The liver cannot be propped up indefinitely during end stage liver disease (decompensated cirrhosis). Unlike the kidneys or the heart the liver cannot be kept going artificially. Ultimately the liver will fail completely and unless a transplant is performed the patient will die.
Liver transplants, despite the complexity and risks of the operation have a good success rate. Over 80% of liver transplants are considered successful; success is defined as being able to enjoy a normal or near normal life within a year of the transplant. Survival rates have improved considerably with major advances in surgical techniques, more experience with post-transplant medical management and better immunosuppressive drugs to counter the bodys attempts to reject a new liver.
There are between 600 - 700 liver transplants a year in the UK. Between 1 April 2006 and 31 March 2007 a total of 647 patients received a liver transplant (inclusdes 8 living donor transplants) and in 2007-2008 638 patients received a liver transplant (includes 20 living donor transplants). The number of people waiting for a liver transplant has risen from 199 in 1997/8 to 268 on 31st March 2008. Transplants are only carried out at specialist units. There are seven transplant units in the UK, six across England and one in Scotland. At 31 March 2008 there were about 6,000 recipients with a functioning liver transplant being followed-up.
In Britain HCV is the second most common cause of liver transplants. Alcohol-related liver disease is the most common cause. Between 2001 and 2005 there were 3,365 liver transplants. 459 of these were carried out on people with HCV induced cirrhosis.
Survival rates for liver transplants for people with HCV between 2001 and 2005 at three months, one year and three years were 90.1%, 83.98%, and 73.6.%, respectively.
Currently, the waiting time for low-risk patients in the UK is on average 18 months. This is because the number of transplants is limited by the availability of donor organs. Around 200 people are waiting for a liver transplant at any one time.
The limited supply of donor livers and the increase in the number of people waiting for transplantation led to the creation of a national organ scheme to ensure equality of access to treatment across the whole country. Organs are now seen as a national resource. Whilst research and the development of new transplant techniques have increased the use made of donated organs, the shortfall in donors means that some people die waiting for a liver to be become available or their health deteriorates to the extent that they are unable to undergo the operation.
Between 2001 and 2005 351 people died while waiting for a liver transplant. and 41 of them were hepatitis C patients.
At present in the UK, we have the system of contracting or opting in for organ donation. This relies on individuals making a conscious decision to donate organs after death. There are currently 15,685,896 million (25% of the population) people registered on the NHS Organ Donor Register.
To read the latest information about Opt In or Opt out 
Some European countries (Belgium, Spain and Austria) have introduced a system of opting out, where consent is presumed unless there is evidence that it is against the patients wishes or if relatives of the dead person object.
To find out more about signing up to the organ donor register
