No cause of death has been determined for actor Michelle Trachtenberg, whose body was found on Wednesday at her Upper West Side home, according to the New York City chief medical examiner’s office.
A source told NBC New York that Trachtenberg, 39, had recently received a liver transplant. It is not known whether she suffered complications from that surgery.
Three doctors who research or treat liver disease said that complications, such as infections or blood clots, are somewhat expected after a transplant, but patient outcomes are generally positive. The five-year survival rate exceeds 75%.
“Typically, by the time that someone is leaving the hospital, there are usually all indications that the liver is working,” said Dr. Danielle Brandman, medical director for liver disease and transplantation at NewYork-Presbyterian and Weill Cornell Medicine.
Some serious complications that may arise after surgery include heart attacks and breakages or clots in the arteries or veins where the new liver was attached, which can lead to liver failure.
In other cases, medications prescribed after surgery may generate high levels of potassium in the blood, causing irregular heartbeats, said Dr. Elliot Tapper, an associate professor of hepatology at the University of Michigan.
“This is one of the most involved surgeries that can be done,” he said. “People are sick afterwards. They’re usually weak or they’ve had an infection or some minor complication, and they’ll need somebody to help them with their activities of daily living.”
Transplants are typically reserved for people whose livers have sustained irreversible damage, leaving them no other options. Around 10,000 people receive liver transplants annually in the U.S., and 24,000 are on a waiting list at any given time.
The reasons Trachtenberg received the transplant are not known. Nationwide, alcohol-related liver disease is the most common reason for a liver transplant — around 41% of recipients in 2023 had alcohol-related liver disease as their primary diagnosis. Fatty liver disease, a condition linked to obesity and diabetes that is characterized by fat buildup in the liver, made up the second largest share: 20%.
Other, less common reasons for a transplant include liver cancer, viral hepatitis and autoimmune conditions.
In recent years, some fans of Trachtenberg — who is best known for her roles on “Buffy the Vampire Slayer” and “Gossip Girl” — had remarked on social media that she looked ill and had lost weight. But more than a year ago, Trachtenberg responded to comments on her Instagram page about her appearance, telling people she was “happy and healthy.”
The doctors interviewed said that rates of both fatty liver disease and alcohol-related liver disease are rising among young adults, though the conditions can affect people of all ages.
“We’ve definitely seen increases in alcohol-related liver disease and need for liver transplant in patients in the 20s to 30s range, particularly that 30s range,” Brandman said.
Tapper said the issue can largely be attributed to lifestyle factors.
“The nation’s livers are not as healthy as they used to be,” he said. “There’s more fat in the liver because of diet, obesity and the epidemic of diabetes. People binge-drinking is more common in younger generations than it ever had been before.”
People who require liver transplants typically have cirrhosis, a condition in which healthy tissue in the liver is replaced with scar tissue caused by swelling and inflammation. This scarring prevents the liver from carrying out vital tasks like filtering toxins from the blood and helping the body digest food and convert it into energy.
Those who have reached this point, known as end-stage liver disease, may experience confusion, weight loss and yellow discoloration in the skin and eyes, among other symptoms.
Most transplanted livers come from deceased donors, but a minority of patients have part of their liver replaced with a section from a living, healthy person.
Transplant recipients usually need to take lifelong medication to prevent their bodies from attacking the donor organ — what’s known as “rejection.” The risk of rejection is highest within the first six months.
“We pick up rejection by looking at liver enzymes in the blood, and then we have a protocol to treat that before it becomes a serious problem,” Tapper said. “So rejection that you can’t get ahead of is actually super rare.”
Dr. Brian Lee, a hepatologist and liver transplant specialist with Keck Medicine of USC, a medical system affiliated with the University of Southern California, said transplant outcomes could be improved if more doctors referred patients earlier in the course of their disease.
“There are so many patients who die from liver disease because they weren’t referred at all, or they weren’t referred early enough for a liver transplant,” he said.
Tapper said it’s also important to reduce risk factors that lead to liver disease in the first place, such as excessive alcohol use, high sugar intake and limited physical activity.
“I would rather people not need a liver transplant,” he said.
