Why Do Younger Adults Need Liver Transplants?

News reports that the Gossip Girl actor Michelle Trachtenberg died at age 39 after a recent liver transplant have left many people wondering why somebody so young would need such a serious operation.

But news outlets including ABC News, the New York Post, People, and TMZ have reported that Trachtenberg had undergone a liver transplant in the months before her death and may have experienced complications.

Here’s what you need to know about liver transplants.

What Does the Liver Do?

What Are Potential Causes of Liver Transplants?

• Hepatitis B and C: Both of these viral infections damage the liver.
• Alcoholic liver disease: Excessive alcohol consumption can cause liver disease.
• Metabolic dysfunction-associated liver disease (MASLD): This is more common in people with obesity and happens when fat accumulates in the liver. MASLD used to be called nonalcoholic fatty liver disease.
• Genetic diseases affecting the liver: They include hemochromatosis, which causes excessive iron buildup in the liver, and Wilson's disease, which causes excessive copper buildup in the liver.
• Bile duct diseases: Diseases that affect the tubes that carry bile away from the liver, or bile ducts, include primary biliary cirrhosis, primary sclerosing cholangitis and biliary atresia. Biliary atresia is the most common reason for liver transplant among children.
• Liver cancer: Some liver cancer patients may receive transplants.

Hepatitis C, previously a leading cause of liver transplants in the United States, contributes to far fewer operations today, says Leopoldo Arosemena, MD, a transplant hepatologist at Cleveland Clinic Weston Hospital in Weston, Florida.

“Hepatitis C has decreased significantly as a cause of cirrhosis and the need for transplantation because we can cure this infection now with very effective medications,” Dr. Arosemena says.

Why Are Liver Transplants Becoming More Common Today?

At the same time, some other causes of cirrhosis may lead to a larger proportion of liver transplants, Arosemena says.

“During and after the pandemic, alcohol consumption increased in the United States, leading to more liver-related problems, like acute alcohol-associated hepatitis and worsening cirrhosis from any etiology,” Arosemena says. “Young adults were more likely to increase their alcohol intake.”

How Many People Need Liver Transplants?

What Are Common Complications After Liver Transplants?

“Initially, there may be technical problems like infections, blood clots, bleeding, and medication side effects, which are usually manageable,” Arosemena says. “Subsequently, we're watching for recurrence of the original disease, rejection, long-term diseases, and malignancies.”

“The great majority of patients have a normal quality of life, as long as they keep following the instructions of the transplant centers,” Arosemena says.

What Are the Survival Odds After a Liver Transplant?