Liver Disease and Conditions
We provide a comprehensive evaluation, assessment and treatment program for a wide range of liver diseases and conditions. It includes:
Adult Liver Disease
- Mount Sinai physicians bring vast experience to the diagnosis, evaluation, and treatment of adults with liver disease. Our liver disease specialists tailor their treatment plan to the individual, with the goal of stopping or slowing the disease so that our patients can continue to lead active lives.
- Primary liver cancer, known as hepatocellular carcinoma (or HCC) is the most common form of liver cancer in adults and the fastest- growing type of cancer in the United States. It is the third leading cause of cancer-related death worldwide.
- The Mount Sinai Hospital is the leader in the clinical management of liver cancer in the United States. The Mount Sinai Hospital evaluates and treats more liver cancer patients each year than any center in the nation.
- Mount Sinai is also a leader in researching new treatments for liver cancer. As a result, our patients often have access to new treatments before they are available elsewhere. For example, Mount Sinai enrolled more patients than any center in the country in studies of sorafenib, the first treatment approved by the US Food and Drug Administration (FDA), proven to extend life for patients with advanced liver cancer. Ongoing clinical trials at Mount Sinai are continuing to advance the boundaries of care in this challenging disease.
- Mount Sinai's Adult Liver Transplant Program is part of the Recanati/Miller Transplantation Institute at Mount Sinai. It is one of the largest and oldest liver transplantation programs in the country.
Fatty Liver Disease
- Fatty liver disease is the most common cause of liver test abnormalities in the United States today. The increase in fatty liver disease is largely due to the rising rate of obesity in this country. Because there are no symptoms in its early stage, patients are sometimes unaware that anything is wrong until the disease has progressed to advanced stages of cirrhosis or liver cancer.
- Treatment strategies for fatty liver disease target the underlying risk factors, such as obesity, hyperlipidemia, and diabetes. In addition to consultation with a liver specialist, our patients have access to an array of multidisciplinary treatment approaches offered by our diabetes team, weight loss and bariatric surgery teams, and, in cases of end-stage liver diseases, referral for liver transplantation. Interested patients may also be able to participate in ongoing clinical trials at Mount Sinai exploring promising new experimental treatments.
- Hepatitis B (HBV) viral infection remains a major global health problem that can cause cirrhosis or fulminant (acute) hepatitis. HBV also is the main cause worldwide of primary liver cancer (hepatocellular carcinoma, or HCC).
- Treatment of chronic hepatitis B is aimed at viral suppression to reduce damage to the liver and to improve the overall survival rate. There are seven drugs currently approved by the FDA for treatment of hepatitis B. Our clinicians participated in the trials that led to FDA approval of entecavir and tenofovir, and are now participating in a trial for a new version of the anti-viral agent interferon to treat HBV. As leaders of the research to develop the next generation of treatments, our physicians have access and knowledge of the latest advances in care. As a result, our patients often receive treatments before they are widely available.
Autoimmune Liver Diseases
- The Mount Sinai Hospital is respected worldwide for its innovative research and state-of-the-art treatment for all forms of autoimmune liver diseases.These diseases include:
- Autoimmune hepatitis
- Primary biliary cirrhosis
- Primary sclerosing cholangitis
- Autoimmune liver diseases occur when your immune system attacks your liver rather than foreign organisms such as viruses and bacteria. We treat the largest number of patients with autoimmune liver diseases in New York State. As a result, we have extensive skill in managing these diseases.
- Autoimmune liver diseases are typically chronic conditions. This means that patients may experience persistent immune system attacks that destroy liver cells over a period of years. As cells die, scar tissue known as fibrosis forms. Fortunately, autoimmune diseases tend to progress slowly. Many patients experience long periods without symptoms.
- When fibrosis does become extreme and liver function is weakened, the condition is called cirrhosis. Also known as liver failure or end-stage liver disease, the only successful cure for this condition is organ transplantation. However, many individuals with cirrhosis can have their symptoms successfully managed with medication, avoiding the need for transplantation.
- A large number of patients with autoimmune liver disease also have additional forms of autoimmunity. Liver specialists work closely with other experts at Mount Sinai to provide a comprehensive approach to treating multiple autoimmune conditions, thereby keeping immune system activity and symptoms under control.
- Most patients with chronic autoimmune liver disease are managed successfully by Mount Sinai liver specialists and their colleagues in rheumatology, endocrinology, gastroenterology, radiology, and pathology, using state-of-the-art methods of diagnosis and treatment. However, when end-stage liver disease develops, liver transplantation may be required. Of note, those with cirrhosis due to autoimmune liver disease do particularly well after transplantation. Mount Sinai has had long experience in caring for hundreds of patients with autoimmune liver disease who have required liver transplantation after having lived many years with this chronic condition.
- Chronic diseases of the liver advance over a long period of time and can provoke a build-up of scar tissue in the liver as it tries to heal itself from repeated damage. As scar tissue accumulates, cirrhosis may develop, which can impede blood flow to the liver. Scar tissue build-up (fibrosis) leading to cirrhosis can ultimately cause liver failure in adults and may provoke the need for liver transplantation.
- Efforts to halt fibrosis at an early stage may prevent the life-threatening complications associated with viral hepatitis, alcoholic liver disease, fatty liver disease, Wilson's disease, hemachromatosis, and an array of genetic liver diseases. If these fibrosis treatments are successful, adult liver disease patients may not require transplantation.
HIV Hepatitis Co-Infection Treatment Program
- As highly active anti-retroviral therapy (HAART) has improved and extended the lives of people living with HIV/AIDS, hepatitis C virus (HCV), and the liver disease that it can cause has become an increasing problem. HCV co-infection is responsible for a five-fold increase in hospitalizations and has become a leading cause of complications and mortality in HIV-infected individuals. Liver diseases resulting from HCV infection are responsible for 50 percent of all deaths of people living with HIV/AIDS in the United States.
- As a leader in care of those affected by HIV and liver diseases, Mount Sinai has exceptional resources for patients co-infected with both HIV and hepatitis C virus (HCV). In liver diseases, Mount Sinai physicians and researchers have published numerous scientific studies that have made major contributions to our understanding of HIV, as well as to the development of treatment and prevention strategies.
- Mount Sinai's HIV and liver disease experts work together in a variety of settings to provide integrated care for co-infected patients.
- HIV and liver disease specialists, mental health providers, and social workers provide coordinated care. When it is necessary, liver transplant and liver cancer teams are brought in to provide essential expertise and services.
- Mount Sinai infectious disease and liver disease doctors also conduct clinical research for HIV and hepatitis C co-infection. These studies offer patients access to experimental treatments not yet available elsewhere.