The liver is an abdominal glandular organ in the digestive system.

It is located in the
right upper quadrant of the abdomen, under the diaphragm and on top of the stomach.
The liver is a vital organ that supports nearly every other organ to some capacity.

The liver is the body's second-largest organ (skin is the largest organ), according to the
American Liver Foundation (ALF), weighing about 3 lbs. (1.4 kilograms). At any given
moment, the liver holds about 1 pint (half a liter) of blood — about 13 percent of the body's
blood supply, according to Johns Hopkins Medicine.

The liver is shaped like a football, or a cone, and consists of two main lobes. Each lobe
has eight segments that consist of 1,000 small lobes, or lobules, according to Johns
Hopkins. The lobules are connected to ducts that transport bile to the gallbladder and
small intestine.

Function
"The liver has a complex role in the function of the body," said Jordan Knowlton, an
advanced registered nurse practitioner at the University of Florida Health Shands
Hospital. "Detoxification, metabolism (including regulation of glycogen storage),
hormone regulation, protein synthesis, digestion, and decomposition of red blood cells,
to name a few."

In fact, more than 500 vital functions have been identified with the liver, according to
Johns Hopkins, including:

 Production of bile, which helps carry away waste and break down fats in the small intestine
during digestion.
 Production of certain proteins for blood plasma.
 Production of cholesterol and special proteins to help carry fats through the body
 Conversion of excess glucose into glycogen for storage (glycogen can later be converted
back to glucose for energy) and to balance and make glucose as needed
 Regulation of blood levels of amino acids, which form the building blocks of proteins
 Processing of hemoglobin for use of its iron content (the liver stores iron)
 Conversion of poisonous ammonia to urea (urea is an end product of protein metabolism and
is excreted in the urine)
 Clearing the blood of drugs and other poisonous substances
 Regulating blood clotting
 Resisting infections by making immune factors and removing bacteria from the bloodstream
 Clearance of bilirubin, also from red blood cells. If there is an accumulation of bilirubin, the
skin and eyes turn yellow.

Detoxification
One of the best-known roles of the liver is as a detoxification system. It removes toxic
substances from blood, such as alcohol and drugs, according to the Canadian Liver
Foundation. It also breaks down hemoglobin, insulin and excessive hormones to keep
hormone levels in balance. Additionally, it destroys old blood cells.
The liver is vital for healthy metabolic function. It metabolizes carbohydrates, lipids and
proteins into useful substances, such as glucose, cholesterol, phospholipids and
lipoproteins that are used in various cells throughout the body, according to Colorado
State University's Department of Biomedical Sciences' Hypertexts for Pathophysiology:
Metabolic Functions of the Liver. The liver breaks down the unusable parts of proteins and
converts them into ammonia, and eventually urea.

Liver disease
According to the Canadian Liver Foundation, there are more than 100 types of liver
disease, and they are caused by a variety of factors, such as viruses, toxins, genetics,
alcohol and unknown causes. The following are among the most common types of liver
disease:
 Alagille syndrome
 Alpha 1 anti-trypsin deficiency
 Autoimmune hepatitis
 Biliary atresia
 Cirrhosis
 Cystic disease of the liver
 Fatty liver disease
 Galactosemia
 Gallstones
 Gilbert's syndrome
 Hemochromatosis
 Liver cancer
 Liver disease in pregnancy
 Neonatal hepatitis
 Primary biliary cirrhosis
 Primary sclerosing cholangitis
 Porphyria
 Reye's syndrome
 Sarcoidosis
 Toxic hepatitis
 Type 1 glycogen storage disease
 Tyrosinemia
 Viral hepatitis A, B, C
 Wilson disease
According to the National Institutes of Health (NIH), one symptom of liver disease is
jaundice — yellowish skin and eyes. Other symptoms include abdominal pain and
swelling, persistent itchy skin, dark urine, pale stools, bloody or black stools,
exhaustion, bruising easily, nausea and loss of appetite.

Fatty liver
There are two types of fatty liver, according to the Cleveland Clinic: that caused by
excessive alcohol consumption (fatty liver) and that which is not (non-alcoholic fatty liver
or non-alcoholic steatohepatitis).

Speaking of both conditions, Knowlton said, "Some fat on the liver is normal, but when it
starts to accumulate to greater than 5-10 percent, it can lead to permanent liver damage
and cirrhosis." It also increases the chance of liver failure or liver cancer. Fatty liver "can
be caused by genetics, obesity, diet, hepatitis, or alcohol abuse," said Knowlton. Other
risk factors include rapid weight loss, diabetes, high cholesterol, or high trigycerides,
according to the ALF.

Some people may get fatty liver even if they don't have any risk factors. Up to 25
percent of the U.S. population suffers from fatty liver disease, according to the University
of Michigan Health System. There are no medical treatments for fatty liver disease,
though avoiding alcohol, eating a healthy diet, and exercising can help prevent or
reverse fatty liver disease in its early stages.

Enlarged liver
According to the Mayo Clinic, an enlarged liver (or hepatomegaly) isn't a disease itself,
but a sign of an underlying serious problem, such as liver disease, cancer or congestive
heart failure. There may be no symptoms of an enlarged liver, though if they are they
are the same as the symptoms for liver disease. Normally, the liver cannot be felt unless
you take a deep breath, but if it is enlarged, your doctor may be able to feel it, according
to the NIH. The doctor may then do scans, MRIs, or ultrasounds of the abdomen to
determine if you have an enlarged liver. Treatment will involve addressing the
underlying problem.

Liver pain
Liver pain is felt in the upper right area of the abdomen, just below the ribs. Usually, it is
a dull, vague pain though it can sometimes be quite severe and may cause a backache.
Sometimes people perceive it as pain in the right shoulder. It is often confused with
general abdominal pain, back pain or kidney pain, according to New Health Guide. It can
be hard to pinpoint the exact location or cause of such pains, so it is important to see a
doctor. Doctors may do blood tests, ultrasounds or biopsies to determine the cause of
pain.

Liver pain can be the result of a variety of causes. Some common causes are: ascites
(fluid in the abdomen), cirrhosis, hepatitis, liver failure, enlarged liver, liver abscess, and
liver tumors.

Liver failure
Liver failure is an urgent, life-threatening medical condition. It means that the liver has
lost or is losing all of its function. "Livers typically fail gradually," said Knowlton, "but
sometimes [it] can be rapid." Early symptoms of liver failure are general, making it
difficult to know that the liver is failing. Knowlton said, "Symptoms of liver failure may
include nausea, appetite changes, fatigue, diarrhea, jaundice, easy bleeding." As the
condition worsens, she said symptoms might include "mental confusion and coma."

"Typical causes of liver failure include Tylenol overdose, viruses, hepatitis B & C,
cirrhosis, alcoholism, and some medications," said Knowlton. Georgia's Emory
Healthcare stated that there are two types of liver failure: chronic and acute. Chronic liver
failure is the most common type of liver failure. It is the result of malnutrition, disease
and cirrhosis, and it can develop slowly over years. Acute liver failure is rarer, and it can
come on suddenly. Acute liver failure is usually the result of poisoning or a drug
overdose.

Liver failure treatments depend on the case. Knowlton said, "Treatment options are
mostly supportive (hospitalization and treatment until the liver recovers), but ultimately
may require liver transplantation."
Liver transplant
Donated livers can come from cadavers or living donors. In the case of living donors,
the donor donates part of his or her liver to another person, according to the American
College of Gastroenterology. The liver can regrow itself, so both people should end up
with healthy, functional livers. According to the National Institute of Diabetes and Digestive
and Kidney Diseases the most common reason adults get liver transplants is cirrhosis,
though transplants can also be done for patients with various liver diseases or early
stage liver cancer.
A liver transplant is a very serious surgery that may take up to 12 hours. According to
the Mayo Clinic, there are several risks involved with liver transplants, including:
 Bile duct complications, including leaks or shrinking
 Bleeding
 Blood clots
 Failure of donated liver
 Infection
 Memory and thinking problems
 Rejection of donated liver

If you have a liver transplant, you can expect to stay in the hospital for at least a week
after the surgery, to get regular checkups for at least three months, and to take anti-
rejection and other medications for the rest of your life. It will take six months to a year
to feel fully healed from the surgery.

Liver transplant success depends on the individual case. Transplants from cadavers
have a 72 percent success rate, meaning that 72 percent of liver transplant recipients
lived for at least five years after the surgery. Transplants from living donors had a
slightly higher success rate, at 78 percent, according to the Mayo Clinic.

Things that can harm the liver

While some liver diseases are genetic, others are caused by viruses or toxins, such as
drugs and poisons. Some risk factors, according to the Mayo Clinic, include drug or
heavy alcohol consumption, having a blood transfusion before 1992, high levels of
triglycerides in the blood, diabetes, obesity and being exposed to other people's blood
and bodily fluids. This can happen from shared drug needles, unsanitary tattoo or body
piercing needles, and unprotected sex.
Pesticide exposure was associated with a 71 percent increased risk of liver cancer,
according to a meta-analysis of more than 480,000 participants in Asia, Europe and the
U.S. Though the study was large, more research needs to be done on what exact
pesticides are the most harmful.
Alcohol is big player in liver damage. It is believed that alcohol could possibly change
the type of fungi living in the liver, leading to disease, according to a small study
published May 22, 2017, in the Journal of Clinical Investigation. If this is true, it could
lead to new treatment options. The findings suggest that "we might be able to slow the
progression of alcoholic liver disease by manipulating the balance of fungal species
living in a patient's intestine," study co-author Dr. Bernd Schnabl, an associate
professor of gastroenterology at the University of California, San Diego School of
Medicine, said in a statement. [How Alcohol & Gut Fungus Team Up to Damage Your Liver]