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Liver Late Effects

Rarely, some treatments for childhood cancer may damage the liver.

How the Liver Functions

The liver is a triangular-shaped organ located under the rib cage on the right side of the body. It helps clear wastes from the blood, makes bile to help digest food, produces blood-clotting proteins, and stores energy to fuel the body.

A graphic of a liver, showing the triangular shape and the yellow falciform ligament on top.

Risk Factors for Liver Health

Cancer treatments

Other risk factors

  • Chronic graft-versus-host disease (cGVHD)
  • Multiple blood transfusions
  • Surgical removal of a significant portion of the liver
  • Pre-existing liver problems
  • Hepatitis 
  • Excessive alcohol drinking

What Survivors Can Do

Know Your Risks and Monitor Your Health

Ask your oncologist about your risks of developing late effects.

Inform your primary health care provider about your risks. Share a copy of your Survivorship Care Plan, which includes a treatment summary.

Have a yearly physical examination. Your provider may check for liver enlargement and order tests to monitor liver health. If problems are identified, the provider may refer you to a liver specialist for evaluation and further testing.

Survivors may have tests for liver function when they enter long-term follow-up care through their pediatric cancer center.

Blood tests to monitor the liver include:

  • Liver enzyme tests – These tests monitor levels of proteins normally present inside liver cells. If liver cells are damaged, these proteins can leak out, causing high blood levels of liver enzymes.
  • Liver function tests – These tests show how well the liver is working. Common liver function tests include:
    • Bilirubin, a waste product formed during the breakdown of red blood cells
    • Albumin, a blood protein produced by the liver
    • Prothrombin Time (PT), a measure of blood clotting
  • Tests for liver infection – Specific tests for viral hepatitis A, B, and C
  • Tests to check for iron overload that may occur after multiple transfusions

Maintain Good Liver Health

Survivors can take steps to keep their liver healthy:

  • If you do not have immunity to hepatitis A and B, get immunized. A blood test for Hepatitis A and B antibodies will indicate immunity.
  • If you drink alcohol, consume it in moderation.
  • Eat a well-balanced diet high in fiber and low in fatty, smoked, and cured foods.
  • Drink plenty of water.
  • Maintain a healthy body weight.
  • Take recommended doses of medications.
  • Check with a health care provider before taking new over-the-counter medications, herbs or supplements.
  • If you are sexually active, use latex condoms during intimate sexual contact.
  • Avoid exposure to solvents, aerosol cleaners, insecticides, paint thinners, and other toxins.
  • Do not use illegal drugs.


Reviewed: June 2018