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.
No official cause of death or details about Trachtenberg’s medical history have been released. The New York Police Department (NYPD) responded to a 911 call just after 8 a.m. EST on Wednesday and found Trachtenberg unconscious and unresponsive in a Manhattan apartment, according to the New York Times. She was pronounced dead by emergency medical workers at the scene. The NYPD said the medical examiner had yet to determine a cause of death.
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?
The liver is one of the largest organs in the body. It helps us digest food, rid the body of waste products, and makes substances known as clotting factors that keep blood flowing well.
Liver disease can be caused by genetics, but more often it’s caused by viruses, alcohol use, and obesity. Over time, people with liver disease can develop scarring called cirrhosis. Cirrhosis can lead to liver failure, a life-threatening condition, and is the most common cause of liver transplants.
What Are Potential Causes of Liver Transplants?
The most common causes of liver failure and cirrhosis that leads to a liver transplant are:
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.
A report from the Health Resources and Services Administration (HRSA) suggests two reasons: more cases of obesity-related MASLD and an increased number of people with alcohol-related liver disease.
“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.”
Alcohol-related liver disease accounted for 41 percent of adult liver transplants in 2022, up from 17 percent a decade earlier, according to the HRSA report. Over this same period, the number of transplants caused by MASLD climbed to 20 percent from about 14 percent.
Transplants are also rising among younger adults. The proportion of transplant recipients ages 35 to 49 climbed to 23 percent in 2022, up from 17 percent a decade earlier.
How Many People Need Liver Transplants?
There were 9,424 people waiting for liver transplants in the United States as of September 2024, according to HRSA. In 2023, a total of 10,659 people received liver transplants.
Not everybody who needs a liver gets one. One study looked at more than 15 years of liver transplant data and found about 13,000 to 15,000 people are on the waiting list at any given time. About 6,000 of them receive a liver and about 2,000 people die waiting, while others move on or off the list based on changes in their health status, this study found.
What Are Common Complications After Liver Transplants?
Many people can return to their daily routine within three months after liver transplant surgery and go on to have a normal life for decades. Still, transplants, like all surgeries, come with some risks and the potential for complications.
“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.”
Patients have to take immune-suppressing medications to prevent organ rejection. Organ failure is a risk when people don’t follow this medication regimen correctly.
“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?
The survival odds after a liver transplant depend on many factors, including the patient’s age and overall health at the time of surgery.
For the most common type of transplant, when a person receives a liver from a deceased donor, the one-year survival rate is 86 percent and the five-year survival rate is 72 percent. More than half of patients survive at least 20 years.
