Human Liver

The liver is considered as the most vital organ of the body present in every vertebrate. It has natural regenerative power can regenerate itself (as fast as cancerous tumor) as well as take part in performing the wide range of functions such as protein synthesis, detoxification, biochemicals production required for digestion and so many. It is a most essential organ required for the survival of human being as there is no way other than it. This is a largest gland of the body involved in the metabolism, important functions, glycogen storage, RBCs decomposition, hormone production, plasma protein synthesis and etc.

Facts about the Liver

Liver: a largest, solid and regenerative organ of the body.

Size:

Width: 8 inch or 20 cm

Length: 6.5 inch or 17 cm

Thickness: 4.5 inch or 12 cm

Weight: around 3.5 pounds or 1.6 kilograms

Location: lies under the ribs in right upper part of the abdomen and below the diaphragm in the abdominal-pelvic region.

Structure: Have two large lobes (a big right one and a smaller left one) and two small lobes (caudate lobe and quadrate lobe).

Functions: Have more than 500 different and important functioning.

Contains: Around 13% of the total blood of the body at a time and pumps out around 1.4 litres per min.

Liver Transplantation: first human liver transplantation was performed by the Dr. Thomas E. Starzl performed the in 1963 at the “University of Colorado Medical School”.

Anatomy of the Liver

The liver is located to the right side, below the diaphragm in the abdominal-pelvic region to the top of the stomach, right kidney and intestine. It is a very soft, solid, cone shaped or triangular organ of dark reddish-brown color weighs around 3 pounds or above and encapsulated with connective tissue capsule.

Blood Supply

It gets blood supply through an artery (hepatic artery carries oxygenated blood to it) and a vein (hepatic portal vein carries nutrient-rich blood to it, Receives blood from the spleen, stomach, pancreas, gallbladder, and intestines and delivers to the liver tissues to get processed before being delivered to other body parts). It gets around 13% of the body’s blood at a time. Blood from the liver tissues again gets collected into the hepatic veins which carry blood to the vena cava and then to the heart.

Structure

It consists of two main lobes (right big and left small) which in turn consist of thousands of lobules joined with small ducts and then larger ducts to form the hepatic duct. Hepatic duct plays a great role in transporting the bile, made by liver cells, to the gallbladder and duodenum.

Liver is attached to the peritoneum as well as diaphragm through the first coronary ligament, second left and right triangular ligaments and third falciform ligament which provides support to the liver and keeps it at one place. It consists of four lobes, the left and right lobes (separated by falciform ligament), small caudate lobe (cover the inferior vena cava) and small quadrate lobes (cover the gallbladder).

Liver lobes consist of around 100,000 small lobules which consist of 6 hepatic portal veins and 6 hepatic arteries surrounding a central vein. These blood vessels are formed by joining many sinusoids. Liver tissues contain Kupffer cells (acts as a macrophage which captures and break down the old and damaged RBCs from sinusoid) and hepatocytes (cuboidal epithelial cells make the linings of sinusoid) through which the sinusoid passes. Hepatocytes involve in many liver functioning like digestion, metabolism, storage and bile production.

Bile Ducts

Bile ducts carry bile through the liver to the gallbladder and later form a branched structure called biliary tree. Liver cells produce bile and drain it into the microscopic canals, bile canaliculis which joins together to form larger bile ducts of the liver. Bile ducts join again to form larger left and right hepatic ducts carrying bile from left and right liver lobes.

Hepatic ducts of the liver again join to form common hepatic duct, carrying bile away from the liver, which later joins to form cystic duct of the gallbladder (bile storage organ). Cystic duct again forms the common bile duct which carries bile to the duodenum (part of the small intestine).

Functions of the Liver

The liver is a major body organ involves in the various essential functions carried out by the liver cells called as hepatocytes. Liver has no another option of getting replaced means there is no artificial organ which can perform the functions of liver; it can only be transplanted if any problem occurs to the previous one. However, liver dialysis can be performed as an experimental treatment to the liver failure. The functions of the liver which it involves alone or in combination with other body organs are listed below:

  • It involves in the protein metabolism, synthesis, degradation and amino acid synthesis.
  • It performs carbohydrate metabolism in various ways like gluconeogenesis (synthesize glucose from amino acids, lactate or glycerol), glycogenolysis (breaks glycogen molecules into glucose) and glycogenesis (synthesize glycogen from glucose).
  • It involves in the lipid metabolism, lipogenesis, cholesterol synthesis, produce triglycerides (fats) and lipoproteins synthesis.
  • It involves in producing the blood clotting factors or coagulation factors I (also called as fibrinogen), II (also called as prothrombin), V, VII, IX, X and XI, protein S, protein C as well as antithrombin.
  • It involves in the red blood cell production in the fetus during the first trimester which is later performed by the bone marrow.
  • It involves in the production and excretion of the bile for fat metabolism and absorption of vitamin K.
  • It generates insulin-like growth factor 1 (called IGF-1) which is a polypeptide protein hormone involves in the childhood growth as well as anabolic effects among adults.
  • It produces the thrombopoietin which is a glycoprotein hormone involves in the regulation of platelets production from bone marrow.
  • It involves in the breakdown of insulin including other hormones.
  • The glucoronidates bilirubin produced by the liver facilitates the bile excretion.
  • It breaks and detoxifies the toxic substances including medicinal products from the body through the process of drug metabolism.
  • It involves in the conversion of ammonia into the urea through the urea cycle.
  • It is a major storage organ of the body which stores various substances like glucose (as a glycogen), vitamin K, vitamin A (to supply at least 1–2 years), vitamin D (to supply at least 1–4 months), vitamin E, vitamin B12 (to supply at least 1–3 years), iron, copper and other minerals.
  • It involves in many immunological functioning such as its reticuloendothelial system has many immunologically active cells which acts as a filter for antigens carried through portal system.
  • It involves in producing the albumin protein (component of blood serum).
  • It involves in the synthesis of angiotensinogen hormone which elevates the blood pressure when getting activated by rennin enzyme (released by kidney during low blood pressure).
  • It helps in the absorption of fat and fat soluble vitamins through the production and secretion of bile.
  • It stores sugars, carbohydrates, fats, vitamins and nutrients foods for better energy and brain functioning.
  • It controls the body health by breaking down the harmful chemicals released during digestion.
  • It involves in maintaining the blood purity (cleanse blood) and proper blood flow through the protein synthesis.
  • It helps the body by detoxifying the drugs, alcohol, environmental toxins as well as filtering out wastes from blood.
  • It involves in protecting the body by removing the poisons from air, smoke, exhaust and other chemicals come in during breathe.
  • It helps in controlling the blood sugar to the normal level by storing the extra glucose of the blood in the form of glycogen.
  • It is the only organ which has regenerative capacity and can regenerate into full size in the donor as well as in the receiver if a portion of the liver is donated or received.
  • It protects the body from various microorganisms or infectious disease such as cold-germ, flu-bugs, antibodies and etc.
  • It enhances the body immune system level because of its Kupffer cells, lining sinusoids, which acts as mononuclear phagocyte system and capture and digests fungi, bacteria, damaged RBCs, parasites, cellular debris and etc.

Diseases of the Liver

As liver is our main body organ involves in the essential functioning, gets some problems, diseases or even damage if not cared or used carefully throughout the life. Some of the problems and diseases of the liver are mentioned below:

  • Liver cancer
  • Liver failure
  • Ascites
  • Gallstones
  • Hemochromatosis
  • Primary Biliary cirrhosis
  • Autoimmune liver disorders
  • Galactosaemia
  • Wilson’s disease

Some Diseases which Leads to the Liver Transplantation

  • Primary sclerosing cholangitis
  • Cirrhosis
  • Metabolic diseases
  • Biliary atresia
  • Acute hepatic necrosis
  • Hepatitis A, B, C, D, E (viral, autoimmune or idiopapathic)
  • Liver tumors
  • Portal hypertension

Other liver problems

A struggling liver leads to the various health problems:

  • Headache
  • Enlarged blood vessels
  • Easy bruising
  • Anxiety
  • Depression
  • Diarrhea
  • Dark urine
  • Weight loss
  • General malaise
  • Fever
  • Bloated abdomen
  • Swollen ankles
  • Abdominal pain in the upper right side
  • Anaemia
  • Vomiting of blood or black stools
  • Drowsiness
  • Loss of appetite
  • Light colored stools
  • Impaired libido
  • Nausea
  • Vomiting
  • Food allergies
  • Mental confusion
  • PMS (pre menstrual syndrome)
  • Tiredness and fatigue
  • Jaundice
  • Chemical sensitivities
  • Alcohol damage
  • Fatty liver
  • Drug damage

Pediatric Liver Diseases

  • Biliary atresia
  • Langerhans cell histiocytosis
  • Alpha-1 antitrypsin deficiency
  • Progressive familial intrahepatic cholestasis
  • Alagille syndrome

What are the causes of liver disease?

  • Non-alcoholic fatty liver disease or fatty liver
  • Toxic effect of medications including herbal medicines
  • Congenital or inherited liver abnormalities such as the accumulation of iron and copper in body as well as rare enzyme disorders
  • Liver cell or bile duct damage
  • Hepatitis virus infections
  • Alcohol-related liver disease

Liver Function Tests

Blood Tests:

  • Liver function panel
  • AST (Aspartate Aminotransferase)
  • ALT (Alanine Aminotransferase)
  • Alkaline phosphatase
  • Bilirubin
  • Ammonia
  • Albumin
  • Hepatitis A tests
  • Hepatitis B tests
  • Hepatitis C tests
  • Partial Thromboplastin Time (PTT)
  • Prothrombin Time (PT)

Imaging Tests

  • Ultrasound
  • Liver biopsy
  • CT scan (computed tomography)
  • Liver and spleen scan

Liver Treatments

  • Hepatitis A treatment
  • Hepatitis B treatment
  • Hepatitis C treatment
  • Paracentesis
  • Liver transplant
  • Liver cancer treatment
  • ERCP (Endocscopic retrograde cholangiopancreatography)
  • Rest
  • Avoiding of alcohol and drugs causing liver damage
  • A well-balanced and nutritious diet with low salt
  • Medication of exact problem
  • Surgery, chemotherapy or radiotherapy if required

Care of the Liver

It is well known that liver has regenerative capacity itself; however it needs some care to maintain the healthy lifestyle for whole life. Dangerous eating habits (like burgers, fries, soft drinks and etc) lead the liver to get damaged, failure or various permanent problems. Never let your liver to get fatty as it may develop some serious complications. I have listed some points regarding what care we should give to our liver to maintain healthy life style:

  • Maintain less fatty food to the diet as high fatty food enhances the alanine aminotransferase (ALT) enzyme secretion which is the indication of liver damage as well as increases the risk of Type 2 diabetes and hepatitis C. More fatty food enhances fat cells building in the liver which endanger the health.
  • Maintain the healthy and balanced diet plan as unhealthy food and consumption of food additives, tobacco, alcohol, caffeine, pharmaceutical and OTC (over-the-counter) drugs enhances the death of liver cells.
  • Maintain healthy environment to the home as environmental pollutants including cosmetic ingredients, garden chemicals, household cleaning products, home repair materials and etc are toxic to the liver. Damaged liver become less capable to remove toxins which reach to the blood and brain.
  • Liver is the life as it does a lot of functions in the body so it needs some maintenance like be active and eat right at right time. Maintain the weight as overweight or lot of drinks lead to liver damage.
  • Try eating organic foods, fruits or vegetables without any insecticides, fertilizers, antibiotics, growth hormones or be conscious about products to apply on the skin. The chemicals sprayed over plants or vegetables kill both, the insects and liver.
  • Limit the intake of fried or processed foods as they have trans fats, fructose and hydrogenated oils which is hard for liver to digest and makes liver fatty.
  • Maintain the intake of fresh fruits and vegetables (natural detoxifier) including liver healthy foods in the diet.
  • Try eating sulfur-rich foods like onions, collard greens, garlic, broccoli, turmeric, cinnamon, licorice, kale, Brussels sprouts, cabbage, cauliflower and etc to help liver to naturally detoxify the environmental toxins, drugs and pesticides. Vegetables are fiber rich food which enhances the toxins removal throughout the digestive tract as well as lessens the liver stress.
  • Avoid drink alcohol as it destroys the liver cells and causes symptoms like fatty liver, inflammation, alcoholic hepatitis or cirrhosis and etc.
  • Try using natural household products, natural personal care products, drink water free of contaminants, use air purifier in home if living in crowded area to reduce more burdens to the liver.
  • Detox the body regularly and try exercising daily to make the liver healthy.
  • Be conscious of taking medications causing liver damage like Acetaminophen (brand name Tylenol).
  • Avoid smoking and be active for at least 150 mins a week in order to maintain the secretion of liver enzymes.
  • Milk thistle seed extract provides help in protecting and promoting the liver health.
  • Try having detox nutrients in the diet like Grape Seed Extract, herbs Milk Thistle, Curcumin, Green Tea, Alpha Lipoic Acid and etc which have powerful antioxidant property and enhances natural defense systems of the body.
  • Try drinking enough lemon water as it enhances the natural detox system to remove the toxins. Citric acid of lemon increases the bile production from liver which helps to excrete toxins.
  • Some of the minerals like calcium, sodium, potassium, copper, magnesium, iron, zinc, manganese, selenium and etc are very necessary for the liver detoxification so try having food rich in these minerals.
  • Papaya is very good home remedy to treat the cirrhosis caused by alcoholism or malnutrition.
  • The mix juice of carrots (300 ml) and spinach (200 ml) or carrot (300 ml), cucumber (100 ml) and beet root (100 ml) are very helpful in treating cirrhosis of liver.
  • It really works eating vegetables like beet root, tomatoes, squashes, carrots, bitter guard, eggplant, radishes and papaya during cirrhosis.
  • Avoid intake of fried, refined, processed or canned foods, spices or condiments, strong tea or coffee, or foods prepared using ghee, oil or butter with limited use of salt.
  • Applying hot and cold compresses for 2-3 mins on liver or drinking 8 cups of luke warm water a day (2 cups in early morning) is also beneficial.
  • Try having lots of vitamin C, at least 500 mg daily, in the diet as it protects the liver from fatty buildup and cirrhosis.
  • Take vitamin B-12 and folic acid rich foods to reduce the occurrence of jaundice, hepatitis, anorexia, serum bilirubin and etc.
  • Unsafe sex with many partners increases the risk of hepatitis.
  • It is healthy practice of washing hands properly before taking anything in mouth.
  • Avoid taking animal foods as it contains cholesterol which forms gallstones.
  • Sleep well for accurate time as during sleep in night brain releases a chemical, Melatonin, which helps in controlling the sleep cycle as well as shares the toxin load of body with liver in neutralizing the free radicals and refreshing the body.
  • Flush the liver with mixture of epsom salts, olive oil and grapefruit juice before going to bed to remove extra toxins, cholesterol and gallstones.
  • Flush the liver by drinking lots of safe water a day, at least 2-3 litres, small and frequent.
  • Avoid drinking lots of water, especially cold, just after the meal as it dilutes the stomach or gastric juices which inhibits the proper digestion and increases the workload of liver.

It is very proved fact and good saying that “prevention is better than cure”, so treat your liver in good and healthy manner to be prevented from the cure and consult your doctor immediately if any problems occur.