Cirrhosis occurs when the liver is severely scarred and not functioning properly. Cirrhosis results from many years of liver injury from a wide variety of conditions like fatty liver, Hepatitis C, and excess alcohol use. People with cirrhosis often develop “decompensation” whereby their brain function can deteriorate (hepatic encephalopathy), they can retain fluid in their abdomen (ascites), and they can have large blood vessels in their swallowing tube (esophageal varices) that sometimes bleed profusely. Patients with cirrhosis are at greatly increased risk for forming liver cancer and need to be screened for this with ultrasound exams every six months. When our patients develop severe liver cirrhosis, we refer them to the liver transplant teams at either UPMC or Allegheny General Hospital. A recent advance has been living-donor liver transplant whereby patients can have a friend or family member donate a portion of their liver. This is fairly safe and allows an extremely ill cirrhosis patient to get transplanted much more quickly.