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COMING SOON...Be sure to keep an eye out for some of our great, inspiring recipes we will share here as we continue to grow together. RECIPES COMING SOON... Be sure to keep an eye out for some of our great, inspiring recipes we will share here as we continue to grow together.

Welcome to RELIVE. No matter where you are on your liver transplant journey, we are here for you- You are not alone. RELIVE was founded to provide free ongoing peer-led support and resources for every patient and caregiver affected by liver failure. Specializing in helping those suffering from alcohol and addiction related liver disease. No matter where you are on your liver transplant journey, we are here for you. You Are Not Alone. PROUD TO BE RECOGNIZED BY: Post-Transplant Patient "RELIVE is what hospitals should adopt in the form of care. We are all so much better when we are connected...RELIVE is uplifting, love-centered and a blanket of safety." OUR MISSION To provide free ongoing support and resources for pre and post-liver transplant patients and caregivers at every stage of their journey, regardless of status, income or background. Specializing in a strong, sustainable program for alcohol and addiction recovery with counseling for patients with liver failure. Through the unique understanding of people with lived experience, we work to destigmatize, educate and address this major cause of liver failure. Building the foundation upon which a sober and serene life may rise from the ashes. Through demonstration of successful progress and outcomes from RELIVE, we hope to improve the liver transplant system in general. To encourage non-transplant centers to be more active in reaching out to transplant centers for patients in need and to encourage many transplant centers to reevaluate their transplant waitlist criteria as it pertains to patients with liver failure due to alcoholism and addiction. OUR VISION RELIVE was founded in 2023 by liver transplant recipient, Trent Ford, and the love of his life and primary caregiver, Natalie Cohen, to share experience, provide hope, healing and support for everyone affected by liver failure- patients and caregivers alike. Services will always be free and confidential . Established to raise awareness about liver disease; so that patients showing signs of end-stage liver disease (ESLD) may be reached sooner and promptly referred to a specialist. To assist patients in need of transplant who are suffering from alcoholism and addiction, particularly with less than six months of sobriety. To collaborate with medical institutions and medical professionals. To provide aid during the transplant evaluation process. Supporting patients’ necessary commitment to lifelong change; helping to maintain and grow sobriety and prevent relapse. We honor and cherish the gift of life received by grace of medicine and our donor. We live to share this gift freely with all in similar need. Trent & Natalie, Founders of RELIVE. P hotographed by Sean Kara

We strive to offer as much information and the best care and support that we possibly can. We pledge to be compassionate, impartial, and always honest. If we can be of assistance to you in any way, we will do our best to do so. PATIENT ADVOCACY We strive to offer as much information and the best care and support that we possibly can. We pledge to be compassionate, impartial and always honest. If we can be of assistance to you in any way, we will do our best to do so. We are also happy to act as a reference, including participation in support group meetings and one-on-one sessions when building a case for listing and compliance, if you need it. We will continue to strive to expand the horizons of the plight of patients suffering from liver failure and to illuminate the great opportunity and progress possible related to patients suffering due to alcoholism and addiction. We will endeavor to encourage medical institutions along these lines- to consider such cases and their potential individually as opposed to through arbitrary indicators. That an adoption of such policies is beneficial for said institutions and for society in general in the long run; especially in the face of the ever-deepening crisis of mental health and related addiction issues. Disclaimer: RELIVE is not affiliated with any doctor, hospital or medical group. RELIVE is not a part of any transplant listing committee and does not guarantee any specific outcome or results.

We need your support to continue our life-saving work. We are grateful for generous donors like you. Your gift makes it possible for us to continue to provide free mental health support, counseling, support group meetings, one-on-one sessions, resources, information, education, advocacy, relief and hope to every liver patient and caregiver in need. DONATE TO RELIVE There are many ways to make a financial donation to support the mission of RELIVE. For more information, please email: info@wearerelive.org . (Compare your options and speak with a financial planner, tax advisor, and/or a philanthropic advisor to help determine the best way to give for your particular situation.) Please consider making a tax-deductible donation to ensure we can continue to support patients and caregivers throughout their liver transplant journey. Your support allows us to continue our life-saving work. We are grateful for generous donors like you. Your gift makes it possible for us to provide free mental health support, counseling, online support group meetings, one-on-one sessions, resources, information, education, advocacy, relief and hope to every liver patient and caregiver in need. Thank you for making a difference in the lives of those we serve. RELIVE is a 501(c)(3) nonprofit organization entirely dedicated to patients and caregivers affected by liver disease- going from liver failure, all the way through to a long, healthy post-transplant life. We specialize in a sustainable program for alcoholism and addiction recovery, with free counseling for patients with end-stage liver disease, those transplanted and regenerating. *Our fundraising platform is Zeffy , where 100% of your donation goes to RELIVE . Zeffy is funded solely through contributions made by donors- you have the option to donate to Zeffy if you wish, but it is not required .

Without these wonderful people, none of this would be possible. The bedrock of our organization, we are forever humbled and grateful. You shape and guide our purpose, like a true arrow in flight set on its target. OUR FOUNDING DONORS Without these wonderful people, none of this would be possible. The bedrock of our organization, we are forever humbled and grateful. You shape and guide our purpose, like a true arrow in flight set on its target. Thank you for your generosity and support . Anne Howorth Kathie Caballero Roslin Atley Yang Jin Yun Duri & Deborah Arquisch Charles Hogg Jennifer Pizzuti Matt & Jenn Walker Patricia & Guy Horanberg MaryAnn & Keats Irvine Earlene Davis & Milton Barcos Ellen Shiau Lynnette Jenkins John & Taryn Soto Jenny Doh Scott McNutt Trish Morris-Thompson Viviana Luna David Montano Karun & Pallavi Sharma Ray Acosta Louise Lesher KellyAnn & San Solaegui Ana & Roman Martinez Kevin & Glenda Navin Tracy Sabol Vanessa Altamirano & Alex Carrillo Lisa Walter Terrie Mckinley Latisha Longoria Melanie Thomas Michelle Gerson Mary Postler Eileen Postler Lori Walker Christina Hunter Nora Moore Lucas Moore Allison Miller Toni Gummow Linda Jensen Dale Giesige Rosalia Fisher Paula Holland Lisa Frey Victoria Scotti Laura Bayliss Ashley Loudan Kerry Borst Leyla Ostovar Bill & Gail Cohen Matthew Brajkovich Jeanie & Kirwin Ford Manley Ford Tamra Ford Guy Ford Scott Webb Graeme McGaw Susan Howell Jason & Catherine DuBois Rosemary Falkenhainer Regina Wolf Laurel Mahaney Alessio, Martina & Milo Giusti Paul Blunt Nicole Muccigrosso Simone Kowalski Sara Pendleton Benjamin Osgood Grayson Elbrecht Jason Heberlein Brandon Davis Alysia Chang Thomas Geraci Darren & Kymberly Keepers Barbara Urban Audrey Martorana Dawna Kincaid Antoinette McKelvey Jamie McLaughlin Sandra Jacobsen Jose Miguel Recio Palomares Andrew Vivian Jason Peachey Laura Blakey Clare Matthews Patricia Carden James Tindale Joe Senyah Paula DiLeo Ashkan Shagheyegh Maria Meyers Lisa Grant Sarah Tahvanainen Suzette Audiss Kristen Wall Ashok Pvt *Anonymous Donor s

Glossary of medical terms, abbreviations, and acronyms that you may encounter on your liver transplant journey: GLOSSARY OF TERMS Glossary of medical terms, abbreviations and acronyms that you may encounter on your liver transplant journey: A B C D E F G H I J K L M N O P Q R S T U V W X Y Z A Ablation - Where doctors use heat to destroy tumors, usually smaller than 4cm across, that started in the liver (primary liver cancer). The two types of thermal ablation for liver cancer are: radiofrequency ablation (RFA) and microwave ablation (MWA) . (see Hepatocellular carcinoma ) A cu t e - S ud de n and severe. Acute hepatic necrosis - When tissue in the liver dies. Possible reasons include acute infections and reactions to drugs, medicines, or toxins. Acute kidney injury (AKI) - A sudden episode of kidney failure or kidney damage that happens within a few hours or a few days. AKI causes a build-up of waste products in your blood and makes it hard for your kidneys to keep the right balance of fluid in your body. A common complication of decompensated cirrhosis and portal hypertension. Dialysis may be needed to help replace kidney function until your kidneys recover. (see Decompensated cirrhosis , Dialysis , Portal hypertension ) A cute liver failure - Develops rapidly, typically over days to a few weeks. The liver suddenly begins to lose its ability to function, often after an overdose of medicine or poisoning. In the U.S., the mo st common cause is taking too much acetaminophen (Tylenol and others). Addiction - A chronic, relapsing, treatable medical disease involving complex interactions among genetics, brain circuits, environment , and an individual's life experiences. Characterized by using substances or engaging in behavior that becomes compulsive and continues despite harmful consequences. Advance directive - A document stating your medical wishes in the event you can't speak for yourself. An advance directive can guide medical decisions made by your health care providers. It can also provide direction for your loved ones and ensure your medical wishes are followed. A lagille syndrome - An inh erited condition in which bile builds up in the liver because there are too few bile ducts to drain the bile. This results in liver damage. Alanine aminotransferase (ALT) and Aspartate aminotra nsferase (AST) - Enzymes produced mainly in the liver. Vital indicators of liver function on blood tests. High levels suggest liver issues. Albumin - A protein made i n the liver that assists in maintaining blood volume in the arteries and veins. If the liver is damaged, then the albumin can drop to very low levels, which may cause fluid to leak into the tissues from the blood vessels, resulting in edema or swelling. (see Ascites , Edema ) Alcohol-associated liver disease (AALD/ALD) - Damage to the liver and its function due to alcohol abuse. Alcoholic liver disease occurs after years of heavy drinking. Over time, scarring and cirrhosis can occur. Some people may have an inherited risk for the disease. (see Cirrhosis ) Alcohol use disorder (AUD) - A medic al condition characterized by an impaired ability to stop or control alcohol use despite adverse social, occupational, or health consequenc es. It encompasses the conditions that some people refer to as alcohol abuse, alcohol dependence, alcohol addiction and alcoholism. The most common form of s ubstance use disorder (SUD) in the United States, fueled by widespread access and social acceptance of alcohol consumption. A lkaline phosphatase (ALP/ALK-PHOS) - An enzyme produced in the bile ducts and elsewhere in the body. High levels can indicate liver disease or blockage of bile ducts. Alph a-1 antitrypsin deficiency - A condition in which the body does not make enough of AAT, a protein that protects the lungs and liver from damage. The condition can lead to chroni c obstructive pulmonary disease (COPD) and liver disease (cirrhosis). T he most common genetic cause of chronic liver disease among children. (see Chronic liver disease ) Ammonia - A waste product that your intestines make when they digest protein. Your liver is responsible for transforming ammonia into urea. If your liver is damaged or diseased, it may not be able to properly process ammonia, which then leads to ammonia buildup in your blood and brain. (see Hepatic encephalopathy ) Angiogram - A test using X-rays to see blood vessels and detect blockages or other problems in the vessels. It can be used to see the blood vessels which supply the liver. A dye (contrast) is injected into the blood vessel to make the blood flow visible on an X-ray. Anticoa gulants - Someti mes called "blood thinners", a family of medications that prevent your blood from clotting too easily. They can breakdown existing clots or prevent clots from forming in the first place. Ascites - A large, abnormal accumulation of fluid in the abdomen that can occur due to cirrhosis, liver cancer and liver failure. Abdominal pain, discomfort and difficulty breathing may occur when too much fluid accumulates in the abdomen or moves up to the space around the lungs. Symptoms include: swollen stomach, hands, ankles, feet, face- 'bloating'. (see Distension , Portal hypertension ) Atresia - Blocked, destroyed , or missing. (see Biliary atresia ) Autoim m une hepatitis (AIH) - Liver inflammation that occurs when the immune system attacks t he liver. Cause is unknown. When treated early, can often be controlled with medications that suppress the immune system. In rare cases, a liver transplant may be neede d. A1C (hemoglobin A1C) t est - A b lood test used to measure average blood sugar (glucose) levels over the past two to three months . One of the commonly used tests to diagnose diabetes. B Bandi ng - A treatment for esophageal varices that are at risk of bursting. Surgical elastic bands are placed around the varices during an endosc opy. (see Varices ) Benign liver tum ors - Abnormal growths or masses. When a tumor is not a cancer, it is called benign. There are three main types of benign liver tumors: (1) adenomas , (2) hemangiomas , and (3) focal n odular hyperplasia (FNH) . Most benign liver tumors do not have symptoms and are found incidentally on an ultrasoun d, CT scan or MRI. If the mass grows and pushes on other organs, it can cause upper abdominal pain, particularly on the right side. Can also cause a sense of fullness afte r eating. Most tumors can be monitored with imaging studies. Surgery requires rem oving the tumor completely, called a liver resection . Bile - A green/yellow fluid that is made and released by the liver and stored in the gallbladder. Bile helps with digestion. It breaks down fats into fatty acids, which can be taken into the body by the digestive tract. Bile ducts - A series of thin tubes that go from the liver to the small intestine, which allow a fluid called bile to travel from the liver and gallbladder into the small intestine, where it helps digest fats. Biliary a tresia - A conditi on in infants in which the bile ducts outside and inside the liver are scarred and blocked. B ile can't flow into the intestine, so bile builds up in the liver and damages it. The damage leads to scarring, loss of liver tissue and funct ion and cirrhosis. Most common reason for a liver transplant in children. (see Cirrhosis ) Biliary tract - The system of tub es which carry bile from the liver and gallbladder and drain into the intestine. Bilir ubin - The yello w pigment in bile that is made during the breakdown of red blood cells. Bilirubin passes through the liver and is eventually excreted out of the body. Higher than usual levels of bilirubin may indicate different types of liver or bile duct problems. (see Jaundice ) Biopsy (liver) - A procedure to remove a small sample of liver tissue, so it can be examined for signs of damage or disease. Budd-chiari syndrome (BCS) - A condit ion in which the hepatic veins are blocked or narrowed by a clot (mass 0f blood cells). This blockage causes blood to back up into the li ver and as a result, the liver grows larger. The spleen may also grow larger. Bun (Blood urea nitrogen) - Measures how well kidneys filter waste. High levels can indicate kidney problems, while low levels might suggest over-hydration or liver issues. C Cann ula - A short, soft, narrow plastic tube temporarily put into a vein so medicines, fluids, bloo d etc. can be given intravenously (IV) as needed. CellCe pt® (Mycophen olate mofetil) - A prescription medicine to prevent rejection (anti-rejection medication) in people who have received a kidney, heart or liver transplant. (see Myc op henolate mofetil , Immunosuppressed , Rejection ) Cent ral ve nous cathet er (CVC) - A thin, flexible tube inserted into a vein, usually below the right collarbone an d guided (threaded) into a large vein above the right side of the heart called the superior vena cava. It is used to give intravenous fluids, blood transfusions, chemotherapy, dialysi s and other drugs. The catheter is also used for taking blood samples. It may stay in place for weeks o r months and helps avoid the need for repeated needle sticks. A peripherally inserted central catheter (PICC) is one type of central venous catheter. (see Dialysis ) Cholangiocar ci n o ma - Can c er of t he bile ducts. (see Bile ducts ) Cholangi ogr am - The inje ction of dye into the bile ducts, either directly or through a T-tube, to see if bile is flowing into the intestine. (see T-tube ) Cholan gitis - Inflam matio n or infection of bile ducts which can cause poor bile flow from the liver and liver damage. Cholestasis - Reduction or bl ockage of bile flow. Chronic - A n illness or condition which lasts over a period of time. Chronic hepatitis - Inflam mation of the liver that lasts over a period of time. Liver cells may be destroyed by the inflammation. (see Hepatitis ) Chronic kidney disease (CKD) - A condition characterized by a gradual loss of kidney function over time. Medications help manage symptoms. In advanced stages, filtering the blood with a machine (dialysis) or a kidney transplant may be needed. (see Dialysis ) C hronic liver disease (CLD) - A progress ive deterioration of liver function over a period of months to years. Also called end-stage liver disease (ESLD). The most common causes are viral infections (hepatitis), long-term alcohol abuse, genetic (inherited) disorders, or liver cancer. (see Cirrh osis , Hepatitis , Hepatocellular carcinoma ) Cirrhos is - A ch ronic scarring and degeneration of the liver cells. Many different diseases can cause cirrhosis. Cirrhosis of the liver has four stages: (1) Inflammation , (2) Fibrosis , (3) Cirrhosis , and (4) Liver failure . Coagulo pathy - Refers to any conditi on where the blood cannot clot properly. CT/CAT scan (Compu terized axial tomography) - A thre e-dimensionaI X-ray picture of the internal organs used to detect a mass, an abscess, tissue damage, or bleeding in the body. Corticoster oids (St ero i d s) - Anti-in flam matory medicine. Following liver transplantation, standard treatment to p revent rejection generally involves a combination of corticosteroids and immunosuppressant medications. (see Predn isone , Cellcept / Mycophenolate mofetil , Prograf / Tacrolim us , Rejection ) Cotrimoxazole (Bactrim DS, Se ptra DS) - An important medication prescribed post-transplant to prevent dangerous infection . Creatin ine - A chemica l waste product o f creatine, an amino acid made by the liver and stored in the liver. Elevation i n creatini ne can indicate the presence of either an acute kidney injury (AKI) or chronic kidney disease (CKD). Acute kidney injury is a common complication after liver transplantation. Patients with cirrhosis typically have decreased creatinine levels, due to liver disease, muscle wasting and malnutrition. (see Acute kidney injury , Chronic kidney disease ) Cy clos p or i ne - An im munosu ppressive med ica tion use d to prevent organ rejection after a kidney, heart or liver transplant. Also used to treat severe psoriasis or severe rheumatoid arthritis. (see Immunosuppressed , Rejection ) Cys tic - Relating to the gallbla dder. D Decompensated cirrhosis - An acute deterioration in liver function in a patient with cirrhosis, characterized by jaundice, ascites, hepatic encephalopathy, hepatorenal syndrome, or variceal hemorrhage. (see Ascites , Cirrhosis , Hepatic encephalopathy , He patorenal syndrome , Jaundice , Varices ) D EXA exam - A bone density test that can gauge your risk of osteoporosis. Liver disease is associated with bone loss. D ia be t es - A ch ron ic h ealth cond ition that affects how your body turns food into energy. The re are three m ain types: Type 1 , Type 2 , and Gestational diabetes (diabetes while pregnant). Diabetes raises your risk of non-alcoholic fatty liver disease (NAFLD). (see NAFLD , NASH ) Dialysis (Hem o dia lysis) - A proc ed ure that involves diverting blood to a machine to be cleaned. This is to remove waste pr oducts and excess fluid from the blood when the kidneys stop working properly. Often used as a treatment in patients with liver failure. (see Acute kidney injur y , H epatorenal syndrome ) Disten sion - Expansion or enlargem ent. For example, ascites causes abdominal distension and weight gain. Duct - A tube which fluid can pass through from one part of the body to another, e.g. bile ducts. E Echo cardiogram (Echo) - A test that uses high frequency sound waves to create a moving picture of the heart and determine how effectively th e heart is pumping. Edema - A con dition in which the body retains too much fluid in the tissues, especially in the hands, legs, ankles and feet. A symptom associated with advanced liver disease. (see Cirrhosis ) Electrocardiogram (ECG) - Recor ds the electrical activity of the heart. Encephalopathy - Changes in the brain seen in advanced liver disease and liver failure, due to the build up of ammonia (toxins) in the blood and brain . Can cause conf usion, tiredness, irritability, changes in behavior, coordination, speech, thinking ability and consciousness. If left untreated, can lead to coma and death. (see Ammonia , Hepatic encephalopathy ) End-stage liver disease (ESLD) - When the liver is damaged beyond repair due to chronic liver disease or acute liver failure. Most often, the result of cirrhosis, a condition in which scar tissue replaces healthy liver tissue until the liver cannot function adequately. Patients with abnormal liver function who develop ascites, vericeal hemorrhage, hepatic encephalopathy, or renal impairment are considered to have end-stage liver disease. Endoscopic retrograde cholangiopancreatography (ERCP) - An end oscopic procedure used to identify the presence of tumors, stones, or narrowing in the biliary and pancreatic ducts. Endoscopy - A small, telescope-li ke instrument that can be inserted into the esophagus, stomach and part of the small intestine. Used to look at the upper end of the digestive system. Inserted through the mouth and down the esophagus (food pipe). eGFR (Estimated glomerular filtration rate) - Calculation of creatinine, age, sex, and sometimes races, used to estimate how well your kidneys filter waste from the blood. Evaluation process (liver transplant) - Transplant center s in the United States evaluate the suitability of potential transplant candidates using listing criteria developed by transplant programs. The transplant evaluation process involves reviewing medical history, verifying health insurance benefits, social support, diagnostic tests, blood work, imaging scans, radiology, consults and exams. Most assessments are done on an outpatient basis, customized to each patient's medical condition. The process takes several days, depending on which tests and screenings are needed. If the transplant team determines you are a candidate for transplant, they will add you to the UNOS national waiting list. (see Transplant waiting list , UNOS ) Exception s cores (Exception points ) - A sepa rately assigned score that may be an option for liver transplant candidates whose medical circumstances require special attention, where a MELD score does not accu rately predict their short-term transplant need. To qualify for a standard exception, the liver transplant program needs to document that the patient's medical condition meets criteria outlined in OPTN policy. (see Model for end-stage liver disease (MELD score) , Organ procurement and transplantation network (OPTN) , Transplant waiting list ) F Fibr osis - Thickening or scarring of tissue that re places normal tissue. Fibrosis is the second stage of cirrhosis. Some fibrosis may be treatable and reversible. (see Cirrhosis ) Fluconazole (Diflucan) - A medication prescribed t o prevent dangerous infection after liver transplantation. G Gab apentin - A m edicin e prescribed to treat nerve pain associated with liver disease. (see Peripheral ne uropathy ) Gallbladder - A small, pear-shaped organ in your upper right abdomen, that stores and releases bile to help your digestive system bre ak down fats. During liver transplant surgery, the gallbladder attached to the donor liver will be detached to prevent gallstones from forming and causing problems with your new liver, and your gallbladder will also be removed. (see Liver transplant ) Gall stones - Pebble -like objects formed by bile that can cause severe pain and may pass into the common bile duct and cause cholangitis or obstructive jaundice. (see Cholangitis , Obstructive jaundice ) Gastroenterology - The study of the digestive sys tem and its disorders. A g astroenterologist ( also called a GI doctor) specializes in treating and preventing diseases in the gastrointestinal or digestive tract. General anesthesia - A method of medically inducing unconsciousness during surgery. Medicine is either inhaled through a breathing mask or given through an intravenous (IV) line. GGT (Gamma-glutamyl transferase) - An enzyme that can indicate liver or bile duct issues. Gilbert syndrome - A mild condition in which the liver doesn't properly process bilirubin. Typically harmless and treatment isn't needed. Often discovered when a person has a blood test done. Condition may be inherited from donor liver . Glomerular filtration rate (GFR) - A test use d to check how well the kidneys are functioning. Graft - An organ, tissue, or cells used for transplantation. Gynecomastia - A condition of overd evelopment or enlargement of the breast tissue in men. Medically attributed to hormonal imbalance, especially of estrogen, due to the poor functioning of the liver. Condition can result from cirrhosis, hormonal imbalance, or certain medications. (see Cirrhosis ) H Hemochromatosis - A hereditary disorder in which extra iron builds up in the body to harmful levels. The liver is the organ most affected by hemochromatosis. Without treatment, cirrhosis is a major complication of iron overload. (see Cirrhosis ) Hepatic - Referring to th e liver. Hepatic artery - A soft, oxygenat ed blood vessel that supplies oxygen-rich blood to the liver, duodenum (first part of the small intestine immediately beyond the stomach) and pancreas. Hepatic encephalopathy (HE) - A reversible complication brought on by advanced liver disease and liver failure. When the liver doesn't function p roperly, toxins (ammonia) build up in the blood. These toxins can travel to the brain and affect brain function, mood, behavior, speech and coordination. Treatments can remove the toxins and alleviate the debilitating symptoms. As liver disease progresses, 'ammonia brain' (HE ) may worsen and become less treatable. Some people with advanced HE lose consciousness and go into a hepatic coma. If left untreated, HE can lead to coma and death. (see Lactulose , Rifaximin ) Hepatic veins - Blood vessels th at carry low-oxygen blood from the liver back to the heart. Hepatitis - Inflammation of the liver. Li ver inflammation can be caused by several viruses, chemicals, drugs, alcohol, certain genetic disorders, or an overactive immune system that mistakingly attacks the liver, called Autoimmune hepatitis (AIH). Hepatitis A (HAV) - One of several v iral infections that can affect your liver. Causes acute liver inflammation and symptoms can last for several months, but eventually goes away without treatment. Transmission is mostly by fecal-to-oral route. Hepatitis B (HBV) - Viral infection spread thr ough bodily fluids. Most people only have a brief, acute infection, which causes inflammation of the liver. For some people, it becomes chronic, which can cause serious long-term damage to the liver. Hepatitis B is preventable with a vaccine, but has no cure. Hepatitis C (H CV) - A virus t hat cau ses chronic liver inflammation and long-term damage. Transmission commonly occurs through infected needles. Treatable with new antiviral medications, but many people don't know they're infected. May not have symptoms until liver disease progresses to liver failure. (see Liver failure ) Hepatitis D (HDV) - Occurs among peop le infected with the Hepatitis B virus. Transmission requires contact with infectious blood. At-risk populations include intravenous drug users and people who have received multiple blood transfusions. There are few treatments specifically for Hepatitis D. Management focuses on supportive care. Hepatitis E (HEV) - Mainly transmitt ed through drinking water contaminated with fecal matter. In rare cases, it may progress to acute liver failure. Usually resolves on its own within 4-6 weeks. Treatment includes rehydration, rest, and supportive care. Hepatocellular car cinoma (HCC) - The mo st common type of primary liver cancer. Primary liver cancer is a disease in which malignant (cancer) cells form in the tissues of the liver. Occurs most often in people with chronic liver diseases, such as cirrhosis caused by hepatitis B or hepatitis C infection. Treatment will depend on the size and location, how well the liver is functioning and overall health. Hepatology - The study, preventio n, dia gnosis and management of diseases that affect the liver, gallbladder and pancreas. Hepatologists are medical doctors who diagnose, treat and manage conditions associated with the liver, gallbladder, bile ducts and pancreas. Hepatopulmonary syndrome - A rare complication of chronic liver disease. It affects the capillaries in your lungs. This condition causes low oxygen levels in your blood, making it hard to breathe. Severe hypoxemia may damage your brain and heart. Hepatorena l syndrome (HRS) - A unique type of acute kidney injury (AKI) and a life-threatening complication of advanced liver disease tha t affects your kidney function. It comes on suddenly, without any previous kidney disease or changes to the kidneys themselves. Kidneys may be healthy, but they lose the ability to function because their blood supply has been compromised. Requires urgent medical intervention. (see Acute kidney injury , D ialysis ) HIDA scan - A test that help s measure general liver function and determines whether there are any blockages of the bile ducts. D uring the test, a special dye (contrast) is injected into an arm vein to track its progress through the liver, bile ducts, gallbladder and pancreas. Hypo/hypertension - Low/high blood pressure. Hypotension is a well-known complication in patients with cirrhosis, mainly stemming from portal hypertension. (see Portal hypertension ) I Immune resp onse - The body's attempt to protect itself from bacteria, viruses and other materials that appear foreign to the body, such as a transplanted liver. Anti-rejection (immunosuppre ssive) medications are used to try to control the body's immune response to a transplanted liver. Immunosuppressants - Medications that prevent organ rejection by reducing immune activity. Blood levels are monitored to balance effectiveness with side effects, such as kidney or nerve issues, and delayed healing. (see CellCept/Mycophenolate mofetil, Program/Tacrolimus ) Immunosuppressed (Immunocompromised) - Having a weakene d immune system. People who are immunocompromised have a reduced ability to fight infections and other diseases. After transplant, immunosuppressant (anti-rejection) medications are taken for life, to prevent rejection of the new organ. These anti-rejection medications lower the body's immune system by making it less active. (see CellCept / Mycophenolate mofetil , Prograf / Tacrolimus ) Inflammat ion - In the early stages of liver disease, the liver will become swollen or inflamed as the body's natural response to injury. Liver inflammation can also occur when there are more toxins in the blood than the liver is able to manage. Inflammation is the first stage of cirrhosis. INR (International normalised ratio) - A type of calculation based on P rothrombin time (PT) test results. A PT/INR test helps diagnose the cause of bleeding or clotting disorders. Also checks to see if a medicine that prevents blood clots is working the way it should. (see Prothrombin time (PT) test ) Intubate d - Process where a healthcare provider inserts a tube through a person's mouth or nose, then down into the ir trachea (airway/windpipe). The tube keeps the trachea open so that air can get through. The tube connects to a machine that delivers air or oxygen. Patients with end-stage liver disease (ESLD) have an increased risk of prolonged intubation, and increased ventilator-related infection. J Jackson -pratt (JP) drain - May be placed during transplant surgery into the abdominal cavity to collect fluids. This drain is attached to a bag or bulb outside the body. Once drainage is minimal, it is usually removed before discharge from the hospital. J aundice - A yellowing of the skin and/or whites of the eyes, membranes and body secretions caused by increased levels of bilirubin. Jaundice occurs when a diseased liver doesn't remove enough bilirubin from the blood. (see Bilirubin , Cirrhosis ) L Lactulose - A medication prescribed by doctors to reduce the amount of ammonia in the blood o f patients with advanced liver disease. (see Hepatic encephalopathy ) Lasix® (furosemide ) - A w ater pill (diuretic) sometimes used in combination with Spironolactone to manage ascites in cirrhosis patients. (see Ascites , Cirrhosis , Spironolactone ) Liver failu re - Occurs eit her suddenly (acute ), or gradually (chronic )- also called end-stage liver disease (ESLD). Acute liv er failure can be caused by hepatitis; it can also be caused by taking too much acetaminophen, Autoimmune disease, and Wilson disease. Sometimes the cause is unknown. Chronic liver failure progresses over months, years, or decades. In many cases, chronic liver failure results from cirrhosis. Liver failure happens when large parts of the liver become damaged beyond repair and the liver can't function properly anymore. Treatment can help but this condition can't be cured. Treatment options may include medications, dietary changes, or a liver transplant. (see Cirrhosis ) Liver trans plant - A com plex surg ery that removes a diseased liver that no longer functions properly and replaces it with a healthy liver from a deceased donor , or a portion of a healthy liver from a living donor. A life-saving gift . Living donor - A healthy living person who donates a part of their liver to someone whose liver is no longer functioning properly. The donor's remaining liver regenerates to its original size within a couple months, and the transplanted liver section grows into a normal sized, fully functioning liver in the recipient. Living donor liver transplants may be an option for some patients . D iscuss with your hepatologist and transplant coordinator. M Magnesium - An essential mineral that plays a major role in muscle function, the nervous system and energy production. Patients with cirrhosis usually have low magnesium levels. It's also common for liver transplant recipients to experience low magnesium levels, due to taking certain anti-rejection medications. Magnesium supplements may be prescribed. Magnetic resonance imaging (MRI) - A noninvasive scan of the body using a large magnet and radio waves to produce detailed images of internal structures in the body, including: organs, bones, muscles and blood vessels. Metabolic associated fatty liver disease (MAFLD) - An umbrella term, formally known as NAFLD, for conditions caused by the build-up of extra fat in the liver that is not caused by alcohol intake. Metabolic dysfunction-associated steatohepatitis (MASH) - A chronic, often considered "silent", progressive, and potentially life-threatening liver disease. Caused by a build-up of excess fat in the liver (steatosis), MASH is characterized by liver inflammation and ballooning, with or without fibrosis. Formally known as NASH. Malnutrition - A common finding in end-stage liver disease (ESLD), leading to a loss of muscle mass, bone loss and an increase in frailty. Model for end-stage liver disease (MELD score) - Helps det ermine how urgently a patient needs a liver transplant within the next three months . Score ranges from 6 to 40, based on blood tests that show how well your body is functioning. Your score may go up or down over time as your liver disease either worsens or improves. Your score may be recalculated a number of times while you are on the transplant waiting list. The sicker a patient is, the higher the MELD score. Although, a significant number of patient s are sicker than what their MELD score can represent. Therefore, patients with a low MELD score should still be considered for a liver transplant. Approval of MELD exception points may be appropriate in some cases. (see Exception scores ) Multiple listing - Involves registering at two or mo re transplant hospitals. Since candidates at hospitals local to the donor hospital are often considered ahead of those who are more distant, multiple listing may increase your chances or receiving a local organ offer. Many factors affect how long you might wait for a transplant. OPTN policy allows multiple listing, however, it will still be up to the individual hospital to decide whether to accept you as a candidate. Ask the transplant team how they handle such requests. (see Transplant candidate , Transplant waiting list ) Multivisceral transplant (MVT) - When the liver, small intestine, and other abdominal organs (for example, the stomach and pancreas) are transplanted at the same time. M ycophenolate m ofetil - Gene ric for CellCept®, a prescription medicine for people who have had a kidney, heart or liv er tran splant. Can help prevent rejection of the transplanted organ. After transplant, you may take several of these anti-rejection medications to keep your immune system from rejecting the transplanted organ. (see CellCept , Immunosuppressed , Rejection ) . N Naltrexone - A m edication to treat both a lcohol use disorder (AUD) and opioid use disorder (OUD), to help achieve abstinence and decrease cravings. N asogastric tube (N G tube) - A special t ube that carries food and medicine to the stomach through the nose. Nephrology - The branch of medicine that concerns the study of the kidneys, preservation of kidney health and the treatment of kidney diseases. A nephrologist is a medical doctor who specializes i n diagnosing and treating kidney conditions. N on-alcoholic fatty liver disease (NAFLD) - Now known as MAFLD, an umbrella te rm that encompasses the entire spectrum of fatty liver dis ease. Non-alcoholic steatohepatitis (NASH) - Now known as MASH, defined as the l iver manifestation of a metabolic disorder. The most severe form of non-alcoholic liver disease (NAFLD), but its symptoms are often silent, making it difficult to diagnose. NASH is heavily influenced by lifestyle (e.g., chronic excessive calorie intake, sedentary activity) and is distinct from other fatty liver diseases caused by alcohol abuse or medication side effects. O Obstructive jaundice - A specific type of jaundice, where symptoms develop due to a narrowed or blocke d bile duct, preventing the normal drainage of bile from the bloodstream into the intestines. (see Jaundice ) Opioid use disorder (OUD) - A complex illness characterized by compulsive use of opioid drugs even when the person wants to stop, or when using the drugs negatively affects the person's physical and emotional well-being. Use of legally prescribed or illegal opioid medications may lead to an opioid use disorder. OUD is a public health crisis in the United States. Organ donation - The process of surgically removing an organ or tissue from one person (the donor) and placing it into another person (the recipient). Transplantation is necessary because the recipient's organ has failed, or has be en damaged by disease or injury and is beyond repair. One deceased donor can save up to eight lives . O r gan procuremen t and transplantation network (OPTN) - The OPTN helps create and define organ allocation and distribution policies that make the best us e of donated organs. This process involves continuously evaluating new advances and discoveries so policies can be adapted to best serve patients waitin g for transplants. All transplant programs and organ procurement organizations throughout the country are OPTN members and are obligated to follow the policies the OPTN creates for allocating organs. (see UNOS (United network for organ sharing) ). P Pantoprazole (Protonix) - O ften prescribed to patients with cirrhosis to prevent and treat upper gastrointestinal ulceration and bleeding. Commonly prescribed to liver transplant recipients as well, to treat gastrointestinal side ef fects, like heartburn, that are common under immunosuppressive therapy. (see Banding , Mycophenolate mofetil , Portal hypertension , Varices ) Paracen tesis - A procedure that uses a hollow nee dle or plastic tube (catheter) to remove fluid from the abdominal cavity or belly. The fluid buildup (ascites) is caused by cirrhosis. (see Ascites , Cirrhosis ) Peripheral n eu ropathy (Neuropathy) - Symp t o ms incl ude numbness or tingling in the hands and feet, often associated with advanced liver disease. Petec hia e - Sm all spots of bl ood leakage in the skin or membran es, often seen with poor clotting. PEth bl ood test - Measures the level of phosphatidylethanol, a direct alcohol biomarker which is found in human blood following alcohol consumption. Phlebot o mist - A m edical professional who is trained to draw blood. Plat elets - The cells that circu late within our blood and bind together when they recognize damaged blood vessels. Platelets can be low in people with liver disease, which can lead to bleeding issues. Polymerase chain reaction (PCR) test - A test used to detect if a virus is present in the blood. Portal gastropathy - Abnormal bl ood vessels in the stomach caused by portal hypertension. Enlarged veins (vascular ectasia) in the stomach and the esophagus (food pipe) are called varices. These blood vessels are more likely to burst due to thin walls and higher pressure. If they bu rst, severe, life-threatening bleeding can happen. Seek medical attention immediately. (see Portal hypertension , Varices ) Portal hypertension - High blood pressure in the veins of the liver caused by the damage and hardening of the liver around the veins. This high blood pressure forces blood to be rerouted to other veins so it can return to the heart. Cirrhosis is the most common cause of portal hypertension. Symptoms include: ascites, gastrointestinal bleeding marked by black, tarry stool or blood in stool, vomiting of blood due to rupture and hemorrhage from varices, low platelet count, low white blood cell count, low blood oxygen. (see Ascites , Varices ) Portal vei n - Also called hepatic portal vein. An important blood vessel that delivers blood to the liver from the intestines, stomach, spleen and pancreas. Potassium - An essential electrolyte from the diet. Helps maintain fluid balance, acid-base equilibrium, and normal muscle and nerve function. Prednisolo ne - A corticosteroid (cortisone-like medicine or steroid) used to treat a wide range of health problems, including many types of inflammatory liver diseases, such as autoimmune hepatitis. P rednisone - Cl assifi ed as a s teroid, used to treat inflammatory liver disease s and to prevent rejection following liver transplantation. Used in combination with other medications. Can cause weight gain and blood sugar to increase. Can also cause confusion, mood disturbances and psychosis, which improves with dose reduction or discontinuation. Patients are gradually tapered off of Prednisone as liver function improves. (see Corticosteroids , SEROquel ) Primary biliary cholangiti s (PBC) - A chronic and progressive condition that causes inflammation and, eventually, the destruc tion of the bile ducts that run through your liver. Bile backs up, causing liver damage. Medication can delay and sometimes prevent it. (see Bile , Cirrhosis ) Primary sclerosing cholangitis (PSC) - Commonly associated with ulcerative colitis. Condition is characterized by decrease in size of the bile ducts due to inflammation and fibrosis. (see Fibrosis , Cirrhosis ) Prograf® (Tacrolimus) - A prescription medicine used with other medications to help prevent rejection in people who have recei ved a liver, kidney, heart, or lung transplant. Prograf/Tacrolimus suppresses your immune system to prevent your body from rejecting the transplanted organ. (see Immunosuppressed , Rejection ) Propranolol - Belongs to a group of me dicines called beta blockers, used to reduce the chance of variceal bleeding in patients with cirrhosis. (see Portal hypertension , Varices ) Prothrombin time (PT) test - Measures how long it takes for a clot to form in a blood sample. An INR is a type of calculation based on PT test results. (see INR ) Pruritis - The medical term for itch/itchiness, a common symptom of liver disease. May be caused by high levels of bilirubin . Pulmonary - Relating to the lungs. Pulse oximeter - A devi ce usually placed on the fingertip to measure the oxygen level (oxygen saturation) of the blood. R Red blood cells (RBC) - Most common type of blood cell that transports oxygen in vertebrates. Also indicators of anemia or other blood disorders on blood tests. Rejection - The body's att empt to protect itself from foreign tissues, such as a new liver. Anti-rejection or immunosuppressive medications are used to prevent this. (see Cellcept / Mycophenolate mofetil , Prograf / Tacrolimus ) Renal - Refers to the kidneys. Respiratory - Refers to breathing. Rifaximin (Xifaxan®) - An antibiotic prescribed to stop bacterial growth. As a result, the body produces fewer toxins. Used to treat HE in patients with advanced liver disease. (see Hepatic encephalopathy , Lactulose ) Rounds - When the medical team vi sits each inpatient as a group to review the patient's status and care plan. S Sclerotherapy - A treatment of varicose (swollen) veins by injecting chemicals that cause hardening and clotting of the veins. Often done to prevent bleeding from the vessels into the esophagus or stomach. (see Varices ) Sengstaken-blakemore tube (Blakemore tube) - A med ical device used in emergency medicine to manage upper gastrointestinal bleeding due to esophageal varices. (see Varices ) Sep sis - Severe infection in the bloodstream. A life-threatening medical emergency. SER Oquel (QUEtiapine) - Often p resc ribed to treat steroid-induced mania following liver transplantation. Has mo od-stabilizing properties, as well as sedative properties. Additionally, may be administered in hospital as needed to treat aggression and agitation in patients with end-stage liver disease. (see Cirrhosis , Hepatic encephalopathy , Prednisone ) Sodium - Electrolyte (most commonly salt) that comes from your eating regimen, and how much sodium in the body is generally constrained from the kidneys. Patients with liver disease are advised to limit their sodium consumption to control excessive fluid retention. Spider angiomas - A collection of blood vessels under the surface of your skin that resembles a spider. Angiomas are red to purple marks on your skin. Multiple angiomas could be a sign of an underlying cond ition. Prevalence of spider angiomas is highest among patients with cirrhosis. Spironolactone - A diuretic used to treat fluid buildup (ascites) and water retention (edema) and lower portal pressure in cirrhosis. (see As cites , Cirrhosis , Lasix , Portal hypertension ) Spleen - An organ located on the uppe r left side of the abdomen that helps fight infection by filtering the blood. Spontaneous bacterial peritonitis (SBP) - A term used to describe acute infection of ascites . Primarily occurs in patients with advanced cirrhosis. (see Ascites , Cirrhosis ) Status 1A - When patients have acute (sudden and severe) liver failure and are not likely to live more than a few days without a liver transplant. Must meet UNO S diagnostic criteria. Status 7 - Whe n potential transplant recipients on the transplant waitlist are listed "temporarily inactive". Potential recipient s may be listed inactive for various reasons, including but not limited to: a change in one's current health, needing further tests, incomplete financial/insurance arrangements, non-compliant with medical instructions or follow-up, or travel. (see Transplant waiting list ) Steatotic liver disease (SLD) - Involves having excess fat in your liver. Metabolic conditions and heavy alcohol use are risk factors. Depending on the type of SLD, the fat buildup may not cause problems, or it may lead to liver damage. Often, you can prevent or even reverse SLD with medications and lifestyle changes. Str ess t est - Involv es walking on a treadmill or receiving medication to see how your heart works when it is working harder than n ormal. This will assist your physicians in deciding if your heart is strong enough for transplant surgery. Substance use disorder (SUD) - A complex condition that involves a problematic pattern of substance use. It can range from mild to severe (addiction). SUD is treatable. It’s important to seek help as soon as possible if you think you , or your loved one, is developing SUD. T Tacrolimus (Prograf) - Tacrolimus is an immunosuppressive medication that is taken to prevent organ rejection after transp lant. Tacrolimus affects creatinine levels and kidney function, and can cause blood sugar to increase. Blood work is checked regularly to adjust the dosage for liver transplant recipients, if necessary. (see Immunosuppressed , Prograf , Rejection ) Thrombosis - The formatio n of a blood clot (partial or complete) within blood vessels, whether venous or arterial- venous ves sels carry blood that is low in oxygen toward the heart, arterial vessels contain oxygenated blood away from the heart. TIPS procedure (Transjugular intrahepatic portosystemic shunt) - A procedure performed by an interventional radiologist (IR) that uses image guidance to create new connections between two blood vessels in the liver. Involves inserting a metal mesh stent (tube) to connect the portal vein to one of the hepatic veins. This new pathway helps relieve the pressure of blood flowing through the diseased liver and can help stop bleeding and fluid build up (ascites). When the liver is very damaged and there are blockages, blood cannot flow through it very easily. A TIPS procedure may be necessary. Development of Hepatic encephalop athy is the most common complication related to the procedure. (see Hepatic encephalopathy (HE) , Portal hypertension , Varices ) Total protein - Measures the total amount of protein in the blood, which includes albumin and other proteins. Low levels may suggest liver or kidney disease. TPN (Total parenteral nutrition) - When the IV administered nutrition is the only source of nutrition the patient is receiving. Indicated when there is impaired gastrointestinal function. Transfusion - A medical procedure in which donated blood or blood product s (plasma) are provided through a narrow tube placed within a vein in your arm. Your blood will be tested before a transfusion to determ ine your blood type (A, B, AB, O and whether your blood is Rh positive or Rh negative). Donated blood must be compatible with your blood type. Transplant candidate - If you have a condition leading to organ failure, your doctor may recommend you for an organ transplant. A transplant hospital must evaluate and accept you for a transplant before you can be considered a transplant candidate . Each hospital uses its own criteria to decide whether or not to accept someone as a transplant candidate. Transplant waiting list - A national lis t of all the people in the United States who need an organ transplant. If the hospital's transplant team decides you are a c andidate for transplant, you are added to the UNOS national waiting list. Most transplant candidates usually wait for some length of time because there are not enough organs for all who need them. Donor organs are distributed locally first and if no match is found, they are offered regionally, then nationally, until a recipient is found. Criteria for matching donor organs with recipients includes medical urgency, blood type and size, genetic makeup, time on the waiting list, and proximity between the donor and recipient. (see Model for end-stage liver disease (MELD scor e) , UNOS (United network for organ sharing) ) T-tube - A small, soft tube that is temporarily inserted into the large bile duct to allow it to heal after liver transplant surgery without scarring and bile blockage. U Ultrasound - The use of sound waves to produce an image of the inside of the body. Often used to detect masses or abscesses, or t o determine bile duct size and blood flow in the liver veins. UNOS (United network for organ sharing) - A non-profit, scientific and educational organization that manages the only Organ Procure ment and Transplantation Network (OPTN) in the United States, established by the U.S. Congress in 1984 by Gene A. Pierce, founder of UNOS. (see Organ procurement and transplantation network (OPTN) ) Ursodiol (Actigall) - Used to tr eat cholestatic (slowing of bile flow) forms of liver disease including primary biliary cirrhosis (PBC). Also prescribed to help increase bile flow and reduce liver enzymes during the first weeks post-liver transplantation. V ValGANciclovir (Valcyte) - An effective antiviral medication prescribed for the prevention of CMV (Cytomegalovi rus) disease in liver transplant recipients. Varices - Swollen blood vessels often found in the stomach, esophagus and intestines when there is high pressure in the liver vein s. Esophageal varices occur most often in people with cirrhosis or scarring of the liver. Usually there are no symptoms. People may experience bloating, difficulty swallowing, blood in stool or dark, tarry stool from digested blood. (see Banding , Portal hypertension ) W White blood cells (WBC) - Also called immune cells or immunocytes, are cells of the immune system that are involved in protecting the body against both infectious disease and foreign entities. Elevated levels can indicate infection, while low levels may suggest immune system issues. Wilson disease - A rare inherited disorder that prevents the body from removing extra copper, causing copp er to build up in t he liver, brain, eyes and other organs. Wilson disease is typically treated with dietary changes and medications. Without treatment, high copper levels can cause life-threatening organ damage. A liver transplant may be necessary if other treatments are not effective or if liver failure occurs.

We are honored to have various experts in their respective fields on our Medical Advisory Board. MEDICAL ADVISORY BOARD We are honored to have various experts in their respective fields on our Medical Advisory Board. Gina Choi, MD Transplant Hepatology Pfleger Liver Institute UCLA Health Akshay Shetty, MD Transplant Hepatology Pfleger Liver Institute UCLA Health Julio Meza, MD Addiction Medicine UCLA Health Richard A. Schofield, LMFT Addiction Specialist Fady M. Kaldas, MD, FACS Liver Transplant Surgery Pfleger Liver Institute UCLA Health Andrew Baird, RN, MSN, CCTC Liver Transplant Coordinator UCLA Health James M. Wilson, MD Nephrology UCLA Health Arpan A. Patel, MD Gastroenterology UCLA Health JOIN RELIVE If you have interest in joining our Medical Advisory Board, please contact us: JOIN US Phone (310) 304-0280

There are many causes of liver disease. Over time, liver disease may lead to scarring and serious complications. Early treatment can help heal the damage and prevent liver failure. In the early stages of liver disease, the symptoms may not be readily apparent. However, at a certain advanced stage, many hold in common symptoms that are strong indicators of a level of damage that would require immediate medical attention. CAUSES & SYMPTOMS There are many causes of liver disease. Over time, liver disease may lead to scarring and serious complications. Early treatment can help heal damage and prevent liver failure. In the early stages of liver disease, the symptoms may not be readily apparent. However, at a certain advanced stage, many hold in common symptoms that are strong indicators of a level of damage that would require immediate medical attention. If you are experiencing any of the following symptoms, it is imperative that you consult a physician as soon as possible. If the situation is, or becomes, in any way critical, it is vital that you dial 911 or proceed immediately to your nearest ER if it is safe and possible to do so. Disclaimer: Please always seek the advice of your primary care physician or qualified health care provider. SYMPTOMS MAY INCLUDE: Severe itching (pruritus) Yellowing of the skin & whites of the eyes (jaundice) Spider-like blood vessels on the skin Swelling in the legs, ankles, feet (edema) Fluid accumulation in the abdomen (ascites) Absence of menstrual periods (amenorrhea) Loss of sex drive (libido) Enlarged breast tissue in men (gynecomastia) Easily bruising or bleeding (gums, nosebleeds) Tenderness or pain in upper right abdomen Confusion, drowsiness, slurred speech, hallucinations (hepatic encephalopathy) Vomiting blood (varices) Black, tarry stool/blood in stool (varices, due to portal hypertension) Dark urine Sleep disturbances, excessive daytime sleepiness (hepatic encephalopathy) Hair loss, body hair loss Pale, brittle fingernails, esp. thumb & index finger Redness in the palms of the hands (palmar erythema) Clubbing of the fingers, where fingertips spread out & become rounder than usual Nerve pain in hands & feet (neuropathy) Cold all the time Shivering & a high temperature (often caused by an infection) Joint pain, esp. knees Extreme shortness of breath (ascites) Fatigue & weakness Nausea Loss of appetite Weight loss Loss of muscle mass Increased vulnerability to infection Muscle cramping Sweet, musty breath ( fetor hepaticus) Excessive burping (varices, portal hypertension) CAUSES OF LIVER DISEASE: (Please see Glossary of Terms for definitions) Viral infections Hepatitis A, B, C, D and E are the main viruses that cause liver inflammation (hepatitis). Metabolic dysfunction-associated steatohepatitis Formally known as NASH or nonalcoholic steatohepatitis. Cause of MASLD is unknown. Risk factors include: obesity, gastric bypass surgery, high cholesterol and type 2 diabetes. The more serious form of MASLD is called MASH. Sustained excessive alcohol use Alcohol-associated liver disease (AALD) results from chronic heavy alcohol consumption. Cancer When abnormal cells multiply in the liver, tumors may develop. Tumors may be benign (noncancerous) or malignant (cancerous). Inherited conditions Genetic conditions (inherited from parents) such as Wilson disease and hemochromatosis. Autoimmune diseases When the body's immune system attacks the liver, causing inflammation. Includes autoimmune hepatitis and primary biliary cholangitis. TYPES OF LIVER FAILURE: Acute liver failure - Develops rapidly, typically over days to a few weeks. Often happens after an overdose of medicine or poisoning. The most common cause in the U.S. is taking too much acetaminophen (Tylenol and others). Chronic liver failure - Progresses over months, years, or decades. Most often the result of cirrhosis. The most common causes are alcohol abuse, chronic viral hepatitis, metabolic dysfunction-associated steatotic liver disease (MAFLD), and hemochromatosis. Acute-on-chronic liver failure - Rapid decompensation of cirrhosis associated with single or multiple-organ failure and high short-term mortality. Bacterial infection and active alcohol intake are the most common triggers in the western world. In the east, hepatitis B flare followed by sepsis and active alcohol intake are the common triggers. There is no known therapy except for liver transplantation.

All Support Groups are free and held online via Zoom. This way, no matter where you are, you can always be connected to Our Family. VIRTUAL SUPPORT GROUPS All RELIVE Support Groups are peer-led and held online via Zoom. This way, no matter where you are, you can always be connected to Our Family. Please click 'Join Us' to receive login information for the meetings you wish to attend. Your privacy and right to confidentiality is of utmost importance to us. Any information shared in these groups remains within the group. Biweekly Liver Transplant Support Group JOIN US Takes place every other Wednesday afternoon. For patients and caregivers- patients who have undergone liver transplant, those going through the evaluation process and/or waiting to be listed, those in hospital and awaiting surgery, those regenerating, and patients' friends and family members. Our transplant support group gives newcomers the opportunity to hear about the liver transplant experience from the patient's and caregiver's perspective. It also gives existing members of the liver transplant community a place to gather and thrive. We provide a safe space and time to share experience, comfort, console and give hope. To support, educate and prepare others for what to expect, as well as the challenges that often arise before, during and after a liver transplant. We face challenges together and share our moments of joy- we're a family. Weekly Transplant AA Hybrid Meeting Group An open meeting that takes place every Sunday morning. For liver patients and caregivers, alcoholic and non-alcoholic, to provide a road to strong recovery and to live a growing, healthy, spiritually active life. JOIN US Biweekly Caregiver Support Group JOIN US Takes place every other Monday evening. For caregivers of pre and post-liver transplant patients. Caregivers play a crucial role throughout the transplant journey. The physical and emotional demands of caring for a loved one can be overwhelming, exhausting and even lead to burnout. It's important to maintain your own health and well-being too. This group is dedicated to caregivers who need a supportive environment to share, listen, learn and gain emotional support and advice from other liver transplant caregivers. Biweekly Legacy & Fireside Chat Support Group Takes place every other Monday evening. Began as a meeting for those who have suffered loss pertaining to liver diseases. To honor and celebrate the lives of those missed, to organize efforts, to share grief, to offer strength, encouragement and support. A safe space always, where we explore, heal and grow together. Recently, we have had others join too, contributing to a warm and loving discussion, and would like to say that this is now open for all affected by liver disease, but to please bear in mind the more intimate and sensitive tone. JOIN US

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Virtual Support Group & One-on-One Session Guidelines: Please ensure you are in a private and quiet space prior to joining a meeting or session, or use headphones. We completely understand if you are in the hospital and unable to control background noise. As a courtesy to the rest of the group, if there is too much background noise, you might be muted. We encourage all members to join in the conversation and ask questions. As always, your privacy and right to confidentiality is of utmost importance to us. Please be respectful and courteous to all. We reserve the right to remove any participant from a group for conduct that is disruptive or disrespectful to other members. The foundation of RELIVE online support groups and one-on-one sessions is to raise up each individual with love, hope and strength, never to denigrate or judge. Any information shared in the RELIVE online support groups should be kept within the group. If you would like to continue discussions in a personal setting, please ensure all parties involved have consented and are in agreement. If you have been instructed to attend any RELIVE support groups or one-on-one sessions by your social worker, please ensure you inform the facilitator of said groups or sessions, so they may make note of your attendance. It is strongly recommended you turn on your camera while participating in RELIVE support groups, especially if you have been instructed to attend. Keeping your camera on helps identify and strengthen our community. RELIVE online support grou ps and one-on-one sessions are intended to offer a safe space to process feelings and experiences related to liver disease, liver failure (and also alcoholism and addiction recovery where relevant) and liver transplant, while receiving peer support. Communication with others you can relate to and come to trust about your condition, concerns and how you are feeling can ease loneliness, anxiety and fear. RELIVE online support groups are educational and supportive in nature and will offer shared experiences and self-care strategies to assist patients and caregivers during difficult times. Any health care or psychological advice RELIVE support groups or one-on-one sessions offer are merely subjective and experiential and definitively are not to be considered professional or medical in any way. No diagnosis or treatment recommendations regarding any medical or mental health condition or illness will be offered. RELIVE online support groups cannot be a substitute for or alternative to treatment when a medical condition is present. RELIVE support group members are advised to seek professional services from licensed physicians, psychologists and health care professionals, if and when necessary. It is the sole responsibility of each attendee to refer any information in said support groups or one-on-one sessions to the appropriate medical professional before considering any action or treatment. All RELIVE support groups and one-on-one sessions are held online via Zoom. To provide protection and privacy and help prevent Zoom-bombing (disruptive, uninvited gate crashers), a unique meeting ID and passcode is required to join all RELIVE support group meetings and one-on-one sessions. This information can only be obtained through personal invitation. New attendees are always welcome and can request to join us through our Site or by email: info@wearerelive.org . RELIVE maintains the right to modify these Terms of Use at any time by electronic notice posted on our Site. By continuing to use our Site, you agree to be bound by our Terms of Use and consent to the data practices described in our Privacy Policy. PRIVACY POLICY Our Commitment to Privacy: RELIVE respects the privacy of every visitor to our Site. The purpose of this Privacy Policy is to describe how we collect and use information about our online visitors, and the choices you have regarding your personal information. This Policy may be changed or updated from time to time. By continuing to use our Site, you consent to the practices described in this Policy. What information do we collect? You may browse our Site without identifying yourself or providing any personally identifiable information. When you interact with us through your computer or mobile device, however, we do record certain non-identifying site-usage data, such as your number of visits to our Site pages, type of internet browser you are using, domain name of the website you clicked on to come to our Site, and/or IP address and server owned by your Internet Service Provider. If you elect to provide us with individually identifying information, this may include name, email address, mailing address, phone number, payment details, other demographic information, and health data. RELIVE keeps all names, addresses, and all other personal information supplied by visitors to our Site strictly confidential unless express consent is given otherwise. How is this information used? This data is used to sto re and process the information to better understand user needs and how we can improve our Site; contact you directly, including to deliver requested invites to virtual support groups or one-on-one sessions; and to track usage behavior. We may use this information to communicate with you by email, phone, SMS (text) message, or postal mail from time to time. We may receive confirmation via HTML code when you open an email from us, which helps us measure our reach and ensure, reduce or eliminate duplicate e-mails. If you no longer wish to receive e-mails from us, please unsubscribe or contact us at: info@wearerelive.org What are Cookies? Some parts of our Site may also use 'cookies,' which are alphanumeric identifiers that are transferred to your computer through your web browser. You may configure your browser to accept all cookies, reject all cookies, or notify you when a cookie is sent. However, if cookies are rejected, some pages on our Site may not function properly. Please view our cookie policy below. Cookies Policy: When you interact with u s, we use technological tools such as "Cookies," "Log Data," and other identifiers to receive and store certain types of information whenever you interact with our Site. Examples include your IP address, unique device identifiers, session IDs, computer or mobile device make and model, operating system, browser program and version, pages you requested and history. We may use this data to, among other things, tailor, customize and enhance services as well as your experience and to help diagnose, operate and administer our Site. We also use cookies to save you time while using the Site, remind us who you are, and track and target user interests in order to provide a customized experience. Cookies allow us to collect Non-Personally Identifiable Information from you, like which pages and applications you visited and what links you clicked on. Use of this information helps us to create a more user-friendly experience for all visitors. You may configure your browser to accept all cookies, reject all cookies, or notify you when a cookie is sent. However, if cookies are rejected, some pages on our Site may not function properly. Our Site may automatically collect usage information, such as the num bers and frequency of visitors to our Site and their components. This data is only used in the aggregate, that is, as a statistical measure, and not in a manner that would identify you personally. We use this information to design and improve our Site and may provide this information to partners so they can understand how often users access areas of our Site. When you visit our Site, we may automatically collect certain information through the use of electronic tools like Cookies and Web beacons or Pixel tags. We use Non-Personally Identifiable Information to troubleshoot, administer our Site, analyze trends, gather demographic and engagement information, enhance and customize our Site, measure the effectiveness of our links, content and programming, comply with applicable law, and cooperate with law enforcement activities. We may also share this information with our authorized third-party service providers. To opt out, you may visit the settings in the browser you are using: Cookie settings in Firefox Cookie settings in Internet Explorer Cookie settings in Google Chrome Cookie settings in Safari (OS X) Cookie settings in Safari (iOS) Cookie settings in Android To opt out of being tracked by Google Analytics across all websites, visit this link: http://tools.google.com/dlpage/gaoptout . Additionally, RELIVE may include a third-party cookie from Google in order to use Google Analytics to monitor Site statistics. Please note that Google and its wholly owned subsidiaries may retain and use, subject to the terms of its Privacy Policy (located at: https://policies.google.com/privacy, or such other URL as Google may provide from time to time), information collected in Your use of the Service. Any automatically collected information may be maintained indefinitely and used for our internal business and marketing purposes, such as assessing traffic patterns and usage of various features on the Site, but will not be s old or otherwise disclosed to third parties for any purposes. Please Note: Children under the age of 13 should receive parental consent prior to disclosing any personal information and utilizing internet websites. What security is provided for the information? Our organization is hosted on the Wix.com platform. Wix.com provides us with the online platform that allows us to share our informational content with you. Your data may be stored through Wix.com’s data storage, databases and the general Wix.com applications. They store your data on secure servers behind a firewall. All direct payment gateways offered by Wix.com and used by our organization adhere to the standards set by PCI-DSS as managed by the PCI Security Standards Council, which is a joint effort of brands like: Visa, MasterCard, American Express and Discover. PCI-DSS requirements help ensure the secure handling of credit card information by our store and its service providers. If you wish to have your data that was submitted to RELIVE through the Site edited or removed, or if you have questions, concerns, complaints or suggestions regarding our Privacy Policy, please email us at: info@wearerelive.org Our Site also has a Secure Socket Layer (SSL) security certificate for website protec tion. You use the Site at your own risk. We implement reasonable technical, administrative, and organizational measures to protect Personal Information both online and offline from loss, misuse, and unauthorized access, disclosure, alteration, or destruction. However, no Internet or e-mail transmission is ever fully secure or error free. In particular, Electronic Communications sent to or from us may not be secure. Therefore, you should take special care in deciding what information you send to us via the Site or Electronic Communications. Please keep this in mind when disclosing any Personal Information to RELIVE via the Internet. In addition, we are not responsible for circumvention of any privacy settings or security measures contained on the Site, or third party websites. Legal Proceedings: We will share personal information with third party companies, organizations or individuals outside of RELIVE if we have a good-faith belief that access, use, preservation or disclosure of the information is reasonably necessary to: Meet any applicable law, regulation, subpoena, legal process or enforceable governmental request. Enforce applicable Terms of Use, including investigation of potential violations. Detect, prevent, or otherwise address fraud, security or technical issues. Protect against harm to the rights, property or safety of RELIVE, our users, or the public as required or permitted by law. Consent to Processing of Personal Data in United States: This Site and Services are not directed to residents of the European Union. By using and accessing our Site, users who reside or are located in countries outside of the United States agree and consent to the transfer to and processing of personal information on servers located outside of the country where they reside, and that the protection of such information may be different than required under the laws of their residence or location. Our Commitment to Our Donors: We will not sell, share or trade our donors' names or personal information with any other entity, nor send mailings to our donors on behalf of other organizations. This Policy applies to all information received by RELIVE, both online and offline, on any Platform ('Platform' includes the RELIVE Site and mobile applications), as well as any electronic, written, or oral communications. To the extent any donations are processed through a third-party service provider, our donors' information will only be used for purposes necessary to process the donation. RELIVE is committed to providing a website that is accessible to the widest possible audience, regardless of circumstance and ability. We aim to adhere as closely as possible to the Web Content Accessibility Guidelines (WCAG 2.0, Level AA), published by the World Wide Web Consortium (W3C). These guidelines explain how to make web content more accessible for people with disabilities. Conformance with these guidelines will help make the web more user friendly to everyone. While RELIVE strives to adhere to the guidelines and standards for accessibility, it is not always possible to do so in all areas of the Site and we are currently working to achieve this. Be aware that due to the dynamic nature of the Site, minor issues may occasionally occur as it is updated regularly. We are continually seeking out solutions that will bring all areas of the Site up to the same level of overall web accessibility. If you have any comments and/or suggestions relating to improving the accessibility of our Site, please don't hesitate to contact RELIVE by phone or email . Your feedback will help us make improvements. RELIVE maintains the right to modify this Privacy Policy at any time by electronic notice posted on our Site. By continuing to use our Site, you consent to the collection, use, and sharin g of your information as described in this Privacy Poli cy.