Liver transplantation or hepatic transplantation is a surgical procedure that replaces a patient's diseased liver with a whole or partial healthy liver from a living or deceased donor. If your liver fails or stops working properly, a liver transplant can save your life. The liver is a vital organ of our body. It helps to digest food, store energy, and remove toxins from the body.
Although a liver transplant may treat acute liver failure, it is more often used to treat chronic liver failure. Chronic liver failure occurs slowly over months and years. Chronic liver failure may be caused by a variety of conditions. The most common cause of chronic liver failure is scarring of the liver (cirrhosis). When cirrhosis occurs, scar tissue replaces normal liver tissue and causes the liver to not function properly.
Causes for Liver Failure
Liver failure occurs when large parts of the liver become damaged beyond repair and the liver is no longer able to function. The most common reason for a transplant in adults is cirrhosis. This is scarring of the liver, caused by injury or long-term disease.
The most common causes of chronic liver failure (where the liver fails over months to years) include:
- Hepatitis B
- Hepatitis C
- Long-term alcohol consumption
- Autoimmune disease
- Cancer or tumors
- Hemochromatosis (an inherited disorder that causes the body to absorb and store too much iron)
Many cases of acute liver failure have no apparent cause.
Symptoms for Liver Failure
- Liver failure may be initially difficult to diagnose as the initial symptoms are often ones that can be due to number of conditions. These early symptoms include:
- Loss of appetite
However, as liver failure progresses, the symptoms become more serious, requiring urgent attention. These symptoms include:
- Bleeding easily
- Swollen abdomen
- Mental disorientation or confusion (known as hepatic encephalopathy)
Candidate for Liver Transplantation
Any patient that will die without a liver transplant is a candidate for the procedure. Liver cancer patients are good candidates for the procedure provided the cancer has not spread. A candidate for liver transplant needs to be in good heart and lung health as well. Somebody with systemic or uncontrolled infections, severe pulmonary hypertension or is active in substance (alcohol/drug) abuse is not a good candidate for the procedure.
Step 1 : Review of Reports and case analysis by LiverTransplant Team on the basis of available medical reports.
Step 2 : Recipient (Patient) and Donor undergo pre-transplant work up.
Step 3 : Donor compatibility is assessed by the transplant team based on HLA testing. If the HLA type of the patient matches with the donor, then it is more probable that the patient’s body will not reject the Liver. The No-Objection Certificate issued to the patient by the High Commission of the native country in India is submitted at the hospital.
Step 4 : Case forwarded to the transplant committee for approval.Patient submits all necessary documents to the transplant committee for approval of transplant.
Step 5 : Committee approval (May take 2-4 weeks after submission of all the necessary documents).
Step 6 : Patient undergoes transplant after Transplant Committee’s approval.
The Liver transplant surgery is a very complex procedure which is performed under general anaesthesia. Procedure usually takes 4 to 14 hours. During the operation, surgeons will remove failed liver and will replace it with the healthy donor liver.
The surgeon will disconnect diseased liver from bile ducts and blood vessels before removing it. The blood flowing into your liver will be blocked or sent through a machine to return to the rest of your body. The surgeon will then put the healthy liver in place and reconnect it to the bile ducts and blood vessels. The blood will then flow into new liver. You’re then taken to the intensive care unit to begin recovery.
One has to take immunosuppressant drugs after the procedure, throughout the life so that the body does not reject the new liver and for preserving its function.
After the procedure, patient is taken to the intensive care unit, where there is very careful monitoring of all body functions, including the liver. Once the patient is transferred to the ward, the frequency of blood testing, etc. is decreased, eating isallowed and physiotherapy is prescribed to regain muscle strength. The drug or drugs to prevent rejection are initially given by vein, but later by mouth.
The average hospital stay after liver transplant procedure is two weeks to three weeks. Some patients may be discharged in less time, while others may be in the hospital for much longer, depending on how the new liver is working and on complications that may arise. One has to be prepared for both possibilities.
After a successful Liver Transplant, the new Liver will filter blood, and patient will no longer need dialysis.
The results of Liver Transplantation procedure are satisfying and good. The life expectancy of more than 90% patient who underwent live donor Liver Transplant increases by 5 years and of 80% patient increases by more than 10 years.