Acute: Occurring rapidly – commonly used by the public to convey seriousness or urgency. In medical terminology it only refers to the time course of a problem.

Acute hepatitis: Acute inflammation of the liver which is usually due to viral infection

Acyclovir: An anti-viral drug that works against the virus that causes cold sores.

Albumin: One of the most important proteins manufactured by the liver. Low albumin levels in the blood usually indicate poor liver function.

Alcoholic liver disease: Liver damage, caused by excessive consumption of alcohol, ranging from too much fat in the liver to cirrhosis.

Alpha-feto protein: A protein normally present in the foetus but occurring in high levels in primary liver cancer.

Alkaline phosphatase: An enzyme normally made by bile duct cells. If the bile duct is blocked, the level of alkaline phosphatase in the blood rises.

Aminotransferase enzymes: Proteins which occur normally in liver cells which are released in increased amounts into the bloodstream when cells are damaged. Two of these enzymes – alanine aminotransferase (ALT) and aspartate aminotransferase (AST) – are commonly measured in liver function tests.

Anaemia: A condition in which the blood is deficient in red blood cells or oxygen-carrying proteins.

Antibody: Part of the immune system that helps the body fight infection and foreign substances.

Antigen: A substance foreign to the body (usually a protein) which causes the immune system to produce antibodies.

Anti-viral drugs: Drugs used to treat viral infections including viral hepatitis, CMV and herpes.

Ascites: Uncomfortable accumulation of fluid causing abdominal swelling. This occurs when the blood flow through the liver is obstructed. Ascites often occurs with cirrhosis of the liver. It may persist for some weeks after successful liver transplant.

Auto-immune: Immunity misdirected against the body instead of against an invading infection.

Auto-immune hepatitis: A form of chronic hepatitis which occurs when the body’s immune system attacks its own liver cells

Autosomal recessive inheritance: An inherited problem which occurs only when a particular inherited gene is inherited from both parents.

Bile: Yellow-green fluid produces in the liver and stored in the gall-bladder. Bile helps the body break down fats and digest fat-soluble vitamins.

Bile acids: Tubes which carry bile from liver cells to the gall bladder and duodenum.

Bile salts: Sodium and potassium salts in bile acids. Produced in the liver, secreted into the bile and directed to the intestine where they help the digestion and absorption of fats.

Biliary atresia: Congenital condition in which bile from the liver cannot reach the intestine because the bile ducts have developed poorly or not at all

Bilirubin: The breakdown product of old red blood cells excreted by the liver. Bilirubin is normally excreted in bile. If this does not occur, the concentration of bilirubin in the blood rises and leads to jaundice

Blood pressure: The pressure of blood in the arteries. For blood to circulate through the body, the circulatory system must be under pressure to force blood through the system. When blood pressure is measured, the higher number, called the ‘systolic’, refers to blood pressure when the heart is contracting. The lower number, the ‘diastolic’, is when the heart muscle is relaxed.

Blood products: A general term for different compounds of blood which can be transfused into patients to replace various deficiencies

Bone marrow cells: The cells in the bone where red & white cells and platelets are made.

Cholestasis: Failure of bile to flow from the liver through the bile ducts.

Chronic: Occurring over a long period of time. This term does not refer to the severity of a process, only its duration.

Chronic active hepatitis: Long-term liver injury due to inflammation of the liver.

Chronic viral hepatitis: Chronic infection of the liver due to the hepatitis viruses B and C.

Cirrhosis: The end stage of chronic liver disease from any cause. The liver is scarred and its function significantly impaired.

Clotting factors/proteins: Substances made mainly in the liver to help the normal clotting of blood. The ability of blood to clot is controlled by the presence of clotting proteins. Most of these proteins are made in the liver and exported into the blood. Declining liver function results in reduced clotting power. Patients with liver disease often have bleeding problems and lack of clotting factors is one of the reasons for this.

Creatinine: A product of muscle metabolism that is excreted by the kidneys. Creatinine level serves as a very good indicator of kidney function.

Cross matching: A test of compatibility between the potential donor’s and prospective recipient’s blood.

Cytomegalovirus (CMV): A very common virus that harmlessly infects many normal people. It causes lots of trouble in transplant patients because the drugs that prevent rejection of the liver allow this virus to be active. Virus activity can effect the liver, blood and eyes. It can be treated if necessary with a drug called ganciclovir.

Coma: A state of drowsiness followed by loss of consciousness. May occur in liver failure.

Computer Assisted Tomography (CT scan): An X-ray technique using a computer reconstruction of multiple images of the body.

Corticosteroids: Drugs used to suppress inflammation, such as prednisolone, prednisone or hydrocortisone.

Cryptogenic: Literally means “unknown cause”. Some cases of liver cirrhosis have no known cause and are given the diagnosis “cryptogenic cirrhosis” to distinguish them from other known causes of cirrhosis such as alcoholic cirrhosis.

Cyclosporin (Neoral): A very important drug which virtually all transplant patients now receive. Its function is to prevent rejection of the liver by the body’s immune system.

Cytotoxic: Damaging to cells, for example drugs used to destroy cancer cells.

Defective virus: A virus which needs the help of other viruses to grow, eg. Hepatitis D.

Dehydration: Loss of water from body cells

Diabetes mellitus: A condition of abnormal glucose metabolism. Blood glucose levels increase due to the lack of or low effectiveness of the hormone insulin. Also effects the way the body uses proteins and fats.

Donor liver: The liver provided to the recipient in a liver transplant operation

Donor: Someone who provides an organ for transplantation.

Doppler ultrasound: An easily performed, painless test that is often performed after liver transplantation and shows whether or not the blood flow to and from the liver is normal.

Duodenum: The first part of the small intestine, joins the stomach to the jejunum.

Electrolytes: Minerals in solution in body fluids. The major electrolytes, sodium, potassium and chloride, influence the distribution of water in the body. Magnesium and calcium are also electrolytes

Encephalopathy: Confusion or unconsciousness that can occur when someone had advanced liver failure or cirrhosis. It can be treated, but indicates that the liver disease is becoming severe.

Endotracheal tube: An airway tube inserted through the mouth leading to your windpipe to help you breathe during surgery.

ERCP: A special test for examining the bile ducts. An endoscope is passed down through the mouth and stomach and into the upper part of the small intestine. Fluid that shows up on X-ray is then injected into the opening of the main bile duct at the point where it drains into the small intestine. The resulting X-ray picture is used to diagnose certain diseases affecting the bile ducts.

Fatty liver: Excessive deposit of fat in the liver.

Fetor: A sweet smell on the breath of liver patients that results from an abnormal build up of certain chemicals in the blood.

Fibrinogen: A protein factor important in blood clotting.

Fibrosis: Formation of excess fibrous (scar) tissue in an organ such as the liver.

Flap: An uncontrollable jerking of the hands sometimes seen in advanced liver disease. A flap indicates poor liver function.

Foley catheter: A tube inserted into the bladder to drain urine.

Ganciclovir: See CMV.

Gastroenterologist: A physician who specialises in treating diseases of the digestive system and liver.

Glucose: A type of sugar found in the blood.

Graft: Your new liver.

Haematemesis: Vomiting up of blood. May result from bleeding from varices or a peptic ulcer (see below).

Haemachromatosis: Deposition of excess iron in the liver, skin, joints and pancreas. This is an inherited disease in which large amounts of iron are transported from the intestine, accumulate in the liver, and cannot be processed normally. Iron build up affects other areas of the body as well as the liver.

Haemoglobin: The red pigment which carries blood to the liver. The portal vein is the other main source of blood flow to the liver.

Hepatic: Referring to the liver.

Hepatic artery: The artery which carries blood to the liver. The portal vein is the other main source of blood flow to the liver.

Hepatic vein: The vein which drains blood from the liver towards the heart.

Hepatitis: Acute inflammation of the liver often caused by viruses, drugs, alcohol or toxins.

Hepatitis viruses: Viruses causing inflammation of the liver.

Hepatocytes: Liver cells.

Hepatologist: A physician who specialises in liver diseases.

Immune system: The body’s natural system defending itself from viruses, infections or any foreign body (such as a new organ).

Immunosuppressives: Drugs used to reduce the body’s defence mechanism, the immune system. These drugs keep the body from rejecting the transplanted organ, but they also reduce the body’s ability to fight off infection.

Immunosuppressive medication: A drug that suppresses the body’s immune system. It helps prevent the recipient’s own immune system from attacking and rejecting the new liver

Imuran: trade name for azathioprine (see above).

Inflammation: The end result of the reaction of the immune system to any foreign infection

Interferon: A protein produced by the immune system to fight viral infection.

Intravenous (IV): the infusion of fluids, blood or drugs into a vein. Literally into or within a vein; also refers to fluids and medications that are injected into a vein through a needle or catheter

Jaundice: Yellow color of the eyes and skin due to excess bilirubin in the blood. Usually occurs because the liver fails to excrete bilirubin in the normal manner due to liver failure or obstruction to bile flow.

Lipids: Another term for fats

Liver: The largest organ inside the body with many functions, including manufacturing proteins and blood clotting factors, excreting bilirubin and storing iron

Liver biopsy: The process of removing and inspecting a small sample of liver. A needle is inserted into the liver and a tiny piece removed to be inspected under a microscope.

Liver cancer: Malignant cells in the liver whether from a primary cancer, or, more commonly, a secondary cancer. May complicate chronic liver disease.

Liver failure: Failure of the liver to carry out its normal function. May result in jaundice, ascites or coma.

Liver function tests (LFTs): Blood tests to measure the function of the liver. These are blood tests that are ordered regularly by liver doctors. They give an indication of how well the liver is working and help sort out the type of problem that may be present. They are done daily immediately following transplantation. Abnormalities can indicate rejection, infection, side effects from drugs and many other things. Experience is required to determine what the results mean. Abnormal results do not necessarily imply that a serious problem is present.

Liver transplantation: The surgical removal of a diseased liver and its replacement by a donor liver.

Noncompliance: Failure to take medicine as prescribed or follow the advice of medical and nursing staff

Obesity: Excess accumulation of body fat.

Oedema: Swelling of the ankles and legs due to abnormal collection of fluid in the body and a deficiency of the blood protein albumen (see above). This is an effect of chronic liver disease.

Oesophagus: the tube between the mouth and stomach. Also known as the gullet.

Osteoporosis: A decrease in the density of bone associated with advanced live disease and also with prolonged corticosteroid use. Bones with osteoporosis are more likely to fracture.

Platelets: Cells in the blood which help the blood to clot. Numbers may fall in cirrhosis.

Pneumonia: Inflammation of lung tissue (different from bronchitis).

Portal hypertension: High blood pressure in the portal venous system that carries blood from the intestine, spleen and pancreas to the liver. Portal hypertension can result in ascites or bleeding.

Portal vein: A large vein which carries the major blood supply to the liver from the intestine. Carries nutrients resulting from digestion of food.

Prednisone: A steroid hormone taken my most transplant recipients to help prevent rejection.

Prevalence: The number of people with a given disease at a given time.

Prophylaxis: The prevention of a problem. For example, antibiotics are often given to transplant patients in the first yea after their operation to prevent Pneumocystis pneumonia - a complication of the anti-rejection drugs.

Red blood cells: blood cells which carry oxygen attached to haemoglobin.

Sclerotherapy: Injection of varices (see below) with a clotting agent to prevent them from bleeding. This is done using an endoscope and is painless.

Small intestine: Part of the gastrointestinal tract which includes the duodenum, jejunum and ileum. The major site for digestion and absorption of food.

Spider-Naevi: Small red skin spots with spidery projections that indicate the presence of liver disease.

Spleen: An organ which breaks down ageing blood cells and is also an important part of the immune system.

Thrombosis: The formation or presence of a blood clot.

Tissue typing: A blood test done to evaluate the closeness of tissue match between organ donor and recipient (done before transplant).

Transfusion: Giving blood or blood products through a vein.

Triglyceride: A type of body fat or oil made up of glycerol with three fatty acids attached. Triglyceride levels in blood rise after a meal, falling again as the fat is used for energy or stored as body fat. A continuing high level may occur with high alcohol intake or diabetes.

Vaccination: a technique to produce protective antibodies against an infection by exposing the immune system to a vaccine made of living or dead organisms.

Varices: Large veins n the oesophagus which may develop due to portal hypertension, and which place he individual at significant risk of bleeding into the oesophagus or stomach.

Viral hepatitis markers: Antigens and antibodies measured by laboratory tests to indicate the presence or absence of viral infections that cause liver disease.

White blood cells: elements of blood which fight infection.

Wilson’s disease: A disease due to excessive storage of coper in the liver and brain