Instruct: Given a question, retrieve relevant documents that answer the question.
Query: Does someone with Wilson's disease need a liver transplant?
Wilson's disease is typically treated with dietary changes and medication.[1] Dietary changes involve eating a low copper diet and not using copper cookware.[1] Medications used include chelating agents such as trientine and d-penicillamine and zinc supplements.[1] Complications of Wilson's disease can include liver failure, liver cancer, and kidney problems.[1] A liver transplant may be helpful in those in whom other treatments are not effective or if liver failure occurs.[1]
Lineham suffered from primary sclerosing cholangitis, a chronic disease that damages the liver. She received a liver transplant on Christmas Eve, 1995 in Brisbane, Australia. In rare cases the disease also affects the transplant organ and in 2017, twenty-two years after the first transplant she needed another. Lineham died on 11 April 2018, just three months after her second liver transplant.
Liver transplantation or hepatic transplantation is the replacement of a diseased liver with the healthy liver from another person (allograft). Liver transplantation is a treatment option for end-stage liver disease and acute liver failure, although availability of donor organs is a major limitation. The most common technique is orthotopic transplantation, in which the native liver is removed and replaced by the donor organ in the same anatomic position as the original liver. The surgical procedure is complex, requiring careful harvest of the donor organ and meticulous implantation into the recipient. Liver transplantation is highly regulated, and only performed at designated transplant medical centers by highly trained transplant physicians and supporting medical team. The duration of the surgery ranges from 4 to 18 hours depending on outcome. Favorable outcomes require careful screening for eligible recipient, as well as a well-calibrated live or cadaveric donor match.
Liver disease typically progresses to liver failure in affected children with MPV17-related MDS and liver transplantation remains the only treatment option for liver failure. Approximately half of affected children reported did not undergo liver transplantation and died because of progressive liver failure – the majority during infancy or early childhood. A few children were reported to survive without liver transplantation.
Arabic press sources announced in 2010 that Toni Qattan is suffering from cirrhosis of the liver, where doctors said it was the result of organic autoimmune chronic disease possible to be born with called Primary Sclerosing cholangitis, which do not show symptoms, but in the final stages, which becomes the patient needs to replace his damaged liver through liver transplantation, where there is no other treatment for this disease than a liver transplant. The same sources said that Queen Rania Al-Abdullah of Jordan ensured Qattan treatment at the King Hussein Medical City in Amman, but Qattan is still waiting for a liver donor for the operation.
Confirmed news that Toni Qattan had a liver transplant operation on 26 April 2014 in Niguarda Hospital in Milan in Italy, and he is doing very well and in good health and he went back to his music and career.
The United Kingdom Model for End-Stage Liver Disease or UKELD is a medical scoring system used to predict the prognosis of patients with chronic liver disease. It is used in the United Kingdom to help determine the need for liver transplantation. It was developed from the MELD score, incorporating the serum sodium level.
The Model for End-Stage Liver Disease, or MELD, is a scoring system for assessing the severity of chronic liver disease. It was initially developed to predict mortality within three months of surgery in patients who had undergone a transjugular intrahepatic portosystemic shunt (TIPS) procedure, and was subsequently found to be useful in determining prognosis and prioritizing for receipt of a liver transplant. This score is now used by the United Network for Organ Sharing (UNOS) and Eurotransplant for prioritizing allocation of liver transplants instead of the older Child-Pugh score.
About 20 percent of the infants with neonatal giant cell hepatitis develop chronic liver disease and cirrhosis. Their liver becomes very hard, due to the scarring, and the jaundice does not disappear by six months of age. Infants who reach this point in the disease eventually will require a liver transplant.
Liver transplantation is the only option for those with irreversible liver failure. Most transplants are done for chronic liver diseases leading to cirrhosis, such as chronic hepatitis C, alcoholism, and autoimmune hepatitis. Less commonly, liver transplantation is done for fulminant hepatic failure, in which liver failure occurs over days to weeks.
MELD was originally developed at the Mayo Clinic by Dr. Patrick Kamath, and at that point was called the "Mayo End-stage Liver Disease" score. It was derived in a series of patients undergoing TIPS procedures. The original version also included a variable based on the underlying etiology (cause) of the liver disease. The score turned out to be predictive of prognosis in chronic liver disease in general, and–with some modifications–came to be applied as an objective tool in assigning need for a liver transplant. The etiology turned out to be relatively unimportant, and was also regarded as relatively subjective; it was therefore removed from the score.
Benjamin Hardwick (6 December 1981 – 23 March 1985) was Britain's youngest liver transplant patient. He became a celebrity through appearing on the BBC television programme "That's Life!" after his parents appealed for more awareness of organ donation when their son, who suffered from biliary atresia, urgently needed a transplant. Ben became the first child in the UK to have a liver transplant. Tragically, that transplant failed and he died of complications following a second transplant 15 months later, a few months after his third birthday. However, in the course of the appeal and following his death, tens of thousands of pounds were raised by the public in Ben’s name to support children like him with serious liver disease. 
In November of 2015, blues musician Walter Trout became a patron of the British Liver Trust. Trout found out that he had liver disease in 2013. After spending five months in a liver ward, he received a liver transplant in 2014. By 2015 he had recovered and was able to go on Tour in Europe. “I’m only still here because someone donated their liver” he said.
In acute liver failure, the development of severe encephalopathy strongly predicts short-term mortality, and is almost as important as the nature of the underlying cause of the liver failure in determining the prognosis. Historically, widely used criteria for offering liver transplantation, such as King's College Criteria, are of limited use and recent guidelines discourage excessive reliance on these criteria. The occurrence of hepatic encephalopathy in people with Wilson's disease (hereditary copper accumulation) and mushroom poisoning indicates an urgent need for a liver transplant.
The Division of Transplantation is known for such programs as its living kidney and living liver donor programs, a steroid-free protocol, which reduces medication side effects following a transplant, as well as combined heart and liver transplants, simultaneous bilateral kidney transplant for polycystic kidney disease and domino liver transplants.
Although in rare cases liver cirrhosis is reversible, the disease process remains mostly irreversible. Liver transplantation remains the only definitive therapy. Today, survival after liver transplantation is similar for people with ALD and non-ALD. The requirements for transplant listing are the same as those for other types of liver disease, except for a 6-month sobriety prerequisite along with psychiatric evaluation and rehabilitation assistance (i.e., Alcoholics Anonymous). Specific requirements vary among the transplant centers. Relapse to alcohol use after transplant listing results in delisting. Re-listing is possible in many institutions, but only after 3–6 months of sobriety. There are limited data on transplant survival in patients transplanted for acute alcoholic hepatitis, but it is believed to be similar to that in nonacute ALD, non-ALD, and alcoholic hepatitis with MDF less than 32.
The 'Master Class in Liver Disease' (MCLD) series was envisaged by Prof. Rela as a means to deliver high quality teaching in liver disease and transplantation. Since its first edition in 2011, it has quickly established itself as one of the most popular scientific meetings in the field in the Indian sub-continent. Each edition is planned as a single theme conference with participation of national & international experts. Previous editions have dealt with topics such as the pathological basis of liver disease, hepatobiliary tumours, paediatric liver diseases, peri-operative care of the liver recipient, living donor liver transplantation, and acute liver failure.
Living donor liver transplantation (LDLT) has emerged in recent decades as a critical surgical option for patients with end stage liver disease, such as cirrhosis and/or hepatocellular carcinoma often attributable to one or more of the following: long-term alcohol abuse, long-term untreated hepatitis C infection, long-term untreated hepatitis B infection. The concept of LDLT is based on (1) the remarkable regenerative capacities of the human liver and (2) the widespread shortage of cadaveric livers for patients awaiting transplant. In LDLT, a piece of healthy liver is surgically removed from a living person and transplanted into a recipient, immediately after the recipient’s diseased liver has been entirely removed.
For NASH patients with an end-stage liver disease, liver failure or liver cancer, liver transplantation is an accepted procedure according to the EASL. The overall survival is comparable to transplantation following other diseases. People with a cirrhotic NASH considered for a liver transplantation should be systematically examined for cardiovascular diseases (whether the symptoms are apparent or not).
Liver transplantation is the only proven long-term treatment of PSC, although only a fraction of individuals with PSC will need it. Indications for transplantation include recurrent bacterial ascending cholangitis, decompensated cirrhosis, hepatocellular carcinoma, hilar cholangiocarcinoma, and complications of portal hypertension. Not all patients are candidates for liver transplantation, and some will experience disease recurrence afterward.
The King's College Criteria or the King's College Hospital criteria were devised in 1989 to determine if there were any early indices of poor prognosis in patients with acute liver failure. Acute liver failure is defined as the onset of encephalopathy (altered mental status) or coagulopathy (altered bleeding tendencies) within 26 weeks of a patient diagnosed with liver disease. Patients with hepatitis B acquired at birth, Wilson's disease and autoimmune hepatitis are included if their disease was identified within the past 26 weeks. These patients are very ill, and have a very high risk of dying of their illness without adequate treatment which may include liver transplantation. It is important that physicians find ways of identifying patients with acute liver failure early in their course who will do poorly, and may require liver transplantation. The King's College Criteria have consistently shown excellent operating characteristics for determining prognosis in these patients. As liver transplantation becomes a more accessible option for patients with acute liver failure, the King's College Criteria serve a role in determining which patients may require transplantation.
"Liver transplantation" is the replacement of a diseased liver with a healthy liver allograft. The most commonly used technique is orthotopic transplantation, in which the native liver is removed and the donor organ is placed in the same anatomic location as the original liver. Liver transplantation nowadays is a well accepted treatment option for end-stage liver disease and acute liver failure.
The charity has also developed a range of literature for families, young people and healthcare professionals. CLDF’s literature series includes a medical series, with leaflets on the main liver diseases affecting children (biliary atresia, alpha 1-antitrypsin deficiency, autoimmune hepatitis, hepatitis A, hepatitis B, hepatitis C, Wilson's disease etc.) CLDF has also produced a nutrition series, a support series for families and information written especially for children and young people. CLDF also provides the paediatric liver transplant units with a series of leaflets on transplantation to accompany the paediatric liver transplant programme.
Areas of research include liver transplantation, living donor liver transplantation, herbal and drug hepatotoxicity, nutrition and liver disease, cirrhosis, intestinal transplantation, recurrence of disease post-liver transplantation, treatment of viral hepatitis post-liver transplantation, herbal and alternative treatments of chronic liver disease, complications of cirrhosis, portal hypertension, and cholestasis associated with TPN.
Another example of this situation occurs with a special form of liver transplant in which the recipient suffers from familial amyloidotic polyneuropathy, a disease where the liver slowly produces a protein that damages other organs. The recipient's liver can then be transplanted into an older person for whom the effects of the disease will not necessarily contribute significantly to mortality.
Potential candidates for liver transplantation for treatment of HCC are evaluated and re-evaluated periodically by repeated imaging tests as they wait for donor organ availability. So long as the cancer does not exceed Milan criteria, the person may remain a candidate for transplantation. Thus, accurate and consistent evaluation of the disease burden is critical. For example, if someone with three small HCC lesions develops a new fourth liver nodule, an unequivocal diagnosis of this lesion as cancerous would disqualify this person from transplant candidacy. 