgical team led by Dr. Thomas Starzl of Denver, Colorado, United States. Dr. Starzl performed several additional transplants over the next few years before the first short-term success was achieved in 1967 with the first one-year survival posttransplantation. Despite the development of viable surgical techniques, liver transplantation remained experimental through the 1970s, with one year patient survival in the vicinity of 25%. The introduction of cyclosporine by Sir Roy Calne markedly improved patient outcomes, and the 1980s saw recognition of liver transplantation as a standard clinical treatment for both adult and pediatric patients with appropriate indications. Liver transplantation is now performed at over one hundred centres in the USA, as well as numerous centres in Europe and elsewhere. One year patient survival is 80-85%, and outcomes continue to improve, although liver transplantation remains a formidable procedure with frequent complications. Unfortunately, the supply of liver allografts from non-living donors is far short of the number of potential recipients, a reality that has spurred the development of living donor liver transplantation.
Liver transplantation is potentially applicable to any acute or chronic condition resulting in irreversible liver dysfunction, provided that the recipient does not have other conditions that will preclude a successful transplant. Metastatic cancer outside liver, active drug or alcohol abuse and active septic infections are absolute contraindications. While infection with HIV was once considered an absolute contraindication, this has been changing recently. Advanced age and serious heart, pulmonary or other disease may also prevent transplantation (relative contraindications). Most liver transplants are performed for chronic liver diseases that lead to irreversible scarring of the liver, or cirrhosis of the liver.
Before transplantation liver support therapy might be indicated (bridging-to-transplantation). Artificial liver support like liver dialysis or bioartificial liver support concepts are currently under preclinical and clinical evaluation. Virtually all liver transplants are done in an orthotopic fashion, that is the native liver is removed and the new liver is placed in the same anatomic location. The transplant operation can be conceptualized as consisting of the hepatectomy (liver removal) phase, the anhepatic (no liver) phase, and the postimplantation phase. The operation is done through a large incision in the upper abdomen. The hepatectomy involves division of all ligamentous attachments to the liver, as well as the common bile duct, hepatic artery, hepatic vein and portal vein. Usually, the retrohepatic portion of the inferior vena cava is removed along with the liver, although an alternative technique preserves the recipient’s vena cava (“piggyback” technique).
The donor’s blood in the liver will be replaced by an ice-cold organ storage solution, such as UW (Viaspan) or HTK until the allograft liver is implanted. Implantation involves anastomoses (connections) of the inferior vena cava, portal vein, and hepatic artery. After blood flow is restored to the new liver, the biliary (bile duct) anastomosis is constructed, either to the recipient’s own bile duct or to the small intestine. The surgery usually takes between five and six hours, but may be longer or shorter due to the difficulty of the operation and the experience of the surgeon.
The large majority of liver transplants use the entire liver from a non-living donor for the transplant, particularly for adult recipients. A major advance in pediatric liver transplantation was the development of reduced size liver transplantation, in which a portion of an adult liver is used for an infant or small child. Further developments in this area included split liver transplantation, in which one liver is used for transplants for two recipients, and living donor liver transplantation, in which a portion of healthy person’s liver is removed and used as the allograft. Living donor liver transplantation for pediatric recipients involves removal of approximately 20% of the liver (Couinaud segments 2 and 3).
Like all other allografts, a liver transplant will be rejected by the recipient unless immunosuppressive drugs are used. The immunosuppressive regimens for all solid organ transplants are fairly similar, and a variety of agents are now available. Most liver transplant recipients receive corticosteroids plus a calcinuerin inhibitor such as tacrolimus or Cyclosporin plus a antimetabolite such as Mycophenolate Mofetil.
Liver transplantation is unique in that the risk of chronic rejection also decreases over time, although recipients need to take immunosuppresive medication for the rest of their lives. It is theorized that the liver may play a yet-unknown role in the maturation of certain cells pertaining to the immune system. There is at least one study by Dr. Starzl’s team at the University of Pittsburgh which consisted of bone marrow biopsies taken from such patients which demonstrate genotypic chimerism in the bone marrow of liver transplant recipients.
About 80 to 90 percent of people survive liver transplantation. Survival rates have improved over the past several years because of drugs like cyclosporine and tacrolimus that suppress the immune system and keep it from attacking and damaging the new liver.
Prognosis is quite good. However those with certain illnesses may differ. There is no exact model to predict survival rates however those with transplant have a 58% chance of surviving 15 years.
Living donor transplantation:-
Living donor liver transplantation (LDLT) has emerged in recent decades as a critical surgical option for patients with end stage liver disease, such as cirrhosis and/or hepatocellular carcinoma often attributable to one or more of the following: long-term alcohol abuse, long-term untreated Hepatitis C infection, long-term untreated Hepatitis B infection. The concept of LDLT is based on (1) the remarkable regenerative capacities of the human liver and (2) the widespread shortage of cadaveric livers for patients awaiting transplant. In LDLT, a piece of healthy liver is surgically removed from a living person and transplanted into a recipient, immediately after the recipient’s diseased liver has been entirely removed.
Historically, LDLT began as a means for parents of children with severe liver disease to donate a portion of their healthy liver to replace their child’s entire damaged liver. The first report of successful LDLT was by Dr. Silvano Raia at the Universidade de São Paulo (USP) Medical School in 1986. Surgeons eventually realized that adult-to-adult LDLT was also possible, and now the practice is common in a few reputable medical institutes. It is considered more technically demanding than even standard, cadaveric donor liver transplantation, and also poses the ethical problems underlying the indication of a major surgical operation (hepatectomy) on a healthy human being. In various case series the risk of complications in the donor is around 10%, and very occasionally a second operation is needed. Common problems are biliary fistula, gastric stasis and infections; they are more common after removal of the right lobe of the liver. Death after LDLT has been reported at 0% (Japan), 0.3% (USA) and <1% (Europe), with risks likely to improve further as surgeons gain more experience in this procedure.
In a typical adult recipient LDLT, 55% of the liver (the right lobe) is removed from a healthy living donor. The donor’s liver will regenerate to 100% function within 4-6 weeks and will reach full volumetric size with recapitulation of the normal structure soon thereafter. It may be possible to remove 70% to 75% of the liver from a healthy living donor without harm in most cases. The transplanted portion will reach full function and the appropriate size in the recipient as well, although it will take longer than for the donor.
For More Information:-
American Liver Foundation
75 Maiden Lane, Suite 603
New York, NY 10038
Phone: 1–800–GO–LIVER (465–4837)
Hepatitis Foundation International (HFI)
504 Blick Drive
Silver Spring, MD 20904–2901
Phone: 1–800–891–0707 or 301–622–4200
United Network for Organ Sharing (UNOS)
P.O. Box 2484
Richmond, VA 23218
Phone: 1–888–894–6361 or 804–782–4800
Additional Information on Liver Transplantation :-
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Synonym-:Marian Thistle. Carduus lactifolius. Carduus marianus. Centaurea dalmatica. Mariana lactea. Common Names-:- Cardus marianus, Milk thistle, Blessed milkthistle, Marian thistle, Mary thistle, Saint Mary‘s thistle, Mediterranean milk thistle, Variegated thistle and Scotch thistle, Mary thistle, holy thistle. Milk thistle is sometimes called silymarin, which is actually a mixture of the herb’s active components, including silybinin (also called silibinin or silybin).
Habitat : Milk Thistle is native to S. Europe, N. Africa and W. Asia. Naturalized in Britain. It grows on waste places, usually close to the sea, especially if the ground is dry and rocky. .
Parts Used-: Whole herb, root, leaves, seeds and hull.
Description: Members of this genus grow as annual or biennial plants. The erect stem is tall, branched and furrowed but not spiny. The large, alternate leaves are waxy-lobed, toothed and thorny, as in other genera of thistle. The lower leaves are cauline (attached to the stem without petiole). The upper leaves have a clasping base. They have large, disc-shaped pink-to-purple, rarely white, solitary flower heads at the end of the stem. The flowers consist of tubular florets. The phyllaries under the flowers occur in many rows, with the outer row with spine-tipped lobes and apical spines. The fruit is a black achene with a white pappus
Only two species are currently classified in this genus:
Silybum eburneum Coss. & Dur., known as the Silver Milk Thistle, Elephant Thistle, or Ivory Thistle
Silybum eburneum Coss. & Dur. var. hispanicum
Silybum marianum (L.) Gaertner, the Blessed Milk Thistle, which has a large number of other common names, such as Variegated Thistle.
The two species hybridise naturally, the hybrid being known as Silybum Ã— gonzaloi CantÃ³ , SÃ¡nchez Mata & Rivas Mart. (S. eburneum var. hispanicum x S. marianum)
A number of other plants have been classified in this genus in the past but have since been relocated elsewhere in the light of additional research.
S. marianum is by far the more widely known species. It is believed to give some remedy for liver diseases (e.g. viral hepatitis) and an extract, silymarin, is used in medicine. The adverse effect of the medicinal use of milk thistle is loose stools.
This handsome plant is not unworthy of a place in our gardens and shrubberies and was formerly frequently cultivated. The stalks, like those of most of our larger Thistles, may be eaten, and are palatable and nutritious. The leaves also may be eaten as a salad when young. Bryant, in his Flora Dietetica, writes of it: ‘The young shoots in the spring, cut close to the root with part of the stalk on, is one of the best boiling salads that is eaten, and surpasses the finest cabbage. They were sometimes baked in pies. The roots may be eaten like those of Salsify.’ In some districts the leaves are called ‘Pig Leaves,’ probably because pigs like them, and the seeds are a favourite food of goldfinches.
The common statement that this bird lines its nest with thistledown is scarcely accurate, the substance being in most cases the down of Colt’s-foot (Tussilago), or the cotton down from the willow, both of which are procurable at the building season, whereas thistledown is at that time immature.
Westmacott, writing in 1694, says of this Thistle: ‘It is a Friend to the Liver and Blood: the prickles cut off, they were formerly used to be boiled in the Spring and eaten with other herbs; but as the World decays, so doth the Use of good old things and others more delicate and less virtuous brought in.’
The heads of this Thistle formerly were eaten, boiled, treated like those of the Artichoke.
There is a tradition that the milk-white veins of the leaves originated in the milk of the Virgin which once fell upon a plant of Thistle, hence it was called Our Lady’s Thistle, and the Latin name of the species has the same derivation. Cultivation:
Succeeds in any well-drained fertile garden soil. Prefers a calcareous soil and a sunny position. Hardy to about -15°c. The blessed thistle is a very ornamental plant that was formerly cultivated as a vegetable crop. Young plants are prone to damage from snails and slugs. Plants will often self sow freely.
Seed – if sown in situ during March or April, the plant will usually flower in the summer and complete its life cycle in one growing season. The seed can also be sown from May to August when the plant will normally wait until the following year to flower and thus behave as a biennial. The best edible roots should be produced from a May/June sowing, whilst sowing the seed in the spring as well as the summer should ensure a supply of edible leaves all year round.
Root – raw or cooked. A mild flavour and somewhat mucilaginous texture. When boiled, the roots resemble salsify (Tragopogon hispanicus). Leaves – raw or cooked. The very sharp leaf-spines must be removed first, which is quite a fiddly operation. The leaves are quite thick and have a mild flavour when young, at this time they are quite an acceptable ingredient of mixed salads, though they can become bitter in hot dry weather. When cooked they make an acceptable spinach substitute. It is possible to have leaves available all year round from successional sowings. Flower buds – cooked. A globe artichoke substitute, they are used before the flowers open. The flavour is mild and acceptable, but the buds are quite small and even more fiddly to use than globe artichokes. Stems – raw or cooked. They are best peeled and can be soaked to reduce the bitterness. Palatable and nutritious, they can be used like asparagus or rhubarb or added to salads. They are best used in spring when they are young. A good quality oil is obtained from the seeds. The roasted seed is a coffee substitute
The seeds of this plant are used nowadays for the same purpose as Blessed Thistle, and on this point John Evelyn wrote: ‘Disarmed of its prickles and boiled, it is worthy of esteem, and thought to be a great breeder of milk and proper diet for women who are nurses.’
It is in popular use in Germany for curing jaundice and kindred biliary derangements. It also acts as a demulcent in catarrh and pleurisy. The decoction when applied externally is said to have proved beneficial in cases of cancer.
Gerard wrote of the Milk Thistle that:
‘the root if borne about one doth expel melancholy and remove all diseases connected therewith. . . . My opinion is that this is the best remedy that grows against all melancholy diseases,’
which was another way of saying that it had good action on the liver. He also tells us:
‘Dioscorides affirmed that the seeds being drunke are a remedy for infants that have their sinews drawn together, and for those that be bitten of serpents:’and we find in a record of old Saxon remedies that ‘this wort if hung upon a man’s neck it setteth snakes to flight.’ The seeds were also formerly thought to cure hydrophobia.
Culpepper considered the Milk Thistle to be as efficient as Carduus benedictus for agues, and preventing and curing the infection of the plague, and also for removal of obstructions of the liver and spleen. He recommends the infusion of the fresh root and seeds, not only as good against jaundice, also for breaking and expelling stone and being good for dropsy when taken internally, but in addition, to be applied externally, with cloths, to the liver. With other writers, he recommends the young, tender plant (after removing the prickles) to be boiled and eaten in the spring as a blood cleanser.
A tincture is prepared by homoeopathists for medicinal use from equal parts of the root and the seeds with the hull attached.
It is said that the empirical nostrum, antiglaireux, of Count Mattaei, is prepared from this species of Thistle.
Thistles in general, according to Culpepper, are under the dominion of Jupiter.
Milk thistles have been reported to have protective effects on the liver and to improve its function. They are typically used to treat liver cirrhosis, chronic hepatitis (liver inflammation), and gallbladder disorders. The active compound in Milk thistle credited with this effect is “silymarin”, and is typically administered in amount ranging from 200-500mg per day (common Milk Thistle supplements have an 80% standardized extract of silymarin). Increasing research is being carried out into its possible medical uses and the mechanisms of such effects. However, a previous literature review using only studies with both double-blind and placebo protocols concluded that milk thistle and its derivatives “does not seem to significantly influence the course of patients with alcoholic and/or hepatitis B or C liver diseases.”
Silymarin is poorly soluble in water, so aqueous preparations such as teas are ineffective, except for use as supportive treatment in gallbladder disorders because of cholagogic and spasmolytic effects. The drug is best administered parenterally because of poor absorption of silymarin from the gastrointestinal tract. The drug must be concentrated for oral use. Silymarin’s hepatoprotective effects may be explained by its altering of the outer liver cell membrane structure, as to disallow entrance of toxins into the cell. This alteration involves silymarin’s ability to block the toxin’s binding sites, thus hindering uptake by the cell. Hepatoprotection by silymarin can also be attributed to its antioxidant properties by scavenging prooxidant free radicals and increasing intracellular concentration of glutathione, a substance required for detoxicating reactions in liver cells.
Silymarin’s mechanisms offer many types of therapeutic benefit in cirrhosis with the main benefit being hepatoprotection. Use of milk thistle, however, is inadvisable in decompensated cirrhosis. In patients with acute viral hepatitis, silymarin shortened treatement time and showed improvement in serum levels of bilirubin, AST and ALT.
Treatment claims also include:
1.Lowering cholesterol levels
2.Reducing insulin resistance in people with type 2 diabetes who also have cirrhosis
3.Reducing the growth of cancer cells in breast, cervical, and prostate cancers.
4.Milk thistle is also used in many products claiming to reduce the effects of a hangover.
5.Milk thistle can also be found as an ingredient in some energy drinks like the AriZonaBeverage Company Green Tea energy drink and Rockstar Energy Drink.
How It Is Used:
Milk thistle is a flowering herb. Silymarin, which can be extracted from the seeds (fruit), is believed to be the biologically active part of the herb. The seeds are used to prepare capsules containing powdered herb or seed; extracts; and infusions (strong teas).
What the Science Says:
There have been some studies of milk thistle on liver disease in humans, but these have been small. Some promising data have been reported, but study results at this time are mixed.
Although some studies conducted outside the United States support claims of oral milk thistle to improve liver function, there have been flaws in study design and reporting. To date, there is no conclusive evidence to prove its claimed uses.
NCCAM is supporting a phase II research study to better understand the use of milk thistle for chronic hepatitis C. With the National Institute of Diabetes and Digestive and Kidney Diseases, NCCAM is planning further studies of milk thistle for chronic hepatitis C and nonalcoholic steatohepatitis (liver disease that occurs in people who drink little or no alcohol). The National Cancer Institute and the National Institute of Nursing Research are also studying milk thistle, for cancer prevention and to treat complications in HIV patients.
Other Uses: Green manure; Oil; Oil..……A good green manure plant, producing a lot of bulk for incorporation into the soil.
Known Hazards : When grown on nitrogen rich soils, especially those that have been fed with chemical fertilizers, this plant can concentrate nitrates in the leaves. Nitrates are implicated in stomach cancers. Diabetics should monitor blood glucose when using. Avoid if decompensated liver cirrhosis. Possible headaches, nausea, irritability and minor gastrointestinal upset
The information presented herein is intended for educational purposes only. Individual results may vary, and before using any supplements, it is always advisable to consult with your own health care provider Resources:
The most common cause of severe long-term liver disease in developed countries is excessive alcohol consumption. More men than women have alcohol related liver disease because more men drink heavily. However, women are more susceptible to liver damage from alcohol because of differences in the way that men and women metabolize alcohol. regular excessive alcohol consumption is more likely to cause damage to the liver than sporadic heavy drinking. The longer excessive alcohol consumption continues, the greater the likelihood of developing liver disease. Long-term alcohol-related liver disease is known to increase the risk of developing liver cancer.
click & see the pictures What are the types?
Alcohol may cause three types of liver disease, alcoholic hepatitis, and cirrhosis. Typically, these conditions occur in sequence, but this is not always the case. Over a number of years, most heavy drinkers develop a fatty liver, in which fat globules develop within liver cells. If alcohol consumption continues, hepatitis or inflammation of the liver develops. with continued drinking, cirrhosis develops. In this condition, liver cells that are damage by alcohol are replaced by fibrous scar tissue. If cirrhosis has developed, liver damage is irreversible. it is not known why some heavy drinkers go on to develop hepatitis of cirrhosis while others do not.
What are the symptoms?
In many cases, fatty liver does not cause symptoms and often remains undiagnosed. however, in about 1 in 3 affected people, the liver becomes enlarged, which may lead to discomfort in the right upper abdomen.
Alcoholic hepatitis also may knot produce symptoms, but after about 10 years of heavy drinking in men and sooner in women, the first symptoms may usually develop. these may include:
Â· Nausea and occasional vomiting.
Â· Discomfort in the upper right side of the abdomen.
Â· Weight loss.
Â· Yellowing of the skin and the whites of the eyes.
Â· Swollen abdomen.
Cirrhosis may often cause no symptoms for number of years or only mild symptoms, including:
in some cases, severe cirrhosis may lead to a serious condition in which there is bleeding Into the digestive tract from abnormal blood vessels that develop in the wall of the esophagus. Severe alcoholic hepatitis and cirrhosis can lead to liver failure, in which may result in coma and death.
How is it diagnosed?
A history of heavy alcohol consumption is essential for the diagnosis of alcohol-related liver disease. it is important that you be honest and tell your doctor exactly how much you drink. However, many people who drink heavily are reluctant to do this.
Your doctor may arrange for blood test to evaluate your liver function. You may also have a liver biopsy, a procedure in which a hollow needle is inserted into the liver to obtain a sample of liver tissue. The sample is then examined under a microscope to look for cell abnormalities.
What is the treatment?
People with alcohol related disease must stop drinking completely and forever. Many people need professional help to achieve. If drinking continues, the disease will probably progress and may be fatal. if drinking stops, the prognosis is likely to improve.
Fatty liver often disappears after 3-6 months of abstinence of alcohol. some people with alcoholic hepatitis who stop drinking recover completely. However, damage to the liver is irreversible, and the condition progresses to cirrhosis. severe alcoholic cirrhosis can cause a number of serious complications, which in some cases may be fatal. about half of all people who have cirrhosis die from liver failure within 5 years. More than 1 in 10 people with cirrhosis go on to develop liver cancer. People with alcohol-related liver disease who have no other serious health problems and have stopped drinking may be candidates for a liver transplant.
Many of the symptoms and some of the complications of alcohol-related liver disease can be treated with some success. For example, swelling of the abdomen, which results from fluid accumulation in the abdominal cavity, may be decreased by diuretic drugs and a diet that is low in salt. nausea can frequently be relieved by antiemetic drugs.
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Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.