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Published on January 22, 2020

Awareness Important in Stopping Liver Damage and Disease

The liver is a vital organ like the heart and brain, but too many people overlook liver health. Talk to your primary care provider about the risks of liver disease and potential testing options that can help keep your liver healthier.

“Avera provides a full continuum of liver care, from a specialized hepatology program to liver transplant, with a depth of expertise and experience not otherwise available in the region,” said Beth Plahn, Avera Assistant Vice President who oversees Transplant Services at Avera Transplant Institute in Sioux Falls.

More than a dozen Avera physicians hold transplantation fellowships in addition to nephrology, hepatology, surgery, anesthesia and hematology certifications. The program is integrated with many other disciplines such as cancer care and gastroenterology.

Surgeons at Avera Transplant Institute conducted the first and only liver transplant in all of South Dakota in 2016. Since then, transplant surgeons have performed 30 life-saving transplants. The program, and it recently received accreditation with the Centers for Medicare and Medicaid Services (CMS), meaning that patients in the region with Medicare coverage now have access to liver transplant as an important part of their integrated care at Avera.

Avera has evaluated more than 300 patients for liver transplantation since May 2016. More than 100 patients have been listed on the national waiting list.

“The CMS certification of our liver transplant program is life-changing news for patients, families and loved ones,” said Jeffery Steers, MD, FACS, Avera Medical Group transplant and hepatobiliary surgeon. “It expands access to our services, and it’s recognition of the hard work everyone involved in the patient care continuum has done to develop a full-scope liver program in Sioux Falls.”

With the CMS certification, approximately 20 current patients are eligible for activation on the liver transplant waiting list. Avera now has about 40 patients on the waitlist, all registered nationally to receive organ offers. Prior to the start of Avera’s liver transplant program, only 10 patients in all of South Dakota were on a waiting list anywhere in the country.

“Liver disease, when identified in a timely manner, is treatable. If ignored, it can reduce quality of life and require more extensive treatment, up to and including transplant,” said Ali Al-Hajjaj, MD, ACG, who specializes in transplantation and hepatology with Avera Medical Group Liver Disease. “Discussing the possible risks you might face with your primary care provider is a great place to start. You can discuss the possible need for a liver panel.”

Al-Hajjaj said a liver panel is a series of blood tests for liver health, and it includes the ALT, which measures certain indicators in the blood that can show liver health. A full liver panel exam often will also include hepatitis tests. Many conditions, such as nonalcoholic fatty liver disease or hemochromatosis, can be prevented with lifestyle adjustments – better diet and more exercise.

“As a population, liver diseases and health remain overlooked,” said Steers. “Diet and activity can reverse many conditions that affect the liver because of too much fatty food, sugar or alcohol use. Infrequent activity also hurts the liver, and we estimate that 90 percent of liver problems are related to behavior."

When people have typical signs of liver failure, such as jaundice, fatigue, swelling or tenderness in the abdomen and liver-panel test scores above the guidelines, they often are referred for specialty care.

“The liver is a vital organ, and a strong one, and it can recover from decades of misuse and damage,” Steers said. “Changes in what you do and how you eat and drink can reverse many of the conditions that affect the liver.”

Learn more about liver disease care at Avera or the Avera Transplant Institute.

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