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Intestinal Failure Associated Liver Disease (IFALD)

Intestinal failure associated liver disease encompasses both acute and chronic disturbances of hepatobiliary (liver and bile duct) function, as well as severe complications including fibrosis (scarring), cirrhosis, portal hypertension, and liver cell failure. The identification of IFALD relies on persistent elevations (i.e. for>2 weeks) of one or more liver enzymes or bilirubin in the peripheral blood, as liver biopsy is rarely performed in the early stages.

In later stages, signs may include jaundice (yellowing of the skin), esophageal varices, or ascites (fluid in the abdomen). 

It is important for your transplant team to determine if you have liver disease so they can determine the appropriate type of transplant to give you. During your evaluation your team will evaluate your liver and determine its baseline. Throughout your waiting period your liver will be monitored, and if the status changes, then listing status will be updated accordingly.

If you are listed for a liver, then a MELD score will be calculated for your place on the list. Please visit this website for a detailed explanation.

Note, pediatric patients have a PELD score (age 12 and under), which is different in that it accounts for growth failure and should visit this website for calculation.

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