There is a huge organ shortage in the United States. In order to deal with the fair distribution of organs, Congress passed the National Organ Transplant Act in 1984. This act prohibited the sale of organs in the United States. The Organ Procurement and Transplantation Network (OPTN) brings together medical professionals, transplant recipients and donor families to develop organ transplantation policy. United Network for Organ Sharing (UNOS) manages the national transplant waiting list, and matches donors to recipients.
Cirrhosis is the most common reason for liver transplantation in the United States. For decades, chronic hepatitis C virus (HCV) infection was the main cause of cirrhosis in the U.S., but non-alcoholic fatty liver disease (NAFLD) is quickly catching up.
Liver transplant survival rates have been steadily improving, particularly with the introduction of anti-rejection medications. The American Liver Foundation reports that the five-year survival rate is roughly 75 percent.
Potential disqualifications for liver transplantation:
- Active alcohol or substance abuse (some states are removing legal medical marijuana use as a disqualifier)
- Metastatic cancer and active septic infections are absolute contraindications
- Age – Less likely over age 70
- Other serious health issues, advanced heart, lung or kidney disease, severe infection, other terminal conditions; some centers are transplanting patients living with HIV
- Liver failure that is too massive and complicated to respond favorably to transplantation
- Morbid obesity or advanced malnutrition
- Inability to follow medical instructions
- Lack of support to help manage post-surgical medication regimen
So, if you have cirrhosis and might need a liver transplant down the line, now is a good time to address any alcohol or substance use problems, lose weight if you need to, and start building a support network. Life after transplant can be fantastic.