Glossary Of Liver Transplantation Terms

There are many words and phrases used by doctors, liver specialists and transplant teams to describe specific things when it comes to liver disease, investigations and possible surgery. Some of the most important terms are listed below.

A

Abdomen/Abdominal Cavity: this is the large space between the diaphragm and the pelvis. It contains many organs such as the stomach, liver, spleen, gallbladder, small & large intestines, pancreas, kidneys and many major blood vessels. It is sometimes called “the belly” or “the stomach” although the stomach is a specific organ within the abdomen.

Acute: this refers to a time period of short duration when used in connection with diseases. Therefore, diseases which are of rapid onset and often progress quickly to a serious state are referred to as acute conditions. They typically require urgent medical care.

Alanine Aminotransferase (ALT or SGPT): a liver enzyme, which is raised as a result of damage to liver cells. It can be measured as part of a blood test for liver function tests (LFT).

Albumin: this is the main protein in blood. It is vital for normal fluid balance within blood and body tissues. Fluid balance is maintained by a process called osmosis.

Alcohol: a group of chemicals from which ethanol (C2H5OH) is mainly drunk for recreation. It is metabolised by the liver. But drunk to excess over a long period of time, its toxic effects eventually overwhelm the liver leading to liver failure.

Alcoholic Liver Disease: this forms various stages of liver disease from mild to severe caused by the long term overuse and abuse of alcohol.

Alkaline Phosphatase: this is an enzyme produced in the liver, bones and by the placenta. It is often measured by a blood test called liver function tests (LFT). It’s levels are raised in blood during normal bone growth and during pregnancy. But it can also be abnormally raised with many conditions of the liver such as those causing obstruction of bile flow by a biliary tree blockage. These conditions are known as cholestatic diseases. Examples include Primary Biliary Cirrhosis and Primary Sclerosing Cholangitis.

Alpha 1 Antitrypsin (A1A): a protein produced by the liver in response to proteases such as neutrophil elastase. A1A regulates the activity of proteases and therefore limits damage to healthy tissues such as lung cells.

Alpha 1 Antitrypsin Deficiency (Alpha 1 or A1AD): a disease caused by reduced production or a total lack of production of A1A. This can cause damage to the lungs or liver.

Alveoli: the smallest pockets of air in the lungs. This is where most of the gas exchange occurs and so alveoli are vital for efficient lung function.

Ammonia: see also “Hepatic Encephalopathy”. This is a waste chemical formed by various metabolic processes. It is normally cleared by the liver. But liver failure can lead to the build up of ammonia. This in turn can lead to hepatic encephalopathy.

Anaemia: a reduced level of haemoglobin (a complex molecule within red blood cells which transports oxygen) causing a reduction in the ability of blood to transport oxygen to the tissues. Symptoms of anaemia include lethargy, fatigue and dizziness.

Anaesthetic: this is a medicine given to reduce pain. It can be administered locally, for local or regional pain relief in injectable form or can be general, which induces sleep so that the patient is totally unaware of his surroundings.

Anaesthetist: is a highly specialised doctor responsible for your well-being throughout the operation. He/she will administer the local and general anaesthetic, monitor your vital signs through surgery and ensure that you wake up after the surgery is complete.

Anastomosis: this refers to the surgical joining of two cut ends of a tube. The tube may be any channel or passage such as bowel, blood vessel or bile duct. Anastomosis refers to both the procedure of joining and the joining site itself.

Antibody: or immunoglobulin, this is a highly specialised protein produced by the immune system in response to a foreign attack (an antigen). Antibodies latch onto the antigen and destroy it thus preventing many infections, cancers and other diseases.

Antigen: this is a foreign body or material which triggers the production and release of antibodies by the immune system.

Anti-rejection Drug: see Immunosuppressant.

Ascites: this is the abnormal accumulation of fluid within the abdomen. It can cause bloating or swelling of the abdomen leading to discomfort. It can be caused by liver failure and cancer.

Aspartate Aminotransferase (AST or SGOT): this is an enzyme produced by liver and heart cells. Injury to these organs caused by any condition such as hepatitis of the liver or a heart attack can elevate AST levels in the blood. AST is measured by a blood test called liver function tests (LFT).

Autoantibodies: these are the antibodies produced by the immune system in autoimmune disorders. The presence of autoantibodies therefore represents the misdirected attack by the immune system upon its own organs.

Autoimmune: this is a process where the immune system starts to target and destroys its own body cells. It may target specific cells such as liver cells in autoimmune hepatitis. Why this occurs is still poorly understood but may be a combination of a genetic susceptibility and various environmental factors such as viral infections.

Autoimmune Hepatitis: an immunological disorder where the body’s immune system targets its own liver. This leads to inflammation and damage of liver cells. In severe causes, this leads to cirrhosis and liver failure.

Autosomal Dominant: these are genetic (inherited) diseases which require only 1 of the 2 genes (in a pair of similar genes) to be faulty for the disease to develop, e.g. Huntington's Chorea. See "Gene".

Autosomal Recessive: these are genetic (inherited) diseases which require both genes (in a pair of similar genes) to be faulty for the disease to develop, e.g. Haemochromatosis or Alpha 1 Antitrypsin Deficiency. See "Gene".

Autotransfusion: the transfusion of an individuals own blood into themselves. This is done by a patient donating blood before a major operation so that it may be used by the patient if required through or after surgery. This greatly reduces the risks of blood borne infections and transfusions reactions.

Azathioprine: an immunosuppressant drug.

B

Bacteria: this is a large group of germs composed of single cells. In the right conditions, they can multiply rapidly and can infect any living tissue. In mild cases, our immune systems can deal with these infections but in more severe cases, medicines such as antibiotics may be required to help kill these foreign cells.

Beaded Pattern: the typical appearance of bile ducts in Primary Sclerosing Cholangitis. This is caused by the dilatation and constriction of parts of these ducts.

Beta-blockers: a group of drugs which serve many functions. They can be used to treat certain types of heart disease such as angina, lower blood pressure, treat chronic headaches, prevent migraines, control anxiety and panic symptoms and also certain types of eye disease. In liver disease, they can be used to help prevent bleeding from oesophageal varies.

Bile: this is a yellowish, green liquid produced by the liver and stored in the gallbladder. From there, it is released through the common bile duct into the duodenum where it aids in the digestion of fats. Bile is principally made up of bile salts, cholesterol and bilirubin.

Bile Acid: a component of bile and made in the liver, it helps to digest fats in the upper small intestine.

Biliary System (Biliary Tract or Biliary Tree): this consists of the entire network of small channels within the liver, the larger bile ducts, the main common bile duct and the gallbladder. The bile ducts can be within the liver (intrahepatic) or outside the liver (extrahepatic).

Bilirubin: this is a yellowish chemical produced by the breakdown of red blood cells. Bilirubin is filtered by the liver and excreted through the bile into the intestines.

Biopsy: the removal of a small piece or pieces of tissue from almost any organ for the purpose of examination under a microscope. This enables accurate diagnosis and an assessment of the severity of the condition.

Blood: the red liquid within our circulation which is responsible for supplying every living cell within our body with oxygen, nutrients and energy. It also transports waste products away from cells. In addition, it helps maintain fluid balance and transports cells vital to the immune system. It consists of 2 main components; cells and plasma. Cells are mainly of 3 types; red cells to carry oxygen, white cells to fight disease and foreign elements and platelets to help in the clotting process. On average, we each have 5 litres (8 pints) of blood flowing through our circulation.

C

Cadaver: the body of a deceased person.

Cadaveric Liver Transplantation: a whole liver is removed from a cadaver and transplanted into a suitable recipient with end-stage liver disease.

Caeruloplasmin: a circulation protein that binds to copper.

Cancer: an abnormal growth of cells. This may occur anywhere in the body and affect any organ. The growth of cancer cells may be slow or rapid. Although growth of these abnormal cells can remain confined to one area, the word “cancer” is mostly associated with metastatic spread – this is where abnormal cells spread to other, sometimes distant parts of the body through the lymphatic or blood circulation.

Carrier: a person can be a genetic carrier or have the "trait" for a disease without actually developing the disease. This occurs in autosomal recessive disease where only one faulty gene is present. As these conditions require both genes to be faulty for disease to develop, the person cannot develop the condition him/herself but can transfer the faulty gene in 50% of cases to his/her offspring.

Cell: a basic unit of all living things. Humans are made of trillions of cells which serve specific functions.

Cholangitis: inflammation of bile ducts. This leads to damage and disruption of bile flow which in turn can lead to damage of surrounding liver cells.

Cholestasis: this means disrupted bile flow. The normal flow of bile through the biliary system may be blocked by many conditions. These are called cholestatic diseases. Examples include primary biliary cirrhosis.

Cholesterol: this is a type of fatty chemical called a lipid. It is both produced in the liver and obtained through food. It is essential in small amounts for bile, certain hormones and vitamin D production. But an excess of cholesterol is a risk factor for heart disease and strokes.

Chronic: this refers to a time period of long duration when used in connection with diseases. Therefore, diseases which are of slow onset and progress at a slow pace, sometimes taking months or years to get to a serious level are referred to as chronic conditions. Some chronic conditions may never become serious. Many conditions are controlled using medication long term.

Chromosome: long, thin structures of DNA (genetic material) found inside the nucleus of cells. These contain genes which serve specific functions inside cells. Humans have 46 chromosomes composed of 23 pairs.

Cirrhosis: an irreversible scarring of liver tissue causing cell death. If severe enough, this eventually compromises liver function and leads to liver failure. Compensated cirrhosis means cirrhosis which is stable and free from adverse effects. Decompensated cirrhosis is where the condition is unstable and complications such as haemorrhage or encephalopathy exist.

Colitis: inflammation of the colon (large intestine). This can cause abdominal pain, diarrhoea and rectal bleeding. It can be associated with other diseases.

Colon: the large bowl or intestine. This is a large tube consisting of the caecum, ascending colon, transverse colon, descending colon, sigmoid colon and rectum. It contains digested material. Fluid is removed from the colon and the remaining waste material known as stools is stored in the rectum. Stools are evacuated as faeces from the anus.

Colonoscopy: this is the examination of the colon by passing a thin, flexible tube called an endoscope up the anus and into the colon. The endoscope (or colonoscope used for the examination of the colon) consists of a light and camera. Instruments can also be passed through the colonoscope to carry out procedures such as biopsies. This removes suspicious growths from within the colon for microscopic assessment. Before colonoscopy can take place, the colon must be prepared. This entails giving the patient laxatives to clear out the bowel so that unhindered views can be obtained.

Coma: a state of unconsciousness. It can be caused by many injuries and diseases and ultimately is caused by an insult to the brain. Often this is due to direct trauma to the head and brain but sometimes it is a result of a build up of toxic chemicals which affect normal brain functioning. See also “hepatic encephalopathy”.

Compensated cirrhosis: see Cirrhosis.

Constriction: the process of reduced size or diameter. This particularly applies to tubular organs within our body such as the intestines or the biliary tract.

Corticosteroids: this is a group of drugs which have a marked ability to reduce inflammation and inflammatory processes. They are therefore useful to control diseases which increase inflammation and therefore local damage. They are particularly useful for autoimmune disease in this respect. Corticosteroids are naturally produced by the adrenal glands but are also given in artificial form as medicines in different preparations. The main example of a corticosteroid tablet is Prednisolone.

Crohn’s Disease: an inflammatory bowel disease affecting almost any portion of the small or large intestine. It can be associated with other conditions also.

Cyclosporin: an immunosuppressant drug.

D

Decompensated cirrhosis: see Cirrhosis.

Delirium Tremens (DT): this state occurs with severe alcohol withdrawal. Symptoms include hallucinations and an altered state of consciousness.

Deoxyribonucleic Acid (DNA): this very long molecule which forms the structure of a double helix carries the genetic code for all living organisms and is the main constituent of chromosomes.

Diarrhoea: this is the passing of excessively watery faeces. This may be accompanied by a greatly increased frequency of bowel movements. Diarrhoea may be a sign of many types of disease and conditions.

Dietician: a specialised healthcare worker who deals with all aspects of diet, nutrition, feeding and supplementation.

Dilatation: the process of increasing size or diameter. This particularly applies to tubular organs within our body such as the intestines or the biliary tract.

Donor: this is the source of any liver received by a liver transplant patient. The donor may be a deceased individual (cadaveric liver transplantation) where the whole liver is donated or the donor may be a living close relative or friend (living donor liver transplantation) where a portion (usually the larger right lobe of the liver) is donated.

Duct: a channel, tube or passage which conveys and transports material. This may be air or liquid.

E

Emphysema: a chronic and progressive lung disease caused by the destruction of small air pockets called alveoli in the lungs. This reduces the efficiency of gas exchange in the lungs causing increasing shortness of breath.

Encephalopathy: see Hepatic Encephalopathy.

Endoscopic Retrograde Cholangiopancreatograhy (ECRP): this is an endoscopic procedure used to view the common bile duct, take biopsies and remove gallstones.

Endoscopy: a procedure used to directly visualise an organ inside the body. It is mainly used to view the digestive tract although other organs can also be examined. A long, thin, flexible, fibre optic tube is inserted. This contains a light and camera. An image can be seen on a viewing monitor. Other procedures can be done such as obtaining biopsies of tissue for examination under a microscope. Different scopes are used for different organs e.g. colonoscope for the colon, hysteroscope for the womb and a bronchoscope for the airways of the lungs.

End-stage Liver Disease: a severe and final stage of liver disease where not enough functioning liver is available to sustain the body. Death follows shortly unless a transplant can be arranged quickly.

Enzyme: these are specialised proteins which act as agents (catalysts) for specific chemical reactions and processes. Enzymes speed up these reactions. Specific liver enzymes can be measured using a blood test called liver function test (LFT). These can give a simple guide to the state of the liver.

Extrahepatic: outside the liver.

F

Fatty Liver: this is the first stage of liver disease. It forms a very mild state of change as fat accumulates inside the liver. There are usually no symptoms and fatty change is usually found incidentally. Fatty change is a reversible state.

Fibrosis: the process leading to the formation of scar tissue.

Fulminant Hepatitis: a particularly acute (rapid) onset and severe form of hepatitis leading to liver failure and death if left untreated. It may be caused by infection, exposure to chemicals & poisons or medication even in normal doses.

G

Gallbladder: this is a small muscular bag or pouch located just underneath the right side of the liver. It forms part of the biliary system. Its function is to store bile for use in the upper small intestine when fatty food needs to be digested.

Gallstone: these form from bile and bile salts. They can be solitary or numerous and range in size from a grain of sand to golf ball size. Gallstones can cause pain, lead to infection of the gallbladder (cholecystitis) and can cause obstruction of the bowel. Often, gallstones cause no symptoms and are found incidentally.

Gamma Glutamyl Transferase (GGT): a liver enzyme which is elevated in liver damage. It is particularly sensitive to the effects of alcohol.

Gene: this is a single unit of genetic information and made from DNA. Thousands of genes are found in a single chromosome. As chromosomes are found in pairs, 2 copies of each gene are present in each cell. In "dominant" genetic disorders (autosomal dominant diseases), only one of the two genes needs to be defective to produce the disease e.g. Huntington's Chorea. In "recessive" genetic disorders (autosomal recessive diseases), both genes in the pair need to be defective to produce the disease e.g. Sickle Cell Disease. In recessive conditions, if only one faulty gene is present, the person is said to be a "carrier" or have the "trait" but does not develop the disease.

Genetic: or inherited, this is the transferring of information from parent to progeny (offspring). This is done by the passing of chromosomes through the gamete. See also “Gene”.

Genome: the whole set of genes in all the chromosomes which define an individual's physical appearance and characteristics.

Genotype: the genetic constitution of an individual.

Gilbert’s Syndrome: this is a very common and benign condition that is most often diagnosed incidentally. The key marker is a mildly elevated level of bilirubin. This is particularly so after fasting. The condition is not serious. No liver disease is likely and no treatment is necessary.

H

Haematemesis: vomiting of fresh or old blood.

Haemochromatosis: this is a genetic condition causes a build of up iron in the body. This especially affects the liver.

Haemoglobin: this is a large and complex molecule and is the main constituent of red blood cells. Its primary role is to carry oxygen in the blood. A deficiency of haemoglobin leads to a condition called anaemia.

Haemorrhage: a loss of blood. If enough blood is lost through a massive haemorrhage, the individual can suffer (hypovolaemic) shock. This is often fatal if left untreated.

Hepatic: to do with the liver.

Hepatic Artery: one of the two main blood supplies to the liver. The hepatic artery supplies oxygenated blood to the liver.

Hepatic Encephalopathy: this is a reduction in consciousness levels and can lead to a coma. It is caused by severe liver disease from a build up of ammonia. This is toxic to the brain and interferes with normal brain function causing the above symptoms. In less severe cases, this may cause lethargy, irritability, poor concentration and a change in behaviour or personality.

Hepatic Portal Vein: this supplies the liver with nutrient rich blood directly from the small intestine. All toxins from the bowel are also transferred directly to the liver for processing before they can affect other areas of the body. However, hepatic cirrhosis leads to increased pressure of blood within the hepatic portal vein. This leads to the formation of oesophageal varices.

Hepatitis: inflammation of the liver. This can be caused by any factor such as infection, chemicals and toxins.

Hepatocellular Carcinoma: a primary, malignant tumour of liver cells.

Hepatocytes: liver cells.

Hepatologist: a physician or doctor who specialises in diseases of the liver.

Hepatomegaly: this is enlargement of the liver.

I

Icterus: see jaundice

Immune/Immunity: this is when an individual is protected against a particular infection. This can occur either as a result of a specific vaccination or by a previous exposure to the infection. Antibodies are then present in the circulation for that infection.

Immunoglobulin (Ig): see Antibody.

Immunosuppressant: a drug or medicine which reduces the efficiency of the immune system. This is required after a transplant to prevent rejection of the new liver by the recipients immune system.

Incidence: is a statistical term used to describe the number of new cases of a disease or symptoms in a particular time span, e.g. a year.

Infection: an invasion by a foreign living germ such as a virus, bacterium or fungus. This germ multiplies within the body and obtains its nourishment and sustenance from the host. But in the process of doing so, it damages the host.

Inflammation: this is a non-specific immune response triggered by any insult, injury, irritation or infection. It causes the classical symptoms pain, swelling, redness and warmth.

Intensive Care Unit (ITU): this is a specialised ward in hospital where the sickest and most critically ill patients are cared for. The nurse to patient ratio is usually 1 to 1. Vital signs are constantly monitored and any changes to treatment required are quickly given. Most patients spend 2-3 days on an ITU ward immediately after surgery.

Intestine: a long, convoluted tube located in the abdomen. It consists of many different areas but is divided into 2 main parts – small and large. The small intestine is where food is digested and absorbed into the bloodstream. The large intestine is responsible for absorbing in fluid and storing stools until they are evacuated as faeces.

Intrahepatic: within the liver.

Itch: also called pruritis, this is a sensation of the skin which induces the urge to scratch the affected area. Aggressive itching and scratching can lead to pain and damage to the skin. Itching can be caused by many things from reactions to drugs, allergies to food, drink, cosmetics, toiletries and other chemicals. It can also be due to skin conditions such as eczema and psoriasis, cancers, infections and diseases of the liver, kidneys and other organs. Aged, damaged or dry skin can also cause itching. Sometimes, no cause can be found.

J

Jaundice (Icterus): this is the yellowing of body tissues and secretions. It is most notable by the yellowing of the whites of the eyes (sclera) and skin. Urine is often darker and more yellow in colour. It is caused by the excess of the bile pigment bilirubin in blood. Jaundice is often a sign of liver disease.

K

Kayser-Fleischer Rings: these are distinct rusty brown rings around the iris of both eyes which develop in Wilson’s Disease.

L

Laparoscopy: this is mainly a diagnostic procedure where the abdominal and pelvic organs can be viewed by inserting a laparoscope (a thin telescope like camera) through an incision in the abdomen. However, certain operations can also be carried out by inserting other instruments through other incisions at the same time.

Large Intestine: see also “Colon” and “Intestine”. This is the portion of bowel which extends from the caecum to the anus. The large intestine is responsible for absorbing in fluid and storing stools until they are evacuated as faeces.

Liver: the largest solid, internal organ of the body. It is located in the upper abdomen, just below the diaphragm. It has several hundred functions.

Liver Biopsy: the removal of a small piece or pieces of liver tissue for the purpose of examination under a microscope. This enables accurate diagnosis and an assessment of the severity of the condition.

Liver Function Tests (LFT): a blood test to measure various liver enzymes and other parameters. This is a quick and simple method of assessing liver function. However, sometimes, LFT can be normal even in the presence of some liver disease.

Liver Transplant: a major surgical procedure which removes the patient’s own damaged and failing liver in place of a portion or whole healthy, donated liver.

Living Donor Liver Transplantation: a portion of a liver – usually the larger right lobe – is removed from a living donor and inserted into a patient with end-stage liver disease.

Lungs: a pair of breathing organs in the chest responsible for gas exchange. Gas exchange is where oxygen is transferred into blood from the oxygen rich air breathed into the lungs. At the same time, carbon dioxide is transferred from blood into the air in the lungs ready to be exhaled.

M

Magnetic Resonance Cholangiopancreatograhy (MRCP): this is a specialised MRI scan which can produce detailed images of the biliary tree comparable to ERCP but without the possibility of side effects. It is a safe and non-invasive investigation.

Medication: a drug or medicine for medicinal purposes. The medicine may be prescribed by a healthcare worker such as a physician or nurse or may be bought over-the-counter at a pharmacy.

Melaena: black or very dark coloured stools caused by old (digested) blood.

Metabolic: this relates to the process of breaking down substances entering the body or created by the body. The by-products of metabolism can then be excreted or metabolised further to render them harmless.

N

Nausea: the sensation of feeling sick and wanting to vomit as a result.

Nucleus: the part of a cell which contains genetic material. This is made from DNA.

O

Occupational Therapist: is a therapist who along with the physiotherapist is responsible for the practical aspects of rehabilitation. Examples of this involve any activity related to self caring (activities of daily living).

Oedema: the accumulation of fluid in soft tissues causing swelling. This occurs most frequently around the ankles and lower legs (peripheral oedema) or in the lungs (pulmonary oedema).

Oesophagus: the gullet or foodpipe. This tube extends from the lower throat to the upper stomach and conveys food and drink to the stomach.

Oesophageal Varices: see “Varices”.

Onset: this is the start of disease. The first symptoms or signs can identify this time. Onset of a disease can be sudden or prolonged with a gradual onset.

Organ: this is a collection of either similar cells or different cells which have a common purpose. These cells are structured or arranged into a discrete unit or entity. There are many organs within the body which have specific functions. Each organ is usually a hugely complex but high organised arrangement of cells. Organs also tend to have their own distinct blood supply. Sometimes, a failing organ can be bypassed or completely removed in place of a healthy, donated, similar organ.

P

Pancreas: this is a soft, elongated, triangular shaped organ located underneath the middle and left lobe of the liver. It has 2 main functions. Firstly, it produces most of the enzymes used to digest food in the small intestine. Secondly, it produces insulin which regulates blood glucose (sugar) levels.

Pancreatitis: inflammation of the pancreas. This can occur for many reasons such as alcohol abuse, infection and trauma. It is also a well recognised side effect of ECRP.

Paracentesis: see also “Ascites”. Paracentesis is the procedure to remove the abnormal fluid build up in the abdomen (ascites).

Physiotherapist: is a therapist responsible for many aspects of the rehabilitation process after surgery. Physiotherapy will help in early mobilisation and aid in reducing many potential post operative complications in both recipient and donor.

Placebo: this is a “fake” or “dummy” treatment. It may consist of tablets or another form of medicine which contains no active medical ingredients. It therefore has no medical value. It is used especially in research for “control” purposes so that new active treatments may be compared to having no treatment at all.

Platelets: tiny cells circulating in the blood which play a vital role in clot formation after an injury.

Portal Circulation: this is the blood circulation system from the small intestine to the liver. It carries blood which is full of nutrients and toxins absorbed through the gut. See also “Hepatic Portal Vein” and “Varices”.

Prednisolone: see also “Corticosteroids”. This is a corticosteroid available in tablet form.

Prevalence: this is a statistical figure which identifies the proportion of individuals within a defined population as having a particular disease.

Primary: this means the first or original of something. For example, a primary tumour is the original tumour. Other tumours may have spread from the primary site to other sites. These would be called secondary tumours.

Primary Biliary Cirrhosis (PBC): this is an autoimmune disorder. Antibodies attack the cells lining bile ducts leading to cholestasis. It produces a pattern of disease slightly different to PSC.

Primary Sclerosing Cholangitis (PSC): this is an autoimmune disorder. Antibodies attack the cells lining bile ducts leading to cholestasis. It produces a pattern of disease slightly different to PBC.

Progressive: this means advancing, usually in stages. When referring to diseases, the progress may be rapid (in acute conditions) or slow (in chronic conditions). The progress of a disease may be slowed or even halted with treatment.

Pruritis: see Itch.

Psychiatrist: a doctor who specialises in patients with mental ill health.

Psychologist: a medical therapist who specialises in dealing with patients with psychological illnesses such as anxiety, mild depression and others.

Q

R

Radiologist: a specialist doctor who deals with X-rays and scans.

Recipient: this is the patient who has end-stage liver disease and who has the donated liver transplanted into them.

Red Cells: these are the cells that give blood its red colour. They contain haemoglobin which carries oxygen around the body.

Rejection/Rejection Syndrome: this is the sequence of immunological events that occur after the transplantation of an organ. The recipient’s immune system recognises the transplanted organ as a foreign tissue and tries to mount an immunological attack on the organ to destroy it. This series of events may be controlled by the use of life-long anti-rejection (immunosuppressants) drugs.

Relapse: this is a recurrence of a disease which had been previously controlled with or without treatment. It is not the onset of a new disease.

Remission: this describes the state of disease “at rest” or which is being controlled with or without treatment. Sometimes, diseases under remission may relapse and the symptoms start again.

Resection: this is the surgical removal of part of an organ.

Risk Factor: this is something that increases an individual’s chance (from average) of contracting or developing a particular condition. For example, smoking or being overweight are both risk factors for developing heart disease.

S

Small Intestine: see also “Intestine”. This is the part of the bowel extending from the stomach to the caecum of the large intestine. The small intestine is where food is digested and absorbed into the bloodstream.

Social Worker: is a member of the transplant team who can discuss with donors the reasons for donating parts of their liver and will discuss the social and emotional issues surrounding donation and transplantation. In addition, they will be able to offer practical advice concerning financial matters, the claiming of benefits and other social issues for both donors and recipients.

Splenomegaly: enlargement of the spleen.

Steroids: see also “Corticosteroids” and “Prednisolone”. This is a large group of drugs with many functions. The most useful as far as diseases are concerned are a group of steroids called corticosteroids.

Stricture: an abnormal narrowing of a tube, passage or channel. Strictures may be caused by scar tissue formation, cancers and other reasons. Both the process or narrowing and the narrowing itself is called stricture. The material being conveyed by the affected conduit may be partially or completed blocked.

T

Tacrolimus: an immunosuppressant drug.

Transplant: this refers to both the organ being donated and therefore inserted into the recipient and the process (the surgery) which is required to do this.

Transplantation: this is the process (the operation or surgery) required to obtain a transplant organ.

Transplant Co-ordinator: an individual responsible for all aspects of organising the transplant, waiting lists and co-ordinating the process if a donor is found.

Transplant Surgeon: a specialist surgeon who usually heads up the transplant team and carries out the surgery. Two such surgeons are usually involved with liver transplantation. One removes the liver (or a portion of liver) from the donor while the other inserts it into the recipient.

U

Ulcerative Colitis: see also “Colitis”. This is a specific type of inflammation of the colon (large intestine). It can cause abdominal pain, diarrhoea and rectal bleeding. It can be associated with other diseases.

Ultrasound Scan: this type of scan uses very high frequency waves from a probe to visualise internal organs and structures. Almost any organ can be seen in this way. It is safe to perform in pregnancy.

Urine: this is the liquid waste produced by the kidneys, stored in the urinary bladder and expelled through the urethra. The kidneys filter blood of waste products such as urea and help regulate fluid balance. The resulting waste is called urine.

V

Varices: these are the varicose vein like dilated blood vessels found inside the oesophagus in patients who have severe liver disease. They can bleed causing a massive haemorrhage. Often, this is a fatal event. Varices are produced as liver cirrhosis causes disruption of blood flow through the liver. This creates a back pressure effect on the portal circulation. This in turn creates enough pressure to create abnormal dilatation of veins around the oesophagus.

Virus: a large group of germs. These are microscopic particles that are much smaller than even cells. They invade and infect cells and use the cells to replicate (multiply). Viruses cannot replicate themselves and need host cells to do so. They are much more difficult to eradicate than bacteria.

W

White Cells: there are numerous types of white cells present in blood. They form part of the immune system and respond to foreign triggers such as infections.

Wilson’s Disease: this is a genetic condition causing an excess of copper to accumulate in various organs. Liver disease can progress slowly over the course of several years.

X

Y

Z

From Surgery abroad with Globe Health Tours.