With 1000th transplant, KU Hospital sees new trends in liver disease

Brenda Higgins welcomed her grandchildren for a visit last week at the University of Kansas Medical Center. Higgins was the recipient of the center’s 1000th liver transplant in December. Medical experts there expect a growing number of people to need liver transplants in the future because of the epidemic of obesity. Photos courtesy University of Kansas Medical Center.

The University of Kansas Hospital last year passed the 1,000 mark in liver transplants, a milestone and a warning.

A big reason for more transplants is fatty liver disease – people in the United States and worldwide eat their way into liver failure.

The university hospital program that began in 1990 resulted in 1,005 transplants by the end of last year. They expect to do more liver transplants this year than ever before.

About 45 percent of the hospital referrals for liver problems now involve fatty liver disease and the number continues to grow with the national obesity epidemic, said Dr. Richard Gilroy of the university hospital.

“We have converging storms that will lead to a perfect storm,” he said. “You’re going to have a whole pile of people on the (transplant) list and a diminishing number of donors in the ever growing community of the overweight and obese – people with fatty livers unable to be transplanted.”

Within the next few years, fatty liver disease is expected to be the most common reason for all liver transplants in the United States, replacing hepatitis C as the most common cause, experts say. The hepatitis related liver failures are not increasing and are now treatable, Gilroy said.

But fatty liver disease has no effective treatment medicines and is not even commonly recognized to be a problem, he said.

Nonalcoholic Fatty Liver Disease is a direct result of obesity and it increases as the weight increases, he said. As late as 1990 it was not regarded as a threat because it involved a very small number of people and was felt to not progress to cirrhosis, he said.

Most often, fatty liver disease can progress to nonalcoholic steatohepatitis (NASH), which can cause the liver to fail. NASH cases are now coming on strong, Gilroy said.  A test can indicate if it is present and a liver biopsy is needed to confirm it.

One 2010 study of 380 middle age adults found fatty liver disease in 46 percent and NASH in 12.2 percent of them. It also found those with fatty livers ate at fast food restaurants more often and exercised less than those without it.

So the hospital team’s expertise at the transplants seems to mesh with a growing need.

Jill Chadwick of hospital public relations said more patients are coming from states like California and New York for liver transplants. Wait times for a liver at the hospital are 3.9 months as opposed to 11.1 months nationally, she said, and the success rate is far higher than the national average.

They expect to do 110 liver transplants this year, up from just 25 a decade ago.

Nurse Kristine Brees, the program’s first transplant patient in 1990, shares her perspective with patients.

“I’m thankful every day I get up and live a full life,” Brees said. “I especially enjoy working with those who were part of my transplant team almost 23 years ago.”

Among those helped is the 1,000th liver transplant patient, who was still in the hospital last week for treatment of unrelated problems.

Brenda Higgins, 60, of Kansas City needed a transplant because of hepatitis C damage. She had been ill for three years, on and off the transplant list because she was sometimes too sick for the operation.

Thanks to that new liver, “I’m here,” she said. “I didn’t have that long left.”

The rail-thin woman with eight children and as many grandchildren said she has a simple wish for when she first gets out of the hospital: “I want a hamburger and French fries.”

Obesity didn’t cause her liver disease, her doctors say, but too many hamburgers are part of the nation’s problems.

Doctors at the University of Kansas Hospital predict a “perfect storm” of factors will lead to increasing numbers of people seeking liver transplants with a diminishing number of available donors.


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