Clinical Resource: Inside the Liver Transplant Process at UAMS

How we approach our patients in need of liver  transplantation is through a very comprehensive team effort here at UAMS. What we have is a  collaboration between the transplant hepatologist, the surgeons. We also have a significant group  of uh valuable members of the team that includes the social workers, transplant coordinators,  which are nurses. We have also dieticians, specialized pharmacists, so we create a whole  team that goes around the patient to take them by the hand through this very complex process of  transplant evaluation that includes a series of medical tests but also a lot of interviews  and a lot of procedures that are needed to evaluate the patient to see if they actually  are going to benefit from a liver transplant uh procedure and to maximize the benefit of these  procedures for them So we take them by the hand to get them through this very complex uh situation  to try to minimize the the amount of stress for their families. Liver transplant and hepatology  in general has evolved significantly over the last 30 years. We have gone from these very highly  selected indications to now offer liver transplant to other diseases that you don’t even imagine that  they will need liver transplantation. Nowadays we are even offering liver transplantation for  patients with colorectal metastasis, other type of liver cancers, other diseases that are independent  from the liver but they affect the liver that will benefit from liver transplantation like metabolic  diseases too. In when I started my practice as a fellow and then initial practice uh here at UAMS  our main indication for liver transplantation was hepatitis E and chronic liver disease related  to it and nowadays after we were able through many research and offering these new antiviral  therapies we are curing hepatitis E before they need liver transplant which has come nowadays that  the main indications for liver transplantation is the resurgence of alcohol use disorder and  the main epidemics in metabolic associated liver diseases which is what we commonly known  as fatty liver. There’s no such safe level of alcohol drinking in reality. So alcohol is a risk factor to develop liver disease and any amounts actually of use of alcohol are related  to all cause of mortality including cancer, diabetes, obesity, liver disease so there is  no such a safe threshold of drinking alcohol.