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AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAPAAAAAAAAAA8AAAAAAAAADwAAAAAAAAAPAAA AAAAAAA8AAAAAAAAADwAAAAAAAAAPAAAAAAAAAA8AAAAAAAAADwAAAAAAAAAPAAAAAAAAAA8AAAA AAAAADwAAAAAAAAAPAAAAAAAAAA8AAAAAAAAADwAAAAAAAAAPAAAAAAAAAA8AAAAAAAAADwAAAAA AAAAPAAAAAAAAAA8AAAAAAAAAAMAAAAAAA== ------=_NextPart_01C9B8FC.F52C4B80 Content-Location: file:///C:/6E4BB24E/SaabPresentation_files/master02.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii"
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------=_NextPart_01C9B8FC.F52C4B80 Content-Location: file:///C:/6E4BB24E/SaabPresentation_files/pres.xml Content-Transfer-Encoding: quoted-printable Content-Type: text/xml; charset="utf-8" ------=_NextPart_01C9B8FC.F52C4B80 Content-Location: file:///C:/6E4BB24E/SaabPresentation_files/slide0025.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" Important functions of the liver
1
Viral Hepatitis, Alcohol and Liver = Transplantation
Sammy Saab, MD, MPH, AGAF
= Associate Professor of Medicine and Surgery
= Head, Outcomes Research in Hepatology
David Geffen School of Medicine at UCLA
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2
Aims
•<= /span>Demonstrate how we assess for liver disease= 3;
<= span style=3D'font-family:Arial;visibility:hidden'>•
•Review causes of liver disease – includi= ng = alcohol and viral hepatitis
<= span style=3D'font-family:Arial;visibility:hidden'>•
•Understand role of liver transplantation in patients with cirrhosis
------=_NextPart_01C9B8FC.F52C4B80 Content-Location: file:///C:/6E4BB24E/SaabPresentation_files/slide0022_image003.gif Content-Transfer-Encoding: base64 Content-Type: image/gif R0lGODlhrwEFAHcAMSH+GlNvZnR3YXJlOiBNaWNyb3NvZnQgT2ZmaWNlACH5BAEAAAAALAIAAQCr AQMAgAAAAP8zAAIjjI+py+0Po5y02ouz3rz7D4biSJbmiabqyrbuC8fyTNe2UgAAOw== ------=_NextPart_01C9B8FC.F52C4B80 Content-Location: file:///C:/6E4BB24E/SaabPresentation_files/slide0103.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" Important functions of the liver
3
Behind by ribs
Largest organ in body
Weighs 1200-1500 g
3D"Image
•  Performs complex esse= ntial functions
•
•  Proper function impor= tant for life quality
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4
Important Functions of the Liver
•Storehouse
–iron reserves, vitamins and other minerals
–energy in form of carbohydrates, glucose and fat
•
•Detoxifies
–dangerous substances such as medications, drugs and alcohol
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5
•Filters
–removes chemicals and waste from blood
•Example – ammonia buildup causing confusion= 3;
•
•Manufactures
–Proteins
•Keeps muscle strength
–Bile
•Important for digestion
Important Functions of the Liver
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Content-Location: file:///C:/6E4BB24E/SaabPresentation_files/slide0122_image017.gif Content-Transfer-Encoding: base64 Content-Type: image/gif R0lGODlhrwEFAHcAMSH+GlNvZnR3YXJlOiBNaWNyb3NvZnQgT2ZmaWNlACH5BAEAAAAALAIAAQCr AQMAgAAAAP8zAAIjjI+py+0Po5y02ouz3rz7D4biSJbmiabqyrbuC8fyTNe2UgAAOw== ------=_NextPart_01C9B8FC.F52C4B80 Content-Location: file:///C:/6E4BB24E/SaabPresentation_files/slide0085.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" Important functions of the liver
6
=
3D"HEPA- "
means
“liver”
means
“inflammation” = ;
     “HEPATITIS” means inflammation of the liver!=
Like “tonsillitis= 221; -
inflammation of the tonsils!
Or “appendicitis”- inflammation of the appendix!
Hepatitis can be caused by medications, fat, and viruses.  If hepatitis is cause by a VIRUS, it is given a LETTER, like hepatitis A, or hepatitis B or hepatitis C!
and
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file:///C:/6E4BB24E/SaabPresentation_files/slide0111.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" Important functions of the liver
7
Liver Diseases
Classific= ations
•Viral hepatitis
–A, B, C 
•Autoimmune disease
–Autoimmune hepatitis
•Metabolic disorders
–Iron overload, Wilson’s disease
•Cholestatic disease
–Primary biliary cirrhosis, Primary sclerosing cholangitis =
•Medications
–Methotrexate, Amiodarone, etc
•Toxin
–Alcohol
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8
•Causes of hepatitis
•Viral (Hepatitis A, B, C)
•Medications
•Stea= tosis (Alcohol and NASH)
•Non-viral infections =
•Autoimmune disorders =
•Metabolic disorder
•Malignancies
•Vascular
•
Hepatitis
normal
hepatitis
ALT
AST
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9
 Prevalence of Chronic Liver Disorders
Hilden M et al. Scand J Gastroenter= ol. 1977; Ground KEU. Aviat Spac Environ = Med. 1982;  Alter MF et al.
N Engl J Med. 1999; Venkataramani A= et al. In: Maddrey WC, Feldman M, eds. Atlas of the Liver.
Philadelphia: Current Medicine;1999; McQuillan GM et al. Am J Public Health 1999.
Nonalcoholic Fatty Liver Disorder
Nonalcoholic steatohepatitis
Chronic Hepatitis C
Alcoholic Liver Disease
Hemochromatosis
Chronic Hepatitis B
NAFLD/NASH prevalence relative to other chronic liver disease etiologies.
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10
Monitoring and diagnosing
•<= /span>Signs
•<= /span>Laboratory tests
•<= /span>Biopsy
•<= /span>Imaging
•<= /span>Symptoms
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Content-Type: text/html; charset="us-ascii" Important functions of the liver
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Jaundice