The following contains topics that have been brought up during discussions related to organ disease and treatments. This page contains both a quick-link table and a section further below with more details on some of the topics.

Sections:    A-C  •  D-F  •  G-H  •  I-L  •  M-O  •  P-S  •  T-U  •  V-Z  •  Details

Topic Link
ACR ↓ See Below: ACR
AFP ↓ See Below: AFP
ALP (Alkaline phosphatase) ↓ See Below: ALP
Acyclovir See Below: Acyclovir
Albumin ↓ See Below: Albumin
Ammonia Level See Below: Ammonia Level
Angioplasty https://my.clevelandclinic.org/health/treatments/22060-angioplasty
Ascites ↓ See Below: Ascites
Asterixis ↓ See Below: Asterixis
Atrophy ↓ See below: Atrophy
BK Virus ↓ See Below: BK Virus
BUN Test https://www.mayoclinic.org/tests-procedures/blood-urea-nitrogen/about/pac-20384821
Bausch PAP ↓ https://www.bauschhealthpap.com/eligible-medications/
Bilirubin ↓ See Below: Bilirubin
CMV ↓ See Below: CMV
CPMC https://www.sutterhealth.org/about-us/our-hospitals/california-pacific-medical-center
Camino Hospital IOP ↓ See Below: Camino Hospital IOP
Cirrhosis ↓ See Below: Cirrhosis
Corewell Health ↓ See Below: Corewell Health
CostPlus ↓ See Below: CostPlus
Creatine Test https://www.mayoclinic.org/tests-procedures/creatinine-test/about/pac-20384646
Creatinine ↓ See Below: Creatinine
DSA ↓ See Below: DSA
DXA scan ↓ https://my.clevelandclinic.org/health/diagnostics/10683-dexa-dxa-scan-bone-density-test
Decompensated Cirrhosis ↓ See Below: Decompensated Cirrhosis
Dialysis ↓ See Below: Dialysis
Diverticulitis ↓ See Below: Diverticulitis
Donor Info ↓ See below: Donor Info
Drug Regimen ↓ See Below: Drug Regimen
Duncan Mills ↓ See Below: Duncan Mills
Dupuytren’s contracture https://pubmed.ncbi.nlm.nih.gov/6672504/
Dysphagia ↓ See Below: Dysphagia
ESLD ↓ See Below: ESLD
Edema ↓ See Below: Edema
El Camino ↓ https://www.beverlyhillscarclub.com/1969-chevrolet-el-camino-c-4561.htm
Encephalitis ↓ See Below: Encephalitis
Encephalopathy ↓ See Below: Encephalopathy
Erica Storm ↓ See Below: Erica Storm
Esophageal Varices ↓ See Below: Esophageal Varices
Excess Protein https://protealpes.com/en/whey-danger-rein-ce-que-dit-la-science/
FIB-4 ↓ See Below: FIB-4
Fibroscan ↓ See Below: Fibroscan
Fibroscan ↓ See Below: Fibroscan
Filgrastim ↓ See Below: Filgrastim
Fistula ↓ See Below: Fistula
GFR and Aging ↓ See Below: GFR and Aging
GGT ↓ See Below: GGT
GGT ↓ See Below: GGT
Gabapentin ↓ See Below: Gabapentin
Gallbladder ↓ https://www.dukehealth.org/treatments/transplant-program/liver-transplant/liver-transplant-surgery
Gallbladder Cancer ↓ See Below: Gallbladder Cancer
Gougol ↓ https://med.stanford.edu/profiles/amir-gougol
Gynecomastia ↓ See Below: Gynecomastia
HCC GALAD Model ↓ https://www.mdcalc.com/calc/10094/galad-model-hepatocellular-carcinoma-hcc
HE ↓ See Below: Hepatic Encephalopathy
HIDA Scan ↓ See Below: HIDA Scan
HPMV https://my.clevelandclinic.org/health/diseases/22443-human-metapneumovirus-hmpv
Hemochromatosis ↓ See Below: Hemochromatosis
Hemodialysis ↓ See Below: Hemodialysis
Hepatitis ↓ See Below: Hepatitis
Hypomagnesium ↓ https://my.clevelandclinic.org/health/diseases/23264-hypomagnesemia
INR ↓ See Below: INR
IOP ↓ See Below: Intense Outpatient Program
Immunosuppressant ↓ See Below: Immunosuppressant
Immunosuppression ↓ See Below: Immunosuppression
Itching ↓ See Below: Itching
J-Tube ↓ See Below: J-Tube
Jaundice ↓ See Below: Jaundice
Ketorolac https://www.mayoclinic.org/drugs-supplements/ketorolac-oral-route-injection-route/description/drg-20066882
Kt/V ↓ See Below: Kt/V
LOLA ↓ See Below: LOLA
Lactulose ↓ See Below: Lactulose
Liver Circle ↓ https://www.thelivercircle.org
Liver In A Box ↓ See Below: Liver In A Box
Liver Pain https://www.carygastro.com/blog/what-are-the-possible-causes-of-liver-pain
LiverSpot.org https://liverspot.org
MELD ↓ See Below: MELD
MELD Exception Score ↓ See Below: MELD Exception Score
MRE ↓ See Below: MRE
MRI ↓ See Below: MRI
Medical Marijuana https://disa.com/marijuana-legality-by-state/
Multiple Listing ↓ See Below: Multiple Listing
Mycophenolate Mofetil ↓ See Below: Mycophenolate Mofetil
NASH ↓ See Below: NASH
NIVESTYM ↓ See Below: NIVESTYM
Naltrexone https://www.drugs.com/naltrexone.html
Neuropathy ↓ See below: Neuropathy
Neutropenia ↓ https://my.clevelandclinic.org/health/diseases/21058-neutropenia
Nurse Treats ↓ See below: Nurse Treats
OPTN ↓ See Below: OPTN
Osmolite https://www.amazon.com/Osmolite-Unflavored-High-Protein-High-Calorie-Nutrition/dp/B002C5YLG0
Oxycodone https://medlineplus.gov/druginfo/meds/a682132.html
PEth ↓ See below: PEth
PT ↓ See Below: PT
Paracentesis ↓ https://my.clevelandclinic.org/health/procedures/paracentesis
Pink Cloud https://www.healthline.com/health/pink-cloud
Post-Transplant Relapse ↓ See below: Post-Transplant Relapse
Printed Liver ↓ Colorado.Edu : Printed Livers
Recompensated ↓ See Below: Recompensated
Recteq https://www.recteq.com/
Reddit for Transplant Support Study ↓ https://journals.lww.com/transplantationdirect
Retacrit ↓ See Below: Retacrit
SRTR ↓ <https://www.srtr.org/
Safety net ↓ See Below: Safety Net
Scar Tissue ↓ See Below: Scar Tissue
Skin Cancer Risk ↓ https://www.ucsfhealth.org/education/organ-transplant-and-skin-cancer-risk
St. Mary’s https://saintmarysreno.com
TACE ↓ See Below: TACE
TIPS ↓ See Below: TIPS
Tacrolimus ↓ See Below: Tacrolimus
Tacrolimus Skin Cancer↓ https://www.amjtransplant.org/article/S1600-6135(22)00129-0/fulltext
Tacrolimus vs. CellCept ↓ https://www.amjtransplant.org/article/S1600-6135(22)03862-X/fulltext
Tacrolimus-induced Ascites https://pmc.ncbi.nlm.nih.gov/articles/PMC6390981/
Tattoos ↓ See Below: Tattoos
Thoracentesis ↓ See Below: Thoracentesis
Topical Tacrolimus https://www.mayoclinic.org/drugs-supplements/tacrolimus-topical-route/description/drg-20068159
Tramadol https://www.mayoclinic.org/drugs-supplements/tramadol-oral-route/description/drg-20068050
Transplant Age ↓ See below: Transplant Age
Transplant Games ↓ https://www.transplantgamesofamerica.org
Transplant Survival Benefit ↓ See below: Transplant Survival Benefit
Tumeric https://www.ynhhs.org/articles/supplements-liver-damage
UNOS ↓ See Below: UNOS
UNOS Regions https://www.hrsa.gov/optn/about/governance/regions
Umbilical Hernia https://my.clevelandclinic.org/health/diseases/umbilical-hernia
Ursodiol ↓ See Below: Ursodiol
Valcyte ↓ See Below: Valcyte
Vivitrol ↓ See Below: Vivitrol
XIAFLEX https://dupuytrens-contracture.xiaflex.com/patient/about-xiaflex/
Xifaxan ↓ https://www.rxconnected.com/drug/xifaxan

Topic Details

ACR

Acute cellular rejection

«While antibody mediated hyper-acute vasculitic rejection is rare in liver transplant recipients, acute and chronic rejection have clinical significance. The liver allograft behaves differently to other solid organ transplants as acute rejection generally does not impair graft survival and chronic rejection (CR) is uncommon. The incidence of acute and chronic rejection has declined in current era due to improved immunosuppressive regimens. Acute rejection generally improves with steroid boluses and steroid resistant rejection is uncommon. CR may improve with escalation of immunosuppression or may result in irreversible loss of graft function leading to retransplantation or death. The current review discusses diagnosis and management of acute and chronic liver allograft rejection» — [1]

«High dose corticosteroids are standard of care for ACR and doses vary at different centers. Usually 500–1000 mg pulse of methylprednisolone is given for 1–3 days followed by taper» — [1]

AFP

«An AFP tumor marker test is a blood test that measures the level of AFP (alpha-fetoprotein) in a sample of your blood. It’s usually used to help diagnose certain types of cancer and to check how well treatment is working.» — [1]

ALP

«Alkaline phosphatase (ALP) is an enzyme that’s found throughout your body. ALP blood tests measure the level of ALP in your blood that comes from your liver and bones, and it’s one of the tests included in a comprehensive metabolic panel. High levels of ALP in your blood may indicate liver disease or certain bone disorders» — [1]

Acyclovir

«Acyclovir is used to treat viral infections like chickenpox, herpes zoster (shingles) and genital herpes (a sexually transmitted disease). Acyclovir is in a class of medications called antivirals. It works by stopping the spread of the virus in the body.» — [2]

Ammonia Level

«A blood ammonia level of 200 micromol /L is associated with coma and convulsions.» — [1]

Albumin

«Albumin is responsible for transporting vitamins, enzymes and hormones throughout your body. Albumin makes up 50% of the proteins found in your plasma. When your albumin levels are low, hormones and other important compounds aren’t able to get to where they need to go in your body to fulfill their duties.» — [2]

Ascites

«Ascites is the accumulation of water in the abdomen, commonly due to leakage from the liver’s portal vein. Ascites adds significant body weight as the water accumulates, making movement more difficult. It also pushes on internal organs, and this compression can affect ability to breath, eat, and other body activities.» — [3]

Asterixis

«Asterixis is an inability to maintain sustained posture, commonly causing hands to flap when the wrist is extended. It is a symptom of hepatic encephalopathy and is why a doctor may ask a patient to hold out their hands.» — [3]

Atrophy

«Muscle loss during hospitalization is a major clinical concern, as it has been associated with reduced physical function, quality of life, and increased mortality. This review outlines the key causes of muscle wasting and highlights practical strategies to support muscle mass preservation during hospitalization.» — [1]

«National Institutes of Health. Critical care patients can lose up to 3% of leg muscle mass per day.» — [1]

«showing an average loss of about 1 kg (2.2 lbs) within 24 hours of acute care and up to 2.3 kg (5 lbs) by discharge,» — [2]

BK Virus

«The BK virus is a virus that most people get in childhood. Symptoms can feel like a common cold. Once you get a BK virus infection, the virus stays in your system for good but in an inactive state.

When you take anti-rejection medications due to an organ transplant, the BK Virus can become active to the point that it will damage kidneys.» — [3]

Bausch PAP

Bausch Health PAP Summary (2026) What it is: A program that provides Xifaxan at no cost for up to one year for eligible patients

Bilirubin

«Bilirubin is a yellowish substance made during your body’s normal process of breaking down old red blood cells. Bilirubin is found in bile, a fluid your liver makes that helps you digest food. If your liver is healthy, it will remove most of the bilirubin from your body.» — [1]

CMV

«A cytomegalovirus (CMV) infection is a condition caused by a common virus. The CMV virus stays in the body for life after infection.

[…]

For people who have weakened immune systems, CMV infection can be fatal. The risk is especially high for people who’ve had an organ, stem cell or bone marrow transplant.» — [1]

Alternate name

«Human cytomegalovirus (HCMV), also called human herpesvirus 5 (HHV-5), is a species of virus in the genus Cytomegalovirus» — [3]

CPMC

California Pacific Medical Center (CPMC) — https://www.sutterhealth.org/about-us/our-hospitals/california-pacific-medical-center

Camino Hospital IOP

«The Scrivner Center for Mental Health & Addiction Services’ evening outpatient Addiction Services Program offers expert care and support for adults seeking help for a substance-use disorder or chemical dependency.» — [1]

Cirrhosis

«Cirrhosis is a condition in which your liver is scarred and permanently damaged. Scar tissue replaces healthy liver tissue and prevents your liver from working normally. As cirrhosis gets worse, your liver begins to fail.» — [5]

Corewell Health

3535 W. 13 Mile Road Suite 644, Royal Oak, MI 48073

CostPlus

« We started Mark Cuban Cost Plus Drug Company because every American should have access to safe, affordable medicines. If you don’t have insurance or have a high deductible plan, you know that even the most basic medications can cost a fortune. Many people are spending crazy amounts of money each month just to stay healthy. No American should have to suffer—or worse—because they can’t afford basic prescription medications» — https://www.costplusdrugs.com/

Creatinine

«Creatinine is the waste byproduct of the muscles processing energy from creatine. Properly functioning kidneys remove creatinine from the blood supply.» — [2]

DSA

A Donor Service Area (DSA) is a smaller portion of a UNOS Region in which organs can be transported successfully.

  • [1] https://www.organdonationalliance.org/glossary/dsa/

DXA scan

A DXA scan is an imaging test that measures the strength of your bones. It uses X-rays to measure your bone density. DXA is an abbreviation for dual-energy X-ray absorptiometry.

https://my.clevelandclinic.org/health/diagnostics/10683-dexa-dxa-scan-bone-density-test

Decompensated Cirrhosis

«Decompensated cirrhosis is defined as an acute deterioration in liver function in a patient with cirrhosis and is characterized by jaundice, ascites, hepatic encephalopathy, hepatorenal syndrome or variceal haemorrhage.

Liver damage and severe scarring can progress to the point where the liver can no longer function properly and the patient will begin to experience more severe symptoms. Liver function will continue to decrease with the patient being more at risk for more severe complications like internal bleeding, liver cancer and liver failure and the need for liver transplant.» — [3]

Dialysis

«Dialysis functions as a very effective but partial replacement for the processes of the kidneys. The main capability is the removal of waste products (e.g. see Creatinine above) from the blood supply. A secondary capability is the removal of water from the blood supply, and through that, from areas water is over-accumulating.» — [3]

Diverticulitis

«Diverticula are common, especially after age 50. They are usually found in the lower part of the colon. Most often, they don’t cause problems. The presence of diverticula is called diverticulosis. Diverticulosis isn’t a disease condition. When these pouches become inflamed, the condition is called diverticulitis. Inflammation is immune system activity that increases blood flow and fluids to a site in the body and delivers disease-fighting cells. Inflammation of diverticula can cause severe pain, fever, nausea and changes in your stool habits.» — [1]

Donor Info

Drug Regimen

«A drug regimen describes the specific instructions and schedule for administering one or more drugs to a patient. It includes factors such as drug dosage, frequency, route of administration, and duration of treatment.» — [2]

Duncan Mills

Dysphagia

Dysphagia is an inability to swallow properly. Food and liquids orally taken can be aspirated (inhaled) and cause pneumonia and other illness.

ESLD

End-Stage Liver Disease (ESLD) is when the liver is damaged beyond repair due to chronic liver disease or acute liver failure.

Edema

Edema (or Oedema) is swelling caused by too much fluid trapped in the body’s tissues. Edema can affect any part of the body. But it’s more likely to show up in the legs and feet.

El Camino [Car]

Encephalitis

«Encephalitis is swelling of the brain. Frequently also used as an easier to pronounce version of encephalopathy by laymen, myself included.» — [4]

Encephalopathy

«Encephalopathy is disease affecting the brain, from the Greek ‘enkephalos’ (about the brain) and ‘pathos’ (disease). Depending on severity encephalopathy can show up as symptoms from headaches to coma. Hepatic encephalopathy (HE) is caused by liver problems and accumulated toxins in the blood.» — [3]

Erica Storm

Esophageal Varices

Esophageal varices are enlarged veins in the esophagus, the tube that connects the throat and stomach. Esophageal varices most often happen in people with serious liver diseases.

FIB-4

Fibrosis-4 (FIB-4) Index for Liver Fibrosis. Noninvasive estimate of liver scarring in HCV and HBV patients, to assess need for biopsy.

«We use FIB-4 as an initial assessment. In chronic HCV, when combined with APRI, it has excellent negative predictive value for excluding advanced fibrosis. The positive predictive value is less clear. Those with FIB-4 >1.5 and/or APRI >0.5 often go on to liver elastography.» — [1]

Fibroscan

«FibroScan is a special ultrasound technology that measures liver stiffness (hardness) and fatty changes in your liver. These measurements help your healthcare provider learn more about your liver disease» — [1]

  • [1] <https://www.mskcc.org/cancer-care/patient-education/understanding-your-fibroscan-results
  • [2] <https://agcosprings.com/procedures/fibroscan/
  • [3] <https://tawazunhealth.com/fibrosscan-stiffness-results/
  • [4] <https://tawazunhealth.com/wp-content/uploads/2021/03/Wbe-Stiffness-2021.png

Filgrastim

«Filgrastim injection is used to treat neutropenia (low white blood cells) that is caused by cancer medicines. It is a synthetic (man-made) form of a substance that is naturally produced in your body called a colony stimulating factor. Filgrastim helps the bone marrow to make new white blood cells. » — https://www.mayoclinic.org/drugs-supplements/filgrastim-injection-route/description/drg-20071547

Fistula

«An Arteriovenous (AV) fistula is a direct connection between an artery and a vein. Normal blood flow goes from arteries through capillaries and then into veins. The fistula’s direct connection causes much more blood flow into a vein. Surgically creating a fistula in a chronic hemodialysis patient enables more effective and safer treatment compared to using a central venous catheter.» — [3]

GFR and Aging

«This paper discusses the known effects of ageing on GFR and the consequences of using a classification system for defining CKD that does not take into account the normal decline of GFR with ageing» — [1]

GGT

«A gamma-glutamyl transferase (GGT) test measures the amount of GGT in your blood GGT is an enzyme. Enzymes are proteins that speed up certain chemical reactions in your body. Thousands of enzymes play an important role in all of your body functions. The GGT enzyme is found throughout your body, but it is mainly found in your liver.» — https://medlineplus.gov/lab-tests/gamma-glutamyl-transferase-ggt-test/

Gabapentin

«Gabapentin works in the brain to prevent seizures and relieve pain for certain conditions in the nervous system. It can also be used for controlling the effects of neuropathy.» — [2]

Gallbladder

« gallbladder attached to the donor liver will be detached to ensure that it does not cause problems with your new liver, and your gallbladder will also be removed. » — [1]

Gallbladder Cancer

«Hilar/perihilar cholangiocarcinoma (pCCA), or gallbladder cancer involving the bile ducts, is recognized as a specific MELD exception condition, often receiving a score equal to the median MELD at transplant (MMaT) minus 3 points, subject to National Liver Review Board (NLRB) approval. » — [1]

«To qualify, the tumor must be unresectable, liver-limited, and meet strict » — [1]

Gougol

Professional Education

  • Fellowship: UCSF Dept of Gastroenterology (2023) CA
  • Fellowship: University of Pittsburgh Medical Center Division of Gastroenterology (2022) PA
  • Board Certification: American Board of Internal Medicine, Transplant Hepatology (2024)
  • Board Certification: American Board of Internal Medicine, Gastroenterology (2023)
  • Board Certification: American Board of Internal Medicine, Internal Medicine (2019)
  • Residency: University of Pittsburgh Medical Center Internal Medicine (2019) PA
  • Medical Education: Tehran University of Medical Sciences (2011) Iran

Gynecomastia

«Gynecomastia (guy-nuh-koh-MAS-tee-uh) is an increase in the amount of breast gland tissue in boys or men. An imbalance of the hormones estrogen and testosterone causes it. Gynecomastia can affect one or both breasts, sometimes unevenly.» — https://www.mayoclinic.org/diseases-conditions/gynecomastia/symptoms-causes/syc-20351793

HCC GALAD model

The GALAD model:

Seems pretty well endorsed: « The GALAD model has been demonstrated to have higher diagnostic accuracy for the detection of hepatocellular carcinoma (HCC) when compared to the use AFP, AFP-L3, and DCP markers alone or in combination. The performance of the GALAD score has also been reported to be superior to ultrasound for HCC detection» — [1]

HE

HE is short for Hepatic Encephalopathy.

Encephalopathy is disease affecting the brain, from the Greek ‘enkephalos’ (about the brain) and ‘pathos’ (disease). Depending on severity encephalopathy can show up as symptoms from headaches to coma. Hepatic encephalopathy (HE) is caused by liver problems and accumulated toxins in the blood.

HIDA Scan

«A hepatobiliary iminodiacetic acid (HIDA) scan is an imaging procedure that shows how well your liver, bile ducts and gallbladder are functioning. It can help diagnose certain conditions, such as cholecystitis, biliary leak and biliary atresia.» — [1]

Hemochromatosis

Hemochromatosis (he-moe-kroe-muh-TOE-sis) causes your body to absorb too much iron from the food you eat. Excess iron is stored in your organs, especially your liver, heart and pancreas. Too much iron can lead to life-threatening conditions, such as liver disease, heart problems and diabetes.

Hemodialysis

«Hemodialysis is dialysis done by pulling blood from the body and running it through a dialyzer (filter) along with a dialysate (solution) to filter the blood of toxins.» — [2]

Hepatitis

«Hepatitis means inflammation of the liver. Usually the term is short for one of the five Viral Hepatitis strains: Hepatitis A, B, C, D and E.»

Hypomagnesium

Magnesium oxide, sodium bicarbonate, Sucralfate, or other antacids should not be taken within two hours of taking tacrolimus. For example, if your child takes tacrolimus at 8:00 a.m., magnesium oxide should not be given until 10:00 a.m. or later.

INR

«An International Normalized Ratio (INR) test calculates how long it takes for blood to clot compared to a normal healthy person (with a value of ‘1’). Blood thinners and illness can cause blood to take several times longer than normal to clot.» — [3]

IOP

An Intensive Outpatient Program (IOP) is a hospital program that meets several times a week for several hours at a time. IOPs are supposed to be as effective as residential programs and can also function as a transition from an inpatient program to normal life surroundings.

Virtual IOP

Immunosuppressant

«Immunosuppressants are drugs or medicines that lower the body’s ability to reject a transplanted organ. Another term for these drugs is anti-rejection drugs.» — [5]

Immunosuppression

Itching

«Itching is a common symptom from liver damage. Possible helpful treatments include: Cholestyramime Powder, Hydroxyzine, and Sarna lotion .» — [2]

J-Tube

A Jejunal Tube (J-Tube) is a one-meter tube extending from outside your nose to your duodenum (small intestine). It is used to deliver food and medicines to people who are incapable of orally consuming them.

Jaundice

«Jaundice is a yellow color of the skin, mucus membranes, or eyes. The yellow coloring comes from bilirubin, a byproduct of old red blood cells. Jaundice can be a symptom of several health problems.»

Kt/V

The parameter Kt/V is a measurement of the efficacy of a dialysis session (hemo or peritoneal)

LOLA

L‐ornithine‐L‐aspartate for hepatic encephalopathy

«Results: A total of 12 articles were ultimately included, involving 858 patients, with 433 in the treatment group and 425 in the control group. Meta-analysis results: In terms of the total effective rate (RR: 1.31, 95%CI: 1.22, 1.42), the result is statistically significant (Z = 7.15, P = 0.00001 < 0.05), and for AST, ALT, NH3, TBIL, P = 0.00001 < 0.05. The pooled (RR: 1.31 [95% CI = 1.22, 1.42]), which is statistically significant, LOLA and Lactulose is 31% more effective than Lactulose alone in the control group in treating HE.» — [2]

LOLA is not FDA approved for HE at all, although it wouldn’t really be possible to prevent oral administration using foreign dispensaries. It appears that the studies have been viewed as very weak and the usage of LOLA is always in addition to Lactulose (alone) or with Rifaximin. So it is unclear what the benefits are if you are on L+R (which is FDA approved).

Lactulose

«Lactulose (sometimes called ‘The L-Word’) is a laxative with a secondary treatment for Hepatic Encephalopathy. Its chief mechanism of action is by decreasing the intestinal production and absorption of ammonia.» — [2]

Liver Circle

Imagine a world where a liver disease diagnosis isn’t a dead end, but a new beginning. Where the fear of a “transplant” is replaced by the power of knowledge and a supportive community.

This is the world The Liver Circle, Inc. (TLC) is building. We’re more than an organization; we’re a vital connection for patients, advocates, and medical professionals. We elevate the conversation around liver health and organ donation from the ordinary to the extraordinary, ensuring no one faces this journey alone.

Liver In A Box

The transportation of a donated liver by placing it into a ‘box’ (machine) that provide ‘normothermic’ (standard temperature) perfusion.

MELD

A model for end-stage liver disease

«The model for end-stage liver disease (MELD) score helps decide how urgently someone needs a liver transplant in the next three months. The score ranges from 6 to 40. A person with a higher score needs a liver transplant sooner than does a person with a lower score.» — [1]

Only really relevant if a transplant is indicated, but used somewhat to produce an aggregate sickness level.

There are statistical correlations between level of liver illness (e.g. the MELD score) and the chance of survival for a period of time (E.g. « A MELD score above 30 indicates a 50% chance of dying in three months.» — [2] ).

«A MELD score of 25 indicates a high risk of mortality, with estimated 3-month mortality rates typically falling within the range of 19.6% to 45.5%. » — [6]

MELD Exception Score

A MELD Exception Score is a modifier to the calculated MELD score. Some transplant candidates have a medical condition, such as cancer or rare forms of chronic liver disease, where MELD or PELD will not accurately predict their short-term transplant need. If so, they may qualify for an exception score — a separately assigned score to be used instead of their calculated MELD or PELD in matching the person for available organ offers. The goal of exception scores is to make access to transplant more equitable among patients with similar levels of medical urgency.

MRE

Magnetic resonance elastography (MRE) is a technology that combines MRI imaging with low-frequency vibrations to create a visual map (elastogram) that shows stiffness of body tissues.

MRI

Magnetic resonance imaging (MRI) is a type of diagnostic test that can create detailed images of nearly every structure and organ inside the body. MRI uses magnets and radio waves to produce images on a computer.

Multiple Listing

Multiple listing involves registering at two or more transplant hospitals. In general, candidates listed at hospitals closest to the donor hospital will get more matching priority than other candidates who are in similar medical condition, but listed at transplant hospitals farther away.

Mycophenolate Mofetil

«Mycophenolate Mofetil is an immunosuppressant that prevents rejection of transplanted organs and augments Tacrolimus.» — [3]

NASH

«Nonalcoholic steatohepatitis (NASH) is the most severe form of nonalcoholic fatty liver disease (NAFLD), a condition in which the liver builds up excessive fat deposits.» — [2]

Naltrexone

Neuropathy

Peripheral neuropathy happens when the nerves that are located outside of the brain and spinal cord (peripheral nerves) are damaged.

Neutropenia

«Neutropenia involves having lower-than-normal levels of neutrophils (a type of white blood cell) in your blood. It’s especially common among people receiving cancer treatments, like chemotherapy. Neutrophils help fight infections. If you have neutropenia, it’s important to take extra precautions to avoid germs that may make you sick.» — [2]

« Hand washing should be done: Before eating, drinking, and taking medicine […] After contact with pets

You must avoid all of the following:

  • […]
  • Crowds
  • […]
  • Grooming pets or cleaning bird cages, litter boxes, and fish tanks Long periods of bed rest Hot and humid environments, such as saunas, greenhouses, and pools » — [1]

NIVESTYM

«NIVESTYM (filgrastim-aafi) is a biosimilar to Neupogen (filgrastim) and part of the largest oncology biosimilars portfolio, brought to you by Pfizer» — So it is a brand name related to filgrastim

Nurse Treats

Possible treats that the medical team might like and appreciate from patients in gratitude for their service:

OPTN

«Organ Procurement and Transplantation Network (OPTN) is a unique public-private partnership that links all professionals involved in the U.S. donation and transplantation system. Also crucial to the system are individuals who sign organ donor cards, people who comment on policy proposals and countless volunteers who support donation and transplantation, among many others.» — [1]

PEth

«Phosphatidylethanol (PEth) testing is a reliable method to help create a picture of alcohol consumption.» — [2]

PT

Prothrombin Time (PT) is a measure of blood coagulation.

Paracentesis

«Paracentesis is the process of draining water from the abdominal cavity. A long needle is inserted into a pocket of water (commonly found through ultrasound) and the water drained into vacuum bottles. With severe ascites, several liters can be removed. Beyond the comfort from draining excess water, the fluid can be analyzed for infections or other causes.» — [3]

Post-Transplant Relapse

«The prevalence rate of alcohol relapse in liver transplant patients with ALD varies across studies. Reported post-transplant alcohol relapse rates in recipients with ALD range from 15% to 50% [5].» — [1]

Printed Liver

Could 3D-printed livers make transplant lists a thing of the past?

Recompensated

«As highlighted previously, the term recompensated cirrhosis is only limited to aetiologies where a clear cause is identified and can be targeted. This limits the application of this term to aetiologies like viral cirrhosis and ALD. According to the present evidence, patients with NAFLD by definition cannot be categorized as recompensated despite fulfilling other criteria. This may limit the application of this term as NAFLD remains the most common form of liver disease and in the future may become the leading cause of cirrhosis and its complications worldwide. There is an evidence that sustained weight loss decreases hepatic steatosis and can cause reversal of fibrosis. Defining recompensation in the context of NAFLD may need modification of the criteria mentioned above in the future. However, the pertinent question in this aspect is whether or not a patient with NAFLD can ever be considered recompensated as data regarding recompensation in NAFLD does not exist unlike other aetiologies. Conceptualizing a model to define recompensation in NAFLD cirrhosis with the current backdrop of aetiological suppression would be challenging given the dynamics of metabolic risk factors once cirrhosis sets inpatients with NAFLD.» — [1]

«Adapting a concept of recompensation can have its own ethical issues, especially in countries where disease-specific scores are used to decide the timing of transplantation. Labelling a patient recompensated may lead to delisting from transplant list.» — [1]

Reddit for Transplant Support Study

« Consulting r/Transplant: Assessment of Reddit Use and Sentiment in Solid Organ Transplantation»

« Solid organ transplants are life-changing experiences that impact recipients, donors, care partners, medical teams, communities, and popular media. Social media is an influential part of modern life and provides a platform for healthcare experiences. This study assessed perspectives on solid organ transplantation by exploring the transplant community’s utilization of the social media site Reddit.» — [1]

Retacrit

«This medication is used to treat anemia (low red blood cell count) in people with long-term serious kidney disease (chronic kidney failure), people receiving zidovudine to treat HIV, and people receiving chemotherapy for some types of cancer (cancer that does not involve the bone marrow or blood cells). It may also be used in anemic patients to reduce the need for blood transfusions before certain planned surgeries that have a high risk of blood loss (usually given with an anticoagulant/”blood thinner” medication such as warfarin to lower the risk of serious blood clots).» — [2]

SRTR

«The Scientific Registry of Transplant Recipients (SRTR) supports the transplant community with analyses, in an effort to better patient results and experience. Through the evaluation of national data collected by the Organ Procurement and Transplant Network (OPTN) on transplant programs and organ procurement organizations…» — [1,2]

The SRTR website provides access to a very detailed group of reports and tools to review organ transplant data. This information can be used by patients, family members / caregivers, and living donors / potential living donors, as well as transplant professionals, industry professionals, government regulators, and others.

Safety Net

The website about the safety net program that was on UNOS was seriously messed up recently with an administrative change, but you can read about it here (if the archive works… can be slow) and some quotes are below

« What is a safety net policy?

A safety net policy is for candidates who may not meet eligibility criteria for a simultaneous organ transplant, or who were not listed for a multi-organ transplant. For candidates who need a heart or lung transplant and have some renal dysfunction, transplant programs may opt to proceed with a single organ transplant (in this case a heart or lung transplant) in order to allow the kidneys to recover. If the kidneys do not recover in a timely fashion, a candidate may be eligible to receive safety net priority for a kidney transplant. » — [1]

Scar Tissue

Scar tissue reaches approximately 50% of original skin strength at 6 weeks and up to 80% at 3 months, but it never regains the full elasticity or strength of uninjured skin. — https://pmc.ncbi.nlm.nih.gov/articles/PMC3840475/

Skin Cancer Risk

At least need yearly skin checks, although someone heard it needs to be four times per year.

TACE

«Transarterial chemoembolization (TACE) places chemotherapy and synthetic materials called embolic agents into a blood vessel feeding a cancerous tumor to cut off the tumor’s blood supply and trap the chemotherapy within the tumor. It is most often used to treat liver cancer but may also be used in patients whose cancer has spread to other areas of the body. Chemoembolization may be used as a standalone treatment or in combination with surgery, ablation, chemotherapy or radiation therapy.» — [1]

«Y-90 therapy, also known as selective internal radiation therapy or SIRT, is a minimally invasive, image-guided approach treating malignant lesions in the liver. The procedure uses a catheter to deliver tiny radioactive beads into the blood vessels that lead directly to the tumor. This allows doctors to treat tumors that are not accessible using conventional surgery or radiation treatments. A Y-90 procedure typically takes about two hours, but requires an overnight stay for observation.» — [2]

TIPS

«Transjugular intrahepatic portosystemic shunt (TIPS) is a procedure to create new connections between two blood vessels in your liver. You may need this procedure if you have severe liver problems.» — [2]

«TIPS procedures typically take one to two hours. Your team will move you to a recovery room after the procedure. They’ll check on you as you wake up from anesthesia» — [1]

Tacrolimus

«Tacrolimus is a very powerful immunosuppressant that prevents rejection of transplanted organs.» — [2]

Tacrolimus Skin Cancer

«Tacrolimus is a potent immunosuppressant used in liver transplants that significantly increases the risk of skin cancer—often by 10- to 30-fold—due to suppressed immune surveillance. Risk is linked to cumulative exposure, with higher doses in the first year increasing cancer likelihood. Regular dermatological monitoring is vital» — [1]

Tacrolimus vs. CellCept

«Tacrolimus (a calcineurin inhibitor) is generally more potent at preventing acute rejection, while CellCept is often better tolerated with fewer metabolic side effects» — [AI]

Tattoos

Thoracentesis

Thoracentesis is a procedure that a provider uses to drain extra fluid from around the lungs (pleural space) with a needle. It’s used to test the fluid for infection or other illnesses and to relieve chest pressure that makes it tough to breathe. Thoracentesis is a short, low-risk procedure done while you’re awake.

Transplant Age

«There is no strict, universal maximum age for a liver transplant, as candidacy is based on physiological, not chronological, age. » — AI Summary

Transplant Games

Transplant Survival Benefit

«With 1 year of available post-transplant follow-up, MELD category 15–17 represented a transition point. Posttransplant mortality risk was more than three times higher than waiting list mortality for MELD scores 6–11 (hazard ratio = 3.64; 95% confidence interval = 2.23–5.95; p < 0.001). The hazard ratio was also greater than 1.0 among patients with MELD 12–14 (hazard ratio = 2.35; 95% confidence interval 1.48–3.76; p < 0.001). Conversely, significant transplant survival benefit was observed at MELD scores 18 and higher, and the magnitude of transplant benefit increased with increasing MELD score» — [1]

— [2]

UNOS

«United Network for Organ Sharing (UNOS) manages the transplant system for the United States.» — [2]

Ursodiol

Ursodiol is a bile thinner that helps your body recover from the removal of the gallbladder.

Valcyte

Valcyte: https://www.mayoclinic.org/drugs-supplements/valganciclovir-oral-route/description/drg-20066642 —

Generic name: Valganciclovir

Valganciclovir is used to treat symptoms of cytomegalovirus (CMV) retinitis, an infection in the eyes of people with acquired immunodeficiency syndrome (AIDS). Valganciclovir will not cure this eye infection, but it may help to keep the symptoms from becoming worse.

Vivitrol

«Vivitrol is a long-acting injectable form of naltrexone, which is a medication used to treat two substance use disorders - opioid use disorder and alcohol use disorder (alcoholism). Vivitrol is used as part of a treatment program. It helps prevent people with alcohol or opioid dependence from feeling like they need to use these substances.» — [2]

Xifaxan

Rifaximin (tradename Xifaxan) treats traveler’s diarrhea and irritable bowel syndrome by stopping the growth of the bacteria that cause diarrhea. Rifaximin treats hepatic encephalopathy by stopping the growth of bacteria that produce toxins and that may worsen liver disease.

Xifaxan is now available as a generic (Rifaxamin) in Canada. The patent protection in the US (Until 2029?) did not happen in Canada.

Other brand names are: Xifaxanta/Zaxine