Staying on top of MASH may mean not staying on the transplant list

The past two months have been a whirlwind. I had my left knee replaced in late October, which forced me to slow down and truly recuperate. The only reason I was even eligible for the surgery was the stability of my model for end-stage liver disease (MELD) score. I spiked once near the 20s, but for the past three years, my score has dipped lower than any doctor expected. (The scale ranges from six to 40, and the higher the MELD score, the sicker you are.)

Even so, there’s always the question that lingers: When will I need a transplant, and how long will I remain on the list?

This week, my transplant surgeon at one of the hospitals where I’m listed asked for updated liver labs. These moments always land with a little weight. Staying on the list if I need it — or exploring other options if I don’t — isn’t the kind of thing you can ignore. It’s heavy material to unpack as we tumble toward the end of a dizzying year.

To stay ahead of it all, I’ll be getting my labs drawn. I’m used to these surprise inspections of my liver. Several times a year, my inbox fills with reminders from various doctors about ultrasounds, scans, and blood work. I don’t mind the vigilance. In fact, I’m relieved that the only hospital trips I’ve had in the past few years were bone-related — a broken hip and now a total knee replacement — not liver-related. My liver has been behaving itself. So have I.

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August 25, 2025 News by Lila Levinson, PhD

Drug for fatty liver disease MASH may help prevent transplants

Living longer is worth the work in MASH

People often ask how I cope with the uncertainty of living with metabolic dysfunction-associated steatohepatitis (MASH). I tell them I stay mostly positive, but I also let the hard emotions surface when they need to. I eat foods that support my health. I take my medications. I abstain from alcohol. I listen to my doctors. Even with all of that, the thought of a liver transplant is still a lot to carry.

One of my long-standing hobbies is genealogy. I track down ancestors the way some people hunt for vintage vinyl. That includes learning who they were, who they loved, and, yes, how they died. Studying those patterns offers clues, though not always comfort. Families can be private or embarrassed about causes of death, and sometimes the truth is simply lost to time. Still, I often wish I knew more about the exact medical issues that ended my relatives’ lives.

I do know this: My mother had early fatty liver disease. It likely went undiscussed because her heart was the bigger threat. She died at 48 from complications after heart-valve surgery, a valve that had kept her alive for more than a decade. She died at the same age I was when doctors told me I was in liver failure. That year, I remember praying just to turn 49. Eight years later, I’m still here, still grateful, and still fighting.

The number of people with MASH who will need a liver transplant is expected to rise in the coming decades. Yet so much of this disease is preventable with education, vigilance, and perseverance. To me, living longer is worth the work.

If you’ve been diagnosed with MASH, learn the stage of your disease. Know your MELD score and what it means. Take it seriously. Yes, a transplant can save lives, but organs aren’t sitting on a shelf at the neighborhood convenience store. Staying on the transplant list is not something to take lightly. And here’s the beautiful twist: Doing everything you can to take care of your liver is the best possible reason to be removed from that list.

Note: Liver Disease News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Liver Disease News or its parent company, Bionews, and are intended to spark discussion about issues pertaining to liver disease.

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