Know your Liver

The Human Liver 

The liver is the largest organ in the body (weighing about1.2 to 1.5kg). It is located on the right side of the abdomen, directly beneath the right lung, and is protected by the lower half of the rib cage. It performs many complex functions that are essential to life and good health


Liver Disease

Liver disease is any disturbance of liver function that causes illness. The liver is responsible for many critical functions within the body and should it become diseased or injured, the loss of those functions can cause significant damage to the body. Liver disease is also referred to as hepatic disease.

Liver disease is a broad term that covers all the potential problems that cause the liver to fail to perform its designated functions. Usually, more than 75% or three quarters of liver tissue needs to be affected before a decrease in function occurs.

The liver is the largest solid organ in the body; and is also considered a gland because among its many functions, it makes and secretes bile. The liver is located in the upper right portion of the abdomen protected by the rib cage. It has two main lobes that are made up of tiny lobules. The liver cells have two different sources of blood supply. The hepatic artery supplies oxygen rich blood that is pumped from the heart, while the portal vein supplies nutrients from the intestine and the spleen.

Normally, veins return blood from the body to the heart, but the portal vein allows nutrients and chemicals from the digestive tract to enter the liver for processing and filtering prior to entering the general circulation. The portal vein also efficiently delivers the chemicals and proteins that liver cells need to produce the proteins, cholesterol, and glycogen required for normal body activities.


Liver disease doesn’t always cause noticeable signs and symptoms. If signs and symptoms of liver disease do occur, the may include:

  • Skin and eyes that appear yellowish (jaundice)
  • Abdominal pain and swelling
  • Swelling in the legs and ankles
  • Itchy skin
  • Dark urine color
  • Pale stool color
  • Chronic fatigue
  • Nausea or vomiting
  • Loss of appetite
  • Tendency to bruise easily

When to see a doctor

Make an appointment with your doctor if you have any persistent signs or symptoms that worry you. Seek immediate medical attention if you have abdominal pain that is so severe that you can’t stay still.


To prevent liver disease:

  • Drink alcohol in moderation. For healthy adults, that means up to one drink a day for women and up to two drinks a day for men. Heavy or high-risk drinking is defined as more than eight drinks a week for women and more than 15 drinks a week for men.
  • Avoid risky behavior. Use a condom during sex. If you choose to have tattoos or body piercings, be picky about cleanliness and safety when selecting a shop. Seek help if you use illicit intravenous drugs, and don’t share needles to inject drugs.
  • Get vaccinated. If you’re at increased risk of contracting hepatitis or if you’ve already been infected with any form of the hepatitis virus, talk to your doctor about getting the hepatitis A and hepatitis B vaccines.
  • Use medications wisely. Take prescription and nonprescription drugs only when needed and only in recommended doses. Don’t mix medications and alcohol. Talk to your doctor before mixing herbal supplements or prescription or nonprescription drugs.
  • Avoid contact with other people’s blood and body fluids. Hepatitis viruses can be spread by accidental needle sticks or improper cleanup of blood or body fluids.
  • Keep your food safe. Wash your hands thoroughly before eating or preparing foods. If traveling in a developing country, use bottled water to drink, wash your hands and brush your teeth.
  • Take care with aerosol sprays. Make sure to use these products in a well-ventilated area, and wear a mask when spraying insecticides, fungicides, paint and other toxic chemicals. Always follow the manufacturer’s instructions.
  • Protect your skin. When using insecticides and other toxic chemicals, wear gloves, long sleeves, a hat and a mask so that chemicals aren’t absorbed through your skin.
  • Maintain a healthy weight. Obesity can cause nonalcoholic fatty liver disease.

Liver Transplant

Medical Procedure

A surgical procedure where the diseased liver is replaced with a healthy liver from a donor.

Type of procedure: Open

Recovery time: Can take several months

Duration: About 6-12 hours

Hospital stay: Typically several days

Liver Failure

A rare condition in which the liver is unable to perform its normal metabolic functions.

Rare (Fewer than 10 lakh cases per year in India)

Treatments can help manage condition, no known cure

Often requires lab test or imaging

Can last several months or years

Can be dangerous or life threatening if untreated

Urgent medical attention recommended

Cirrhosis of the Liver

It is a common degenerative disease of the liver resulting in scarring and liver failure.

Common (More than 10 lakh cases per year in India)

Treatments can help manage condition, no known cure

Requires lab test or imaging

Can last several years or be lifelong

Common for ages 50 and older

Family history may increase likelihood for some types

What to expect before procedure

  • The evaluation performed to assess if the patient is a suitable candidate for a liver transplant involves several lab, imaging tests and psychological assessment that span through multiple hospital visits.
  • Blood tests, urine tests, lung function tests, tests to check the functioning of heart etc; are performed.
  • In addition to lab or imaging tests such as pulmonary function tests, coronary artery catheterisation, chest X- ray, CT scan, kidney and liver function tests, other blood tests, information about the mental/emotional state, financial conditions, and family support is also collected.

What to expect during procedure

  • A general anaesthesia is given to maintain unconsciousness throughout the procedure.
  • The bile ducts and the blood supply to the diseased liver are cut off and the healthy liver is put in place. If it is from a living donor, only a portion of the liver is taken, and this regenerates rapidly after transplantation.
  • The bile ducts and the blood vessels are attached to the new liver.
  • Stitches or staples are used to close the incision.

What to expect after procedure

  • Immediately after the procedure, the patient is transferred to the intensive care unit (ICU), and monitored for signs of complications.
  • Once the condition improves, the patient is transferred to a regular hospital room.
  • Before the discharge, instructions are provided on care at home, symptoms to watch out for and medicines to be taken.
  • Regular monitoring and follow up is important. Hospital visits for tests are far more frequent in the first few months.
  • Learn about lifelong medical care such as the need for immunosuppressants and follow the instructions.

Risks and Complications

  • Graft rejection: The body might recognize the new liver as foreign and the immune system could attack it.
  • Graft failure: The transplanted liver might fail to function as expected.
  • Complications of the surgery include, infection, bleeding, blood clots, and blockage or leak in bile duct.
  • Long- term use of immunosuppressants can have side effects such as fluid retention, high blood pressure, weakening of bones, kidney damage, and higher susceptibility to cancer and infection.

The procedure is not performed in case of:

  • Extrahepatic malignancy
  • Severe and uncontrolled extrahepatic infection
  • Advanced heart or lung disease
  • Heart/kidney failure
  • Alcohol use disorder/smoking
  • Inability to adhere to a strict medical regimen

*Data from Focus Medica. Reviewed by a panel of doctors.

**Consult a medical professional for advice

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