1. Liver Seminar for Health Plan Case Managers September 23, 2008 October 2, 2008

2. Goal: A Broad Overview Acute and Chronic Common and Rare

3. Introduction Diseases of the liver and biliary tree are the tenth leading cause of death in the United States 6,500 liver transplants each year In 2004, 42% were for Hepatitis C Virus (19% in 1992) 20% of liver transplants were due to Nonalcoholic Fatty Liver Disease (NAFLD)

4. Introduction Hepatocellular carcinoma is one of the fastest growing cancers in the United States –Cirrhosis usually comes first, but not always –Preventable –Rarely curable

5. Topics The digestive system Anatomy, physiology, function Liver function tests Acute liver failure –Acetaminophen toxicity Chronic liver failure and its complications –Portal hypertension

6. Topics Chronic liver disease –Hepatitis C virus –Alcoholic liver disease –Non alcoholic fatty liver disease Acute hepatitis A Drug induced liver injury

7. Topics The cholestatic liver diseases –Primary biliary cirrhosis –Primary sclerosing cholangitis –Cholestasis of pregnancy Inherited and pediatric liver diseases Prevention Chronic care

8. Case Discussions Can be anything you wish: –Hepatitis C –Hepatitis B –Primary biliary cirrhosis –Primary sclerosing cholangitis –Genetic/inherited liver disorders –Alcohol related liver disease Questions and answers

9. Summary Resources Acronyms and abbreviations General Information for people with liver disease Recommended readings References