The liver has many functions, including building proteins and other substances for the body to use, removal of waste products and toxins from the blood, drug metabolism, and energy storage. Liver disease causes these crucial functions to fail. When liver failure is too severe to respond to medications, liver transplantation may be an option. Because transplantation is a major surgical procedure and there is a shortage of available donor organs, not every person with liver failure can receive a transplant. At each transplant center, a multidisciplinary team reviews and selects patients who are then placed on a waiting list for a suitable donor organ. These donor organs are allocated by the organ donor coordinators based on need (most severely ill persons) and compatibility of donor and recipient. The May 10, 2006, issue of JAMA includes an article about serious liver disease and liver transplantation.