At MedStar Georgetown Transplant Institute, our specialists are experts in treating patients with diseases of the liver, pancreas, kidneys, and small bowel. Because of the nature of these diseases, transplantation is sometimes the best hope for a cure. Our transplant teams are known for their national success rates, history of innovation, cohesive teamwork, and family-friendly approach to the transplantation process. Learn more about our transplant centers and programs.
Our doctors offer innovative treatments and access to clinical trials for patients with a wide range of conditions that may lead to transplantation, including:
Diabetes is a disease in which the body does not produce or properly use insulin. Insulin is a hormone that is needed to convert sugar, starches, and other food into energy needed for daily life. The cause of diabetes is unknown, although both genetics and environmental factors such as obesity and lack of exercise appear to play roles.
The two major forms of diabetes are:
- Type 1: previously called insulin-dependent diabetes mellitus (IDDM) or juvenile-onset diabetes. If you have type 1 diabetes, your body doesn’t not produce insulin. The condition can severely damage the kidneys and pancreas.
- Type 2: previously called non-insulin-dependent diabetes mellitus (NIDDM) or maturity-onset diabetes. Type 2 diabetes (the most common form of diabetes, accounting for 90 of 95 percent of cases) occurs when your body fails to use insulin properly. When suffering from this condition the body does not respond properly to insulin, a condition known as insulin resistance. Insulin is a hormone produced by the pancreas that regulates how the body converts glucose (sugar) into energy.
Both type 1 and type 2 diabetes share one central feature: elevated blood glucose levels due to absolute or relative insufficiencies of insulin. In some cases, diabetes can lead to damage that makes an organ transplant necessary.
Almost everyone experiences abdominal pain on occasion, but when pain keeps recurring and increases in severity, our Chronic Pancreatitis and Autologous Islet Cell Transplant Program can help you determine the cause of your pain and direct you to the right treatment.
Pancreatitis is an inflammation of the pancreas that can be caused by many conditions, including:
- Excessive alcohol consumption
- Abdominal surgery
- Certain medications
With chronic pancreatitis, the inflammation gets worse over time, causing permanent and disrupting the function of the organ, which is to secrete enzymes that aid digestion and hormones to regulate sugar metabolism.
At MedStar Georgetown Transplant Institute, our team of experts can evaluate and determine the best course to relieve the pain of chronic pancreatitis, including the innovative option of auto islet cell transplant.
The kidneys work to keep the blood clean and balanced chemically. Every day about 200 quarts of blood are processed by the kidneys. About 2 quarts of waste product and water are removed from the blood during this process.
Chronic kidney disease affects 26 million Americans. If undetected or treatment is not successful, the disease will lead to end-stage renal disease (ESRD) and kidney failure. Patients with ESRD must receive kidney dialysis treatments or a kidney transplant to survive.
MedStar Georgetown’s Transplant Institute’s provides premiere liver disease diagnosis and treatment for patients suffering from a variety of liver disorders.
Different types of liver disease are treated in different ways. Critical to managing liver disease and perhaps even regenerating new, healthy liver cells, is a healthy diet that supports healthy liver function. However, if your liver is damaged to the point where regeneration is not an option, the best treatment for some types of end stage liver disease is transplantation.
Tumors in the liver may occur because of health conditions such as hepatitis, or they can be a result of problems in other organs. Sometimes, tumors such as colon cancer metastasize to the liver.
It is typically best for tumors in the liver to be removed, although sometimes we can determine that they are not harmful without operating. In these cases, we can observe them over time to make sure they are not causing further damage.
Depending on the size of the tumor, your surgeon will likely opt to remove the tumor and a portion of the liver. In other cases, your hepatologist and surgeon may recommend a liver transplant.
Bile Duct Tumors
Cancerous tumors of the bile ducts are usually slow growing and do not spread quickly. However, many of these tumors are already advanced by the time they are found. Such tumors may start anywhere along the bile ducts and eventually block them off.
Pediatric Liver Disease
A variety of liver conditions can require surgery or a liver transplant in young children. At Georgetown, we have world-class hepatologists who specialize in treating children.
Pediatric liver diseases we treat include:
- Pediatric Hepatitis: Babies and children generally contract hepatitis through contact with contaminated diapers (hepatitis A) or from an infected mother during birth and delivery (hepatitis B). Metabolic diseases can also lead to hepatitis infections.
- Biliary Atresia: Bile helps the body digest food and nutrients. In some babies, the tubes that deliver bile from the liver to the gallbladder do not develop properly. Defective tubes can cause blockages of built-up bile in the tubes, which can lead to complications like cirrhosis (severe liver scarring).
- Liver Tumors/Hepatoblastoma: Hepatoblastoma is a type of cancerous liver tumor that affects babies and children under age 3. It can cause cancer to spread to other organs including the lungs, stomach, or bone marrow.
- Choledochal Cysts: Bile ducts deliver bile from the liver to the gallbladder. Some babies are born with bile ducts that never fully developed. As a result, bile can get stuck in the tubes and form choledochal cysts (lumps), which can cause jaundice or become infected and need to be removed with surgery.
- Metabolic Liver Diseases: A wide variety of metabolic and genetic diseases that can affect and damage the liver, including
- Alpha-1-antitrypsin deficiency
- Wilson’s disease
- Neonatal hemochromatosis.
- Glycogen storage disease type I
- Cystic fibrosis
- Crigler-Najjar Syndrome type I
The doctors at MedStar Georgetown Transplant Institute are experts in treating and managing pancreatic cancer and pancreas surgery, and our expert surgeons are highly specialized in treating all types of tumors and diseases of the pancreas.
Our pancreatic surgery program offers patients the full range of current therapies supplemented by the potential to participate in promising clinical trials that could change how acute and chronic pancreatitis and pancreatic cancer are diagnosed and treated in the future. The surgeons performing pancreatic surgery here have among the highest volume, best technical experience and best survival outcomes in the country.
Portal hypertension is high blood pressure in vein that carries blood from the spleen and GI tract to the liver, which then processes the blood, extracting nutrients and toxins. This increased blood pressure causes other veins to enlarge, especially in the abdomen, where they can bleed easily as they are so weak.
Our liver specialists at MedStar Georgetown Transplant Institute will evaluate you for portal hypertension. Treatment at first may include diet and lifestyle changes. If these fail our doctors may recommend surgery. Surgery may include:
- Transjugular intrahepatic portosystemic shunt (TIPS)
- Distal splenorenal shunt (DSRS)
- Liver transplantation is advised in cases of end-stage liver disease
Small Bowel Disease
If your small bowel (intestine) is damaged by disease or trauma, you can experience intestinal failure, which is when the small bowel loses its absorptive capacity and can’t take in the fluid and nutrition you need on a daily basis.
Total parenteral nutrition (TPN) is a liquid filled with all the nutrients your body needs to survive, given through a central line right into the blood stream. By putting nutrients right into the blood stream, TPN does the job of the small bowel. However, this is not a long-term solution for most patients, and we may recommend a small bowel transplant.