Glossary of terms related to organ failure, medical treatment, and recovery. Note that many of these definitions are extracted from the linked resources within the term, and those links should be considered both citations and sources of additional information. If you have suggestions for glossary additions or corrections please suggest them.
An Alpha Fetoprotein (AFP) tumor marker test is a blood test that measures the level of AFP in a sample of your blood. It's usually used to help diagnose certain types of cancer and to check how well treatment is working.
Normally, the liver makes Acetaminophen (the active ingredient in Tylenol) non-toxic. But if you take too much Tylenol, the liver can't properly process it all. The toxic chemical can then build up and poison liver cells.
Albumin is responsible for transporting vitamins, enzymes and hormones throughout your body. Albumin makes up 50% of the proteins found in your plasma. When your albumin levels are low, hormones and other important compounds aren’t able to get to where they need to go in your body to fulfill their duties.
American Liver Foundation (ALF)
Ascites is the accumulation of water in the abdomen, commonly due to leakage from the liver’s portal vein. Ascites adds significant body weight as the water accumulates, making movement more difficult. It also pushes on internal organs, and this compression can affect ability to breath, eat, and other body activities.
Asterixis is an inability to maintain sustained posture, commonly causing hands to flap when the wrist is extended. It is a symptom of hepatic encephalopathy and is why a doctor may ask a patient to hold out their hands.
The BK virus is a virus that most people get in childhood. Symptoms can feel like a common cold. Once you get a BK virus infection, the virus stays in your system for good but in an inactive state.
When you take anti-rejection medications due to an organ transplant, the BK Virus can become active to the point that it will damage kidneys.
Bilirubin is a yellowish substance made during your body's normal process of breaking down old red blood cells. Bilirubin is found in bile, a fluid your liver makes that helps you digest food. If your liver is healthy, it will remove most of the bilirubin from your body.
A Computed Tomography Scan (CT Scan) uses X-rays and computer technology to create 360-degree views of the human body.
A Central Venous Catheter (CVC) extends from outside the body into the large vein (vena cava) going directly into your heart. This is used for dialysis as well as other medical purposes.
A catheter is type of tube inserted into the body. They can be used for injecting and withdrawing from blood vessels and other passageways. Some catheters have multiple channels (lumens) within an outer sheath. For example, a Trialysis catheter has three lumens.
CellCept® is a brand and common name for Mycophenolate Mofetil.
Cirrhosis is a condition in which your liver is scarred and permanently damaged. Scar tissue replaces healthy liver tissue and prevents your liver from working normally. As cirrhosis gets worse, your liver begins to fail.
Compensated cirrhosis means the liver is scarred but still able to perform most its basic functions at some level.
Creatinine is the waste byproduct of the muscles processing energy from creatine. Properly functioning kidneys remove creatinine from the blood supply.
A Donor Service Area (DSA) is a smaller portion of a UNOS Region in which organs can be transported successfully.
Decompensated cirrhosis is defined as an acute deterioration in liver function in a patient with cirrhosis and is characterized by jaundice, ascites, hepatic encephalopathy, hepatorenal syndrome or variceal haemorrhage.
Liver damage and severe scarring can progress to the point where the liver can no longer function properly and the patient will begin to experience more severe symptoms. Liver function will continue to decrease with the patient being more at risk for more severe complications like internal bleeding, liver cancer and liver failure and the need for liver transplant.
Dialysis functions as a very effective but partial replacement for the processes of the kidneys. The main capability is the removal of waste products (e.g. see Creatinine above) from the blood supply. A secondary capability is the removal of water from the blood supply, and through that, from areas water is over-accumulating.
A drug regimen describes the specific instructions and schedule for administering one or more drugs to a patient. It includes factors such as drug dosage, frequency, route of administration, and duration of treatment.
Dysphagia is an inability to swallow properly. Food and liquids orally taken can be aspirated (inhaled) and cause pneumonia and other illness.
An Emergency Room (ER) or Emergency Department (ED) enables walk-in medical services at a hospital.
End-Stage Liver Disease (ESLD) is when the liver is damaged beyond repair due to chronic liver disease or acute liver failure.
End-stage renal disease (ESRD), also called end-stage kidney disease (ESKD) or kidney failure, occurs when chronic kidney disease — the gradual loss of kidney function — reaches an advanced state. In end-stage renal disease, your kidneys no longer work as they should to meet your body's needs.
Edema (or Oedema) is swelling caused by too much fluid trapped in the body's tissues. Edema can affect any part of the body. But it's more likely to show up in the legs and feet.
Encephalitis is swelling of the brain. Frequently also used as an easier to pronounce version of encephalopathy by laymen, myself included.
Encephalopathy is disease affecting the brain, from the Greek ‘enkephalos’ (about the brain) and ‘pathos’ (disease). Depending on severity encephalopathy can show up as symptoms from headaches to coma. Hepatic encephalopathy (HE) is caused by liver problems and accumulated toxins in the blood.
Esophageal varices are enlarged veins in the esophagus, the tube that connects the throat and stomach. Esophageal varices most often happen in people with serious liver diseases.
Fibrosis-4 (FIB-4) Index for Liver Fibrosis. Noninvasive estimate of liver scarring in HCV and HBV patients, to assess need for biopsy.
«We use FIB-4 as an initial assessment. In chronic HCV, when combined with APRI, it has excellent negative predictive value for excluding advanced fibrosis. The positive predictive value is less clear. Those with FIB-4 >1.5 and/or APRI >0.5 often go on to liver elastography.»
Fatty Liver Disease (FLD) — also called Steatotic liver disease (SLD) — involves having excess fat in your liver. Metabolic conditions and heavy alcohol use are risk factors. Depending on the type of SLD you have, the fat buildup may not cause problems, or it may lead to liver damage. Often, you can prevent or even reverse SLD with medications and lifestyle changes.
FibroScan is a special ultrasound technology that measures liver stiffness (hardness) and fatty changes in your liver. These measurements help your healthcare provider learn more about your liver disease
An Arteriovenous (AV) fistula is a direct connection between an artery and a vein. Normal blood flow goes from arteries through capillaries and then into veins. The fistula’s direct connection causes much more blood flow into a vein. Surgically creating a fistula in a chronic hemodialysis patient enables more effective and safer treatment compared to using a central venous catheter.
Gabapentin works in the brain to prevent seizures and relieve pain for certain conditions in the nervous system. It can also be used for controlling the effects of neuropathy.
A hepatobiliary iminodiacetic acid (HIDA) scan is an imaging procedure that shows how well your liver, bile ducts and gallbladder are functioning. It can help diagnose certain conditions, such as cholecystitis, biliary leak and biliary atresia.
Hemochromatosis (he-moe-kroe-muh-TOE-sis) causes your body to absorb too much iron from the food you eat. Excess iron is stored in your organs, especially your liver, heart and pancreas. Too much iron can lead to life-threatening conditions, such as liver disease, heart problems and diabetes.
Hemodialysis is dialysis done by pulling blood from the body and running it through a dialyzer (filter) along with a dialysate (solution) to filter the blood of toxins.
Hepatitis means inflammation of the liver. Usually the term is short for one of the five Viral Hepatitis strains: Hepatitis A, B, C, D and E.
Hepatologists are medical doctors who diagnose, treat, and manage problems associated with your liver, gallbladder, bile ducts, and pancreas.
A Hoyer Lift is an electrically powered lift than enables people with mobility issues to move between sitting locations (e.g. between a bed and a wheelchair). The inventor Ted Hoyer was a quadriplegic.
Hydroxyzine is in a class of medications called antihistamines. It works by blocking the action of histamine a substance in the body that causes allergic symptoms. It also works by decreasing activity in the brain.
Hypertension is a blood pressure reading of 130/80 millimeters of mercury (mm Hg) or higher
Hypotension is below normal blood pressure. Systolic blood pressure under 90 is below normal and can cause dizziness and fainting.
An Intensive Care Unit (ICU) has additional equipment and increased staffing (one nurse for every two patients) compared to hospital general wards.
An International Normalized Ratio (INR) test calculates how long it takes for blood to clot compared to a normal healthy person (with a value of ‘1’). Blood thinners and illness can cause blood to take several times longer than normal to clot.
An Intensive Outpatient Program (IOP) is a hospital program that meets several times a week for several hours at a time. IOPs are supposed to be as effective as residential programs and can also function as a transition from an inpatient program to normal life surroundings.
Immunosuppressants are drugs or medicines that lower the body's ability to reject a transplanted organ. Another term for these drugs is anti-rejection drugs.
An 'insult' is the cause of some kind of physical or mental injury. A bodily injury, irritation, or trauma.
Itching is a common symptom from liver damage. Possible helpful treatments include: Cholestyramime Powder, Hydroxyzine, and Sarna lotion .
A Jejunal Tube (J-Tube) is a one-meter tube extending from outside your nose to your duodenum (small intestine). It is used to deliver food and medicines to people who are incapable of orally consuming them.
K4 is an ICU at Stanford. It is on the fourth floor and ‘K’ wing of the new 500 Pasteur Drive building.
The parameter Kt/V is a measurement of the efficacy of a dialysis session (hemo or peritoneal)
Lactulose (sometimes called 'The L-Word') is a laxative with a secondary treatment for Hepatic Encephalopathy. Its chief mechanism of action is by decreasing the intestinal production and absorption of ammonia.
Lasix (Furosemide) is a diuretic: it causes you to make more urine.
The age limit is individualized as it varies with a patient's overall health condition. However, it is rare to offer liver transplant to someone greater than 70 years old.
The transportation of a donated liver by placing it into a 'box' (machine) that provide 'normothermic' (standard temperature) perfusion.
The Liver Spot is a LifeRing meeting that focuses on medical issues associated with recovery.
A Living Donor is someone that provides an organ to a recipient patient while still being able to live. Examples include donating one of their two kidneys, or half of a full liver.
M5 is the liver and kidney ward at Stanford. It is on the fifth floor and ‘M’ wing of the new 500 Pasteur Drive building.
The Model of End-stage Liver Disease (MELD) score is a calculation based on several test results (e.g. Creatinine levels) that prioritizes the need for a liver transplant. Higher MELD scores are correlated with a high probability of dying within three months, so a higher immediate need for a transplant. The range of the MELD calculation is 6 to 40. A MELD above 30 indicates a 50% chance of dying in three months. A MELD below 20 indicates less than a 10% chance of progressive issues within three months. The MELD score is dynamic and can spike and then subside. A consistently high or severely high score indicates the need for a transplant.
A MELD Exception Score is a modifier to the calculated MELD score. Some transplant candidates have a medical condition, such as cancer or rare forms of chronic liver disease, where MELD or PELD will not accurately predict their short-term transplant need. If so, they may qualify for an exception score — a separately assigned score to be used instead of their calculated MELD or PELD in matching the person for available organ offers. The goal of exception scores is to make access to transplant more equitable among patients with similar levels of medical urgency.
Magnetic resonance elastography (MRE) is a technology that combines MRI imaging with low-frequency vibrations to create a visual map (elastogram) that shows stiffness of body tissues.
Magnetic resonance imaging (MRI) is a type of diagnostic test that can create detailed images of nearly every structure and organ inside the body. MRI uses magnets and radio waves to produce images on a computer.
Mycophenolate Mofetil is an immunosuppressant that prevents rejection of transplanted organs and augments Tacrolimus.
Nonalcoholic steatohepatitis (NASH) is the most severe form of nonalcoholic fatty liver disease (NAFLD), a condition in which the liver builds up excessive fat deposits.
A nephrologist is a medical doctor who specializes in diagnosing and treating kidney conditions.
Nephrotoxicity is toxicity in the kidneys. It is a poisonous effect of some substances, both toxic chemicals and medications, on kidney function
Nystatin is an antifungal mouthwash to reduce the chance of infection from immunosuppressants.
Organ Procurement and Transplantation Network (OPTN) is a unique public-private partnership that links all professionals involved in the U.S. donation and transplantation system. Also crucial to the system are individuals who sign organ donor cards, people who comment on policy proposals and countless volunteers who support donation and transplantation, among many others.
Phosphatidylethanol (PEth) testing is a reliable method to help create a picture of alcohol consumption.
Prothrombin Time (PT) is a measure of blood coagulation.
Paracentesis is the process of draining water from the abdominal cavity. A long needle is inserted into a pocket of water (commonly found through ultrasound) and the water drained into vacuum bottles. With severe ascites, several liters can be removed. Beyond the comfort from draining excess water, the fluid can be analyzed for infections or other causes.
Peet’s Coffee is a coffee chain that started in Berkely California and later became a national chain after Alfred Peet passed. Alfred Peet taught the Starbucks founders how to roast coffee.
Perfusion is the passage of fluid into organs or tissues. Normally this is done through the circulatory (or lymphatic) systems of the human body, but also applies to when devices produce similar result (e.g. Liver In A Box)
Peripheral neuropathy happens when the nerves that are located outside of the brain and spinal cord (peripheral nerves) are damaged.
Peritoneal Dialysis is dialysis done by putting a dialysate (solution) into your abdomen where it interacts with your blood through the peritoneum and toxins migrate into the solution. Subsequently the dialysate is drained, and with it the toxins.
A phlebotomist is a medical technician that collects blood from patients.
Prograph® is a brand and common name for Tacrolimus.
Post procedure recovery tends to require large amounts of protein.
Recompensated Cirrhosis is the concept that decompensated cirrhosis can improve to being compensated. This is a relatively recent concept with limited studies.
The Scientific Registry of Transplant Recipients (SRTR) supports the transplant community with analyses, in an effort to better patient results and experience. Through the evaluation of national data collected by the Organ Procurement and Transplant Network (OPTN) on transplant programs and organ procurement organizations…
Satellite Healthcare is a non-profit that provides kidney care, including dialysis.
Sober can mean sparing use of alcohol, such that it has no significant impact on your body and life. It can also mean complete abstinence from alcoholic drinks for either a period ("sober driver tonight") or permanently. But the most extreme form of sober is to avoid all sources of alcohol. Usually that is the definition associated with medically required (e.g. being on a liver transplant list) sobriety.
Cutting down salt intake will help to reduce the amount of excess fluid in the body. When we eat too much salt, the body retains extra sodium which increases the amount of fluid in the body, outside of the cells. This increase in fluid allows the body to continue retaining sodium and fluid while excreting higher levels of sodium in the urine. Approximately 1.5 litres of fluid is retained in the body when we eat too much salt and this continues as long as a higher salt intake is consumed.
Transarterial chemoembolization (TACE) places chemotherapy and synthetic materials called embolic agents into a blood vessel feeding a cancerous tumor to cut off the tumor's blood supply and trap the chemotherapy within the tumor. It is most often used to treat liver cancer but may also be used in patients whose cancer has spread to other areas of the body. Chemoembolization may be used as a standalone treatment or in combination with surgery, ablation, chemotherapy or radiation therapy.
Y-90 therapy, also known as selective internal radiation therapy or SIRT, is a minimally invasive, image-guided approach treating malignant lesions in the liver. The procedure uses a catheter to deliver tiny radioactive beads into the blood vessels that lead directly to the tumor. This allows doctors to treat tumors that are not accessible using conventional surgery or radiation treatments. A Y-90 procedure typically takes about two hours, but requires an overnight stay for observation.
Transjugular intrahepatic portosystemic shunt (TIPS) is a procedure to create new connections between two blood vessels in your liver. You may need this procedure if you have severe liver problems.
Tacrolimus is a very powerful immunosuppressant that prevents rejection of transplanted organs.
Thoracentesis is a procedure to remove fluid or air from around the lungs.
Toxoplasmosis can cause serious illness in people with weakened immune systems.
A Transjugular Liver Biopsy (TJLB) consists of obtaining liver tissue through a rigid cannula introduced into one of the hepatic veins typically using jugular venous access.
An ordered or prioritized list of potential recipients for a donated organ. The list (or registry) also includes characteristics of the recipient to match with the characteristics of the organ (e.g. blood type).
A Travel Nurse is a registered nurse that takes short term (less than a year) assignments at different locations around the country.
A Trialysis catheter combines a central line lumen (tube) with two dialysis lumens so that central line can be used while dialysis is occurring for a patient.
United Network for Organ Sharing (UNOS) manages the transplant system for the United States.
Ursodiol is a bile thinner that helps your body recover from the removal of the gallbladder.
Rifaximin (tradename Xifaxan) treats traveler's diarrhea and irritable bowel syndrome by stopping the growth of the bacteria that cause diarrhea. Rifaximin treats hepatic encephalopathy by stopping the growth of bacteria that produce toxins and that may worsen liver disease.
