Gastroenterology

Liver Disease

Penn Medicine gastroenterology and transplant surgery divisions — as well as radiology, pathology and other departments — all work closely together to ensure a seamless experience for patients with liver disease. A highly skilled professional nursing and technical staff further enhances the patient experience and provides the highest standard of care.

Causes of Liver Disease

The liver is the largest organ in the gastrointestinal tract and it performs more than 100 separate functions. Its complexity also makes it susceptible to many different liver diseases.

Liver problems can be genetically inherited, occur as a result of disease, or be caused by environmental stressors. Some liver problems are acute and go away on their own, while others become chronic and can lead to serious complications. Left untreated, liver disease can progress over time to liver failure. Liver failure can also occur suddenly when the body is exposed to toxins or poisonous substances that severely compromise liver function.

Common liver diseases and causes of liver failure and function include:

  • Hepatitis B
  • Hepatitis C
  • Autoimmune hepatitis
  • Long-term/excessive alcohol consumption
  • Non-alcoholic fatty liver disease (NAFLD)
  • Nonalcoholic Steatohepatitis (NASH)
  • Wilson's disease
  • Hemachromatosis
  • Primary biliary cirrhosis
  • Primary sclerosing cholangitis
  • Cirrhosis
  • Liver cancer
  • Severe malnutrition

Common causes of sudden liver failure include:

  • Medication overdose
  • Acetaminophen (Tylenol) overdose
  • Herbal supplement overdose
  • Ingestion of certain poisonous mushrooms

Symptoms of Liver Disease

Common symptoms of liver disease include:

  • Jaundice (yellowish discoloration of the skin and eyes)
  • Nausea
  • Vomiting
  • Abdominal pain
  • Fatigue
  • Chronic itching of the skin
  • Muscle weakness
  • Weight loss

Treatment for Liver Disease

Our liver specialists provide all types of liver and biliary disorder services including:

  • Assessment, treatment and management for liver disease and acute liver injury.
  • Treatment and management of chronic viral hepatitis, alcohol-related liver disease, and acute liver injury.
  • Diagnosis and treatment for people with complex liver disease, including: management of intractable ascites, recurrent variceal hemorrhage, hepatic encephalopathy and hepatocellular carcinoma.
  • Transhepatic intravascular portosystemic shunt (TIPSS), performed by interventional radiologists for complications of portal hypertension.

Liver Transplant

Patients with end-stage liver disease are referred to the Penn Transplant Institute for liver transplant evaluation. Each year, more than 400 patients are evaluated and Penn surgeons perform more than 140 liver transplants, making it the largest liver transplant program in the Philadelphia region and one of the top 10 programs in the nation. The success rates for liver transplantation at Penn greatly exceed the national averages.

Diagnosis and Management of Liver Transplant Patients

Patients with end-stage liver disease undergo an extensive medical evaluation before being listed for a liver transplantation. During this process, all factors related to the condition, nature and severity of the liver disease are considered. A team of physicians collaborate to assess the unique circumstances of each patient to be approved for final listing.

Our broad-based multidisciplinary team has extensive experience in:

  • Adult-to-adult living donation
  • Hepatitis C
  • Hepatobiliary tumor and hepatocellular carcinoma (HCC) liver cancer
  • HIV

Hepatitis C

Hepatitis C affects nearly four million Americans and about 12,000 people die each year from the infection. Although only a small proportion of people with hepatitis C develop liver failure requiring a liver transplant, the large number of people infected makes this the number one cause of liver failure in the United States.

Penn Transplant Institute's comprehensive, long-term approach to the management of hepatitis C brings together the largest group of liver specialists in the region. They are experienced in treating hepatitis C in patients with advanced liver disease awaiting transplantation as well as those who require treatment after transplant.

Liver Disease Research

Our physicians are at the forefront of clinical research for the treatment of liver disease:

  • Use of new medical therapies for chronic hepatitis B and C
  • New methods of immunosuppressive therapy
  • Combination therapy for liver tumors, including surgical resection, transplantation, chemotherapy and chemoembolization
  • Living related-donor program in collaboration with the Children's Hospital of Philadelphia

Locations

The liver disease program is available at the following locations:

Preparing for Appointments and Procedures

Are you scheduled for a first-time consultation with a gastroenterologist at Penn? Save time at the doctor’s office by completing your registration and medical history forms.