Can You Live Without A Liver?

The liver is a crucial organ in the right upper abdomen. It has many identified vital functions and is so important that you cannot live without it.

Fortunately, it is the only organ capable of regeneration after parts of it have been damaged or removed. It is also possible to live with only a part of your liver. Find out more below about liver failure, regeneration, and transplant.

What the liver does to your body

The liver plays a vital role in digesting food and absorbing nutrients. Your body relies on this organ for a range of functions, including:

• Bile production. Bile helps in nutrient absorption and breakdown. It also helps to eliminate toxins from the body.

• Vitamin storage and metabolism. The liver assists in metabolizing and storing fat-soluble nutrients, such as vitamins A and E. 

• Bilirubin metabolism. The liver converts heme to biliverdin to bilirubin. It then processes the bilirubin, which exits the body as bile in the feces or via the kidney into the urine. Excess bilirubin can accumulate in liver disease or failure cases, resulting in jaundice.¹ ²

• Detoxification. The liver helps to break down alcohol, drugs, and medication, and it also helps to eliminate toxic substances. 

• Blood clotting. The liver makes many of the proteins that are involved in the blood clotting process. 

• Hormone balance. The liver activates thyroid hormone to its most active state and secretes certain other hormones. It also synthesizes a carrier protein that binds to sex hormones (like estrogen and testosterone) in the blood.

• Synthesizing albumin (a carrier protein that helps to transport many other substances in the blood). Albumin is also very important in maintaining normal fluid balance in the body.

• Breaking down old red blood cells (RBCs). This allows the body to remove damaged RBCs safely and recycle the iron that they contain.

What happens when the liver is failing?

There are generally two types of liver failure, each with different causes and symptoms:

1. Acute liver failure, which happens suddenly

2. Chronic liver failure, which happens gradually over time

The most common causes of acute liver failure are viral infections and drug toxicity, primarily due to acetaminophen (Tylenol) overdosing. Although it’s relatively rare, acute liver failure can result in rapid liver deterioration, even when the liver was fully healthy and functional before the illness. 

Symptoms of acute liver failure include:

• Vomiting

• Nausea

• A swollen belly

• Pain in the upper right abdomen

• Yellowing of the skin and eyeballs (jaundice)

• Tremors

• Sleepiness 

• Confusion

• A general sense of feeling unwell

On the other hand, chronic liver failure is likely caused by inflammation and scarring that occurs gradually. This gradual liver deterioration is often a result of one of the following:

• Alcohol misuse

• Liver cancer

• Infections such as hepatitis A, B, and C

• Non-alcoholic fatty liver disease

Symptoms of chronic liver failure (cirrhosis) include:

• Fatigue

• Nausea

• Jaundice 

• Itchy skin

• Loss of appetite

• Easy bleeding or bruising

• Absence or loss of periods unrelated to menopause (for women)

• Testicular atrophy, breast enlargement (gynecomastia), or loss of sex drive (for men)

While liver failure can be threatening, it isn't terminal. You can qualify for a liver transplant depending on your health and the liver. 

A liver transplant is a procedure to remove a damaged, injured, or diseased liver and replace it with a healthier liver from another person, known as a liver donor. There are two major types of liver transplants:³

1. Deceased donor transplant. The donor is a recently deceased person. Before they died, they chose to donate their organs in the event of their death.

2. Living donor transplant. In this case, the donor is still alive. A part of the liver is removed from the healthy person and transplanted into the recipient. The transplanted piece and the piece left in place will grow to become a fully functioning liver. 

Can you prevent your liver from failing?

If you notice your liver is failing, you can take preventative actions, such as:

• Eliminate alcohol consumption or significantly reduce it.

• Try to avoid taking medication that can harm your liver. Talk to your doctor about any prescriptions you take to determine whether they may harm your liver. Use caution with any over-the-counter medications, especially painkillers. Many of these are toxic to the liver, so avoid using them as much as possible. 

• If you’re overweight, lose weight. Manage risk factors such as diabetes and high blood pressure.

• Eat a diet low in saturated fat. This means reducing your consumption of foods like red meat, butter, and cheese.

• Avoid taking iron supplements — unless prescribed for iron deficiency anemia. If you take a multivitamin, ensure that it doesn’t contain iron.

Types of liver disease

Some examples of liver disease include:

Non-alcohol-related fatty liver disease

Non-alcohol-related fatty liver disease (NAFLD), also known as nonalcoholic steatohepatitis (NASH), causes fat tissue to build up in the liver. This causes inflammation in the liver, which damages it and interferes with its function. This disease is associated with being overweight or obese.

Infections

Hepatitis (liver inflammation) can be caused by viruses, including the hepatitis A, B, C, and E viruses. Certain other viruses and parasites can also cause damage to the liver. 

Autoimmune hepatitis

In people with autoimmune diseases, the immune system attacks the body’s own tissues. When the immune system attacks the patient’s own liver, this is known as autoimmune hepatitis. 

Alcohol use

When you drink alcohol, the liver metabolizes it. This process produces toxins, which affect the liver cells. Because of this, drinking too much alcohol can slowly damage the liver, leading to cirrhosis (a condition in which scar tissue forms throughout the liver).

Can the liver regenerate after a disease?

Among all organs, one of the unique capacities of the liver is self-regeneration after damage. The liver can regrow to standard sizes, even after up to 90% of it has been removed.⁴

However, when scar tissue forms throughout the liver (a process known as cirrhosis), this can block the liver tissue from regenerating. When this happens, the liver is unable to heal itself, and the person will experience symptoms of liver failure.

What if your liver fails?

The liver performs a significant number of different functions in the body. If it experiences severe and irreversible damage, then severe complications can result. Untreated liver failure will eventually result in death.

With some vital organs in the body, the functions can be at least partly replaced by medical technology. For instance, in people with kidney failure, dialysis can be used to replace the lost kidney function. 

However, there’s currently no medical technology available that can replace the many different functions performed by the liver. If a person’s liver fails, the only way to restore the lost liver function is through a liver transplant.

Can the liver be transplanted?

In a person with severe liver failure, a liver transplant can be life-saving. The donor for a liver transplant may be a recently deceased person. Or the donor may be a living person who donates a part of their liver. 

In many cases, the patient’s damaged liver is removed entirely during the surgery. This is known as an orthotopic liver transplant. However, the damaged liver is sometimes left in place, and a healthy liver (or part of a liver) is transplanted into a different location.

This is known as a heterotopic liver transplant. Orthotopic liver transplantation is usually preferred.

The requirements to qualify for a liver transplant include:

• You are well enough to recover from surgery

• You have clinical signs of liver failure or primary liver cancer that has not spread outside the liver

• You are not considered to be at risk of possible alcohol or drug abuse in the future

Unfortunately, more people need liver transplantation than there are donor livers available. Many people who would benefit from a transplant can’t receive one simply because there aren’t enough donor livers.

The lowdown

The liver performs many crucial functions in the human body, and its failure can have serious and even life-threatening consequences. It’s impossible to live without a functioning liver.

The liver is the only organ in the human body that can regenerate itself. However, in some cases, the damage may be too extensive for the liver to repair. In this case, a liver transplant is the only way to restore liver function.

Untreated liver failure can be fatal. Possible signs of liver damage include low energy, jaundice (yellowing of the skin and eyes), nausea, vomiting, and pain in the upper right abdomen. Seek urgent medical attention if you notice these symptoms. 

Frequently asked questions

Why might I need a liver transplant?

Cirrhosis, or scarring of the liver, is the most common reason for a liver transplant. This may be the result of:

• Infection with the hepatitis B or C virus

• Alcoholic liver disease

• Non-alcoholic fatty liver disease

• Genetic diseases affecting the liver

• Diseases or conditions that affect the tubes that carry bile away from the liver

How do I get ready for a liver transplant?

There are three phases you'll experience as you get ready for a liver transplant:

1. Evaluation. You will need a complete evaluation before doctors determine if a liver treatment is the most suitable option. This evaluation involves a variety of steps, including determining what type of liver disease you have and how advanced it is, as well as deciding whether you’re healthy enough to undergo liver transplantation.

2. Waiting period. If you’re deemed a good candidate for a liver transplant, you will be placed on a waiting list for a liver. You will then wait for a liver to become available that’s a good match for you biologically. 

3. Transplant surgery. This is a major surgery. You will need to stay as healthy as possible while you’re waiting. Ways to do this include:

• Stay physically active — within your body’s capabilities

• Eat a healthy diet

• Avoid alcohol and drug use

• Aim for a healthy weight

• Take medications and supplements exactly as directed by your doctor; make sure that your doctor is aware of everything that you’re taking, including any vitamins, over-the-counter medications, or herbs

• Try to maintain a positive mindset

How much of my liver will be removed?

If you’re receiving a liver transplant, then your entire diseased liver is usually removed and replaced with the healthy transplanted one. If you’re donating part of your liver to someone else, about half of your liver is usually removed, or slightly more. The remaining healthy liver will regenerate and return to approximately its previous size.