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Hepatitis C is the number one disease leading to cirrhosis and liver failure that requires liver transplantation.  In the past, patients that underwent a liver transplant for hepatitis C were immediately re-infected with the hepatitis C virus.  In a number of cases, the reinfection with the hepatitis C virus caused problems related to the transplanted liver.  Following successful liver transplant, a subset of patients developed very aggressive reinfection of the liver, leading to a potentially fatal complication called fibrosing cholestatic hepatitis.  In many cases, this would lead to severe malfunctioning of the transplanted liver, with an unacceptably high mortality rate.  A number of patients that were transplanted for hepatitis C would experience very mild problems related to the hepatitis C, though a good number of patients following transplant would develop progressive damage to the liver over one to three years following transplant.

In years past, the available antiviral therapies for hepatitis C were toxic, and had a number of drug interactions making it very difficult to treat the post-liver transplant patients.  The good news now is that with the widely available direct-acting antiviral agents, without the need for interferon, we are now able to aggressively treat patients both before liver transplant, in the cirrhotic stage, as well as immediately post-liver transplant with a very high cure rate in these patients.  These are successes we were unable to experience prior to this.

The standard approach that we have is to evaluate each patient with cirrhosis, including those with advanced cirrhosis and its complications.  We will carefully explain to the patient the pros and cons of being treated before liver transplant, with the hope that we can cure the patient of their hepatitis C before successful liver transplant.  It would be very beneficial to go into the transplant surgery virus free, essentially eliminating the chance that they will develop recurrent hepatitis C after liver transplant.

In situations where we are unable to treat the patient before transplant, based on their underlying medical conditions or availability of the medicines per their insurance company, we will immediately initiate antiviral therapy following transplant in the first four to eight weeks after liver transplant surgery.  Over the past 18 months, we have had excellent responses and have cured many patients of their hepatitis C post-liver transplant.

New therapies continue to be approved through 2015, and in 2016, we expect additional combinations of new HCV drugs to be FDA approved.

Call our office at 713-794-0700 for an appointment and clinical evaluation.

Obesity and Fatty Liver Disease

Obesity, and all of its related complications, is more serious than most adults in America believe. More than one-third (34.9% or 78.6 million) of U.S. adults are obese. Obesity-related conditions include heart disease, stroke, type 2 diabetes, fatty liver disease, and certain types of cancer, are some of the leading causes of preventable death. We are seeing an increase in the number of young children and adolescents developing obesity, and all of the related complications.

The cost of obesity is staggering, with annual medical cost of obesity exceeding $147 billion in 2008 U.S. dollars. The medical costs for people who are obese were $1,429 higher than those of normal weight.

Dr. Galati and the Liver Specialists of Texas team are dedicated to evaluate, treat, and manage all aspects of obesity and non-alcoholic fatty liver disease (NAFLD and NASH), including the complication of cirrhosis and liver failure. Developing a customized plan of care for each patient they see is their objective.

Liver Transplant Resources

Dr. Galati has been involved in Liver Transplantation since 1989. As Medical Director for the Center for Liver Disease and Transplantation at Houston Methodist Hospital, Dr. Galati has cared for thousands of patients with advanced liver disease. In those with the most severe form of advanced liver disease and cirrhosis, liver transplantation is a life-saving surgery. For more information on liver transplantation, click here.

Indications for liver transplant include:

Online LIVER Second Opinion

  • 1

    From the comfort of your home, without the need to spend additional money on travel, lodging, and food, receive and expert second opinion from the expert physicians at Liver Specialists of Texas

  • 2

    There are five steps in the process of requesting a second opinion. We anticipate the steps will take you about 30-65 minutes to complete.

  • 3

    Have your medical records or those of your loved one on hand as you fill out the medical history questionnaire portion of the online process. The medical history questionnaire is detailed so having medical records to quickly reference will help make the process more efficient.

  • 4

    To start the process of an Online Liver Second Opinion, please fill out the initial contact form and fax back to our office. A representative from our office will call you for additional details.