At Yale Medicine, our experts and caregivers give comprehensive and compassionate treatment for those with end-stage liver, kidney, and pancreas organ failure who might benefit from transplantation. We offer many treatment options and hope for high-risk patients who may have been turned down for transplant elsewhere, in addition full support services. Our expert physicians specialize in anesthesiology, internal medicine, pediatrics, surgery, transplant immunology, kidney diseases, liver diseases, diabetes mellitus, and transplant surgery. Our caring, highly skilled nurses, physician assistants, nutritionists, pharmacists, social workers, and financial counselors further support your needs. Many inherited metabolic liver diseases such as Wilson's disease, Gaucher's disease, lipidosis, alpha-1 antitrypsin deficiency, hemochromatosis, tyrosinemia, and glycogen storage diseases are cured by successful liver transplantation. We specialize in genetic testing for liver diseases and treatments that provide comprehensive care for affected patients. Even though we treat some of the most seriously ill patients, our program's survival rates are consistently higher than the national average. We offer many options for advanced liver disease, including living donor and deceased donor transplantation, liver transplantation in HIV-infected individuals, and pre- and post-transplant antiviral therapy to prevent or treat recurrent hepatitis C. Through our acute liver failure program, we can transfer patients to Yale New Haven Hospital in a timely manner for transplant evaluation and medical management. In collaboration with the hospital’s Medical Intensive Care Unit, we offer innovative techniques such as hypothermia therapy for the treatment of acute liver failure. Pancreatic transplants are less common than kidney or liver transplants and are usually performed in patients with type 1 diabetes. Our physicians perform isolated pancreas transplantation, simultaneous kidney/pancreas transplantation, and pancreas transplantation following kidney transplantation. Specialized care is offered in the following areas: Combined organ transplantation including kidney, kidney/liver, and kidney/heart Comprehensive tissue typing and immune evaluation services Follow-up and psychosocial support Leading-edge treatment options for immunosuppression Liver transplantation, including adult-to-adult living donor, pediatric living donor, and other surgeries Minimally invasive living-donor kidney surgeries Robotic hepatobiliary surgery Surgical therapy of diseases of the liver and biliary systems and end-stage kidney and liver disease Telemedicine via patient portal

The incidence of liver and bile duct cancer is growing, and about 42,000 new cases are diagnosed each year in the United States. While the incidence is rising, new surgical, interventional, and medical treatments are being added to our therapeutic armamentarium and are available to our patients. After treatment, our team of hepatologists provides continued care to manage the underlying liver disease, preserve liver function, monitor for possible recurrence of cancer, and re-treat, if necessary, while our medical oncologists apply systemic cancer treatment for those in need, as well as access to innovative medications through clinical trials. The Liver Cancer Program at Smilow Cancer Hospital has assembled a dedicated group of specialists, including hepatologists, hepatobiliary and transplant surgeons, diagnostic and interventional radiologists, pathologists, medical oncologists, and nurses. The team meets weekly at a NCI-designated tumor board to discuss each patient’s diagnosis and reaches a consensus on the best personalized treatment plan. Our guiding principle is to personalize and adapt care to the changing needs of the patient. Clinical trials, using new ablation treatment, new targeted agents, and combinations of treatments to target specific intracellular mechanisms of the liver cancer, are also available for patients with advanced disease. A combination of interventional radiology and surgical techniques, including ablation therapy, liver resection, new chemotherapeutic options, and liver transplantation, are available to our patients. For some patients, these treatments can cure their disease. For patients diagnosed with early disease, liver transplantation can provide definitive cure for both the cancer and advanced liver disease that frequently accompanies a diagnosis of cancer. For patients who do not have advanced liver disease or for those who cannot receive a liver transplant, surgical resection and ablative therapies such as transarterial chemoembolization (TACE) or radiofrequency ablation (RFA) can provide excellent survival rates. TACE delivers chemotherapy through a catheter directly to the liver tumor. RFA is a common treatment method for small tumors and uses a direct current to destroy tumors. NanoKnife therapy is a state-of-the-art minimally invasive cancer treatment that applies a high voltage of electrical pulses to induce precision targeted cancer death, while minimizing surrounding tissue damage in the liver. After treatment, our onco-hepatologist team provides continued care to manage the underlying liver disease, preserve liver function, and monitor for possible recurrence of cancer and re-treat, if necessary.

Our hepatologists, or those who specialize in treating disorders of the liver, gallbladder, and bile ducts, are highly trained and equipped to treat acute or chronic liver disease. Our doctors are able to provide answers to patients with acute or chronic liver disease, from initial evaluation to management of difficult and complex disease. Our special services include: Diagnosis and treatment of complex liver disorders, including cholestasis, autoimmune diseases, and metabolic diseases (such as Wilson's Disease, hemochromatosis, and alpha-1 antitrypsin deficiency) Liver biopsy, large volume paracentesis, infusions, invasive measurement of portal pressure, endoscopic treatment of variceal bleeding, and Transjugular Intrahepatic Portosystemic Shunts (TIPS) Nutrition evaluation and treatment Management of chronic liver disease and cirrhosis Inpatient treatment of decompensated liver cirrhosis and acute liver failure Our primary clinical programs are: The Viral Hepatitis Program provides state-of-the-art therapy for patients with Hepatitis B and Hepatitis C infections. The Steatohepatitis Program specializes in nonalcoholic steatohepatitis (NASH), a liver disease that is related to fatty liver that is becoming more common. It is associated with a number of metabolic disorders, including diabetes and obesity. The Liver Cirrhosis Program periodically monitors patients for the development of cirrhosis, in which scar tissue replaces healthy liver tissue. The Liver Cancer Program features a team of specialists, from transplant surgeons to medical oncologists, who work together to find the best treatment in order to preserve liver function and monitor for possible recurrence of the cancer. The Liver Transplant Program offers comprehensive care to patients who need living or deceased donor transplantation. Liver transplantation is the cure for many acute and chronic liver diseases.