The MedStar Georgetown Transplant Institute in Washington, D.C. is the largest academic liver disease treatment program and the area’s leading liver transplant program. Hospitals from all across the country refer their complex cases to us because our team has more experience and better outcomes caring for these patients. With 7 locations or virtual appointments, we make it easy to be evaluated.
- Cirrhosis of the liver
- Hepatitis B and Hepatitis C
- Autoimmune hepatitis
- Fatty liver disease, e.g. nonalcoholic steatohepatitis (NASH)
- Hepatocellular carcinoma (liver cancer)
Different types of liver disease are treated in different ways. Critical to managing liver disease and perhaps even regenerating new, healthy liver cells, is a healthy diet that supports healthy liver function. However, if your liver is damaged to the point where regeneration is not an option, the best treatment for some types of end stage liver disease or liver failure is transplantation.
- Jaundice: yellowing of the eyes, darkening of the urine
- Itching: bile does not drain appropriately, so left over bile salts can lead to itching
- Fatigue: liver can no longer convert nutrients or store vitamins, leaving your energy level low
- Fluid retention: the diseased liver cannot use protein in the body, leading to fluid buildup
- Bleeding problems: the diseased liver cannot make those materials needed for blood clotting
- Mental confusion, irritability
Cirrhosis of the liver
There are often no symptoms of cirrhosis until liver damage is extensive, but symptoms of cirrhosis may include the following:
- Fatigue
- Bleeding or bruising easily
- Itchy or discolored skin
- Loss of appetite or nausea
- Weight loss
- Confusion or slurred speech
- Swelling in your legs
- Fluid accumulation in your abdomen
Understanding the Liver Transplant process
Watch as the MedStar Georgetown Transplant Institute Liver Team discusses liver disease, liver transplant and transplant options.
Learn from the people who make the MedStar Georgetown Transplant Institute among the top ten transplant centers in the nation. They discuss a wide range of topics including advanced liver disease, liver failure, symptoms of liver failure, cirrhosis, causes of cirrhosis, liver transplant evaluation and liver transplant options.
Treatment options
Many patients benefit from medications to manage their liver disease. For patients with viral hepatitis, antiviral medications can keep the disease at bay.
For patients with high blood pressure in the arteries to their liver, known as portal hypertension, surgery is an option to relieve excess pressure.
For liver cancer patients: surgery, radiation and chemotherapy options are available.
For patients with cirrhosis of the liver: a wide range of treatments are available for both the causes and complications of cirrhosis, including medications and treatments for alcohol dependency.
MedStar Georgetown Transplant Institute is one of the largest liver transplant centers in the region, providing premiere liver disease and liver failure care and performing roughly 106 transplants a year. The most complex cases need the expertise of the area’s longest-running program.
- Excellent outcomes
- A dedicated transplant coordinator to assist you in preparing for your consultation
- Patient and family centered care from a multi-disciplinary team of physicians, nurses, pharmacists, social workers, financial counselors and nutritionists
- Liver disease and liver failure care and evaluation services in convenient locations across the Washington, D.C. metro area
- Top 25 percent in volume of liver transplants in U.S.
A Family Affair: Bonnie Embrey's Story
After her doctors discovered tumors in Bonnie Embrey's liver, Bonnie turned to social media in search of a living liver donor. Fortunately, Bonnie's daughter Samantha ended up being the match that she needed. Samantha donated half of her liver to Bonnie, who is still doing well over six years later.
Considering transplant?
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Liver Transplant Evaluation
The process to be cleared for a liver transplant includes a two-part pre-transplant evaluation, also known as a work-up. This evaluation process includes interviews with different members of the liver transplant team and diagnostic testing to determine your overall general health, as well as your end-stage liver disease.
If your child suffers from a serious liver disease and may require a transplant, The Transplant Center for Children at MedStar Georgetown Transplant Institute has innovative and compassionate expertise to care for the whole family.
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Process
Before the transplant surgery, important blood tests are undergone to ensure that your body is compatible with the donated organ and to check that antibodies in your body don't reject the donor's cells.
During surgery, your surgeon will remove your liver and replace it with the donor liver, making all the necessary internal connections.
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Recovery
Beginning immediately after surgery, the transplant team monitors you very carefully for any signs of rejection or other complications. Your pain will be controlled using medications, and we will do everything possible to ensure you are as comfortable as possible.
Nationwide, liver transplants are effective about 85 percent of the time, whether a donor organ or living donor is used.
Donor information
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Living Liver Donor Transplant
In living donor liver transplantation, a piece of liver is removed from a living donor and transplanted into a recipient.
The liver's unique ability to regenerate itself combined with the expertise of our physicians and staff allow for more people with liver failure to obtain a liver transplant.
If you donate part of your liver through the MedStar Georgetown University Hospital's Liver Transplant Program, both the transplanted piece and the piece that remains will grow to pre-surgery size. The donor liver typically regenerates to its original size in 30 days, on average.
The number of patients waiting for organ transplants far exceed the number of organs donated, which has significantly increased awareness about living donor transplantation.
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Evaluation: Who can be a Donor?
To meet living donor criteria, an individual must:
- Be physically fit and in good general health
- Have a compatible blood type with the recipient
- Be free from uncontrolled high blood pressure, diabetes, cancer, liver disease and heart disease
- Spouses, friends, and individuals unrelated to the recipient can become living donors.
Spouses, friends, and individuals unrelated to the recipient can become living donors.
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Benefits of Living Liver Donation
Living donor liver transplantation offers immediate organ availability. Patients who receive transplants from living donors can better prepare for their surgery, knowing well in advance when the transplant will take place.
Living donors will need to have a series of tests to ensure they meet the criteria for living donation. Blood tests, family history and medical tests are preformed to ensure it is safe for the individual to donate.
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What Are the Most Common Liver Diseases?
More than 100,000 people in the D.C. metro area have a serious liver condition; some 81,000 of those have hepatitis C. Besides chronic viral hepatitis B and C, other serious liver conditions include drug-induced liver injury, alcoholic liver disease, chronic cholestatic syndromes, and liver and bile duct tumors. -
What Kind of Treatments are Available?
Many patients benefit from medications to manage their liver disease. For patients with viral hepatitis, antiviral medications can keep the disease at bay. For patients with high blood pressure in the arteries to their liver, known as portal hypertension, surgery is an option to relieve excess pressure. For liver cancer patients, a range of surgery, radiation and chemotherapy options are available. -
When Is Liver Transplantation an Option?
For many patients with end-stage liver disease, transplantation is an option. The decision to transplant is based on the patient’s medical condition and quality of life. -
How Long Is the Wait for a Liver Transplant?
n the Washington, D.C. area, the waiting time for a donor liver is on average six months long. The actual waiting time depends on the number of people on the transplant list and more importantly, the patient’s overall health. A patient who is more ill will automatically move higher on the list to receive their transplant faster. -
What Are My Other Transplant Options? (Living Donor Liver Transplantation)
Living donor liver transplantation is another option for patients who need a liver transplant. In this kind of transplant, a healthy person (family member, friend or coworker) donates a portion of his or her liver to the transplant patient.
Doctors remove a portion of the donor’s liver, remove the recipient’s damaged liver and attach the healthy partial liver in its place, where it begins to regenerate to normal size. The donor’s liver quickly regenerates, too, and continues to function normally. Both procedures are performed at the same time in two adjacent operating rooms.
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What Are the Advantages of Living Donor Liver Transplants?
This kind of surgery can be scheduled and can be performed before the transplant recipient becomes extremely ill. The donor is thoroughly evaluated and their liver is known to be in excellent quality. These factors may lead to fewer complications, faster recovery and good long-term results. This is a very safe procedure for donors. -
What Can I Expect During a Liver Transplant?
- Evaluation: patients undergo a series of tests to determine if they are a candidate for liver transplantation.
- Donor: the transplant program coordinates with the local and national transplant lists to find a donor organ.
- Organ allocation is based on medical urgency, time on the waiting list and blood type compatibility. Living donors also must undergo evaluation and must have compatible blood types.
- Surgery: The transplant surgeon removes the donor organ (or portion of healthy liver for a living donor), removes the recipient’s damaged liver and the attaches the donor liver.
- Recovery: most liver recipients spend several weeks in the hospital; living liver donors spend about one week in the hospital. Doctors monitor liver recipients closely for signs of organ rejection, infection or other complications.
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What Is the Success Rate of Liver Transplants?
Nationwide, liver transplants are effective about 85 percent of the time, whether a donor organ or living donor is used. -
How Do You Prevent Organ Rejection?
Luckily, a number of very effective medications are available to prevent organ rejection. These medications suppress the immune system, which inhibits rejection of foreign tissue. After a liver transplant, recipients must take medications daily for the rest of their lives. Once the first few months after transplant have passed, the medications are a relatively low dose and easy to take.
Life-saving liver transplant care for U.S. veterans at MedStar Georgetown Transplant Institute. Covered through your VA benefits.
The Veteran’s Administration recently added the Institute to its network, giving veterans access to the expert, compassionate care provided by the multidisciplinary MedStar Georgetown transplant team.
This collaborative program allows veterans to continue receiving much of their care pre- and post-transplant at the VA, with the transplant procedure taking place at MedStar Georgetown University Hospital in Washington, D.C. The MedStar Georgetown team of transplant specialists provide care tailored to the needs of each patient, using the latest surgical techniques and technology, including minimally invasive and robotically-assisted surgery and living donor transplant to treat end-stage kidney and liver disease.
And as long as you have your evaluation with your local VA, VA benefits can used, including travel and lodging. Fisher House provides high quality temporary lodging, at no charge, to families of Veterans who are undergoing inpatient or extensive outpatient treatment at the Washington, D.C., Veterans Affairs Medical Center. Fisher House is considered to be a “home away from home” and offers a warm, compassionate environment and a sense of comfort while a loved one is undergoing medical treatment.
If you're a veteran, to learn more about the process, please call 202-914-0223, or
Meet the Veterans Health Administration Team and Hear How They Can Help You
The Veterans’ Health Administration has added MedStar Georgetown Transplant Institute to its National Solid Organ Transplant Network. Meet the team at the Washington, DC VA Medical Center and learn about the partnership with MedStar Georgetown Transplant Institute for veterans in need of a liver transplant. Hear from Jessica Davis, MD, VA Director for liver transplantation, and Atoosa Rabíee, MD, VA Medical Director of Solid Organ Transplant. Learn why someone might need a liver transplant, hear about the evaluation process and the team members that care for patients, and the transplant surgeries that are performed at MedStar Georgetown University Hospital in collaboration with your local VA medical team