Hepatitis C: What happens in end-stage liver disease?

End-stage hepatitis C means the liver has been severely damaged by the hepatitis C virus. The hepatitis C virus slowly damages the liver — often over the course of several decades. In some people, this long-term hepatitis C damage may eventually cause permanent scarring of the liver (cirrhosis). People with cirrhosis can go on to develop liver failure or liver cancer.

Signs and symptoms of end-stage liver disease or liver cancer may include:

• Fatigue
• Persistent or recurring yellowing of your skin and eyes (jaundice)
• Loss of appetite
• Nausea
• Abdominal pain
• Abdominal swelling due to fluid accumulation (ascites)

In addition to liver failure or cancer, people with cirrhosis may also develop:

• Gastrointestinal bleeding due to enlarged veins in the esophagus (esophageal varices)
• Brain and nervous system damage due to the accumulation of toxins in the bloodstream (hepatic encephalopathy)

The treatment for people with end-stage liver disease is a liver transplant. During a liver transplant, the diseased liver is removed and is replaced with a healthy liver from a donor. Liver transplants most often use livers from deceased organ donors. In some cases, a living-donor liver transplant can be used. During a living-donor liver transplant, you receive only a portion of a healthy liver from a living donor.