Liver disease is on the rise. Successfully managing this complex disease takes an experienced team. For many patients with advanced disease, a life-saving liver transplant is needed. At Froedtert & The Medical College of Wisconsin, world-class expertise and comprehensive care translate into patient outcomes that are among the best in the nation.


L


ast March, Debbie and Jack Fleming of New Berlin were invited to dinner with friends out of town. Debbie Fleming decided to stay home.


“I didn’t want to go, because I wasn’t supposed to be


more than an hour from the hospital,” she recalled. Fleming had liver disease for years and was on the national


liver transplant wait list through Froedtert & The Medical College of Wisconsin. She had been on the list just a short time, but the severity of her illness placed her near the top.


Jack attended the dinner alone,


then returned home later that evening. The couple had just turned in when the phone rang.


“It was about 12:30 at night,”


Fleming said. “I didn’t quite believe it. When you get a late- night call, you think something’s wrong, but it was the opposite.” A donor liver was available. The couple immediately left for Froedtert & The Medical College.


a growing need More than 16,000 people in


the United States are on the United Network for Organ Sharing national wait list for liver transplant. Unfortunately, only about one-third will actually receive a donor organ. Experts expect the gap to grow even wider in the coming years as liver disease becomes more common.


The liver is the largest organ in the human body and


one of the most versatile, aiding in digestion of food, making agents that help blood clot, and filtering toxins out of the bloodstream.


Diseases that may affect the


liver include hepatitis (inflammation of the liver), cirrhosis (scarring), fatty liver (accumulation of fat in the liver cells), and liver cancer (hepatocellular carcinoma).


“Not everyone with liver disease


n samer gawrieh, md


will need a transplant,” said Samer Gawrieh, MD, Medical College of Wisconsin gastroenterologist/ hepatologist and medical director of the Liver Transplant Program at


n debbie fleming plays with her grandson, eThan.


Froedtert & The Medical College of Wisconsin. “Many people with less severe disease can live for a long time without developing complications.”


It takes a comprehensive team to successfully manage


liver disease, and Froedtert & The Medical College of Wisconsin provide care for people with acute and chronic liver disease as well as end-stage liver disease. Team members include hepatologists (physicians who specialize in liver disease), physician assistants, nurses and others who are highly trained and experienced in managing all types of liver disease. Froedtert & The Medical College also conduct research to study the effects of new drugs and treatments that can improve outcomes for patients.


For people whose liver


disease has progressed to liver failure, the symptoms become more notable: fatigue, jaundice, fluid build-up in the abdomen or legs, internal bleeding and even mental confusion. Cirrhosis, or scarring of the


liver tissue, also puts people at higher risk for liver cancer. “When liver disease progresses to liver failure, cirrhosis


or liver cancer, the patient should be evaluated for liver transplant,” Dr. Gawrieh said.


A multidisciplinary medical review board evaluates the


patient’s candidacy for transplantation and other treatments and therapies; candidates accepted for liver transplantation are registered on the national waiting list. In liver transplantation, the organ allocation system is complex, but the overall goal is to get organs to the sickest patients regardless of how long they have been waiting.


“running ouT of sTeam” Fleming’s journey to transplant began nearly 20 years


ago, when routine blood work revealed she was infected with hepatitis C. “I don’t know how I acquired it – nobody does,” she said. “I had never had any symptoms.”


Fleming’s liver disease was monitored by her


gastroenterologist for many years. She eventually developed cirrhosis and began to experience the symptoms of liver failure.


froedtert.com Froedtert Today January 2012 11 continued


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