Often during conversations that transplant surgeons have with potential candidates for liver transplantation procedure, it can take a while to reach an understanding of exactly why the whole liver needs to be replaced. Particularly as this will involve major surgery along with waiting for a suitable liver from an organ donor. Also there are currently no other types of medical treatment which can reverse end stage liver disease once it is diagnosed.
With the liver being hidden from view under the right lower rib cage at the top of the abdomen as described in this British Liver Trust post, it can be hard for any individual with liver disease to know exactly what is going on. Plus many types of liver disease in the early stages do not usually lead to specific symptoms such as abdominal pain or the development of yellow jaundice.
So by the time the symptoms of chronic liver disease do occur there is often already a significant amount of liver scarring present, i.e. there is cirrhosis. This means that the underlying disease process in the liver can already be well advanced. Cirrhosis affects the whole liver and the scarring process turns the liver from being a slightly soft triangular shaped organ into being a far harder, scarred organ with lots of nodules. This can be seen in the image below or via watching this video What is cirrhosis of the liver?
Cirrhosis can also lead to other significant changes occurring within the abdomen which also tend not to be visible until this type of liver damage is well advanced. Changes like the accumulation of fluid lead to abdominal swelling and this is otherwise known as ascites. Increased pressure within certain veins in the abdomen cause a condition known as portal hypertension which can lead to major bleeding from the junction of the oesophagus with the stomach. In advanced cirrhosis yellow jaundice and problems with kidney function may also occur. Further information on liver disease and cirrhosis can be obtained via the MedLine Plus WebMD or the American Liver Foundation sites.
If you are a patient receiving treatment for liver disease or a relative you should always check with your doctor that any information you source online is appropriate for your circumstances.