What is a Liver Transplant - Procedure, Age Limits, Risks Involved - Health Education - DesiMD Healthcare - India
Health Education

Liver Transplant

Dr.Subba Rao Kanchustambam profile Authored by Dr.Subba Rao Kanchustambam on 12 May 2014 - 22:43.
 
Transplanting is a procedure, where a new organ replaces a damaged organ. It can be an eye or heart or kidney or a liver or a pancreas. The new organ can be from a brain dead person when it is called deceased donor transplant or a live donor which is termed as live donor transplant.
What is a liver transplant?
Transplanting an unhealthy liver with a healthy liver is called Liver Transplant. Liver transplant can be done in two ways. Liver is the only organ in the body which can regenerate. This property of liver is used in liver transplantation where a part of liver donated by patient’s blood relation is transplanted and is called living donor liver transplantation.
The donor should be young, preferably <50yrs and healthy.  The other type is a deceased donor liver transplant where in the whole liver from a brain dead donor is utilized to replace the damaged liver.
Who needs a liver transplant?
Liver transplant is a life-saving procedure and is required for any one whose liver is damaged by any cause. Sometimes liver can be damaged in a short span commonly with drugs when it is termed acute liver failure.
What causes liver damage?
Following are the prominent causes of liver damage:
  • Hepatitis (B and C)
     
  • Alcohol consumption
     
  • Absence or abnormal bile ducts (biliary atresia)
     
  • Metabolic diseases like diabetes
     
  • Early stages of Liver cancer
     
  • Primary sclerosing cholangitis/Primary Biliary cirrhosis
     
  • Wilson's disease
     
  • Genetic disorder (Hemochromatosis)
     
  • Overdose of certain drugs including Acetaminophen
     
  • Adverse reaction to some herbal preparations.
Are there any age limits to get the liver transplant done?
Liver transplant is a major procedure and generally not recommended for those who are more than 70yrs.
Can a male donate a liver to a female?
Yes, male can donate liver to female or vice versa, provided both (donor and patient) are tissue compatible and have other (desired) matching parameters.
 
What to expect?
Before the liver transplant:
  • Pre transplant evaluation or work up
  • Thorough testing of a donor and recipient (who receives the organ) is performed before transplant. The testing procedure includes:

o   Social and psychological parameters including monetary or insurance support, family history and support.

o   Blood examinations to test matching of blood group and other parameters.

o   X-rays, ultra-sonogram, CT scan and several other examinations may be performed to check for overall health.

  • The living donor has to undergo committee interview and clearance prior to transplant and sometimes needs DNA testing to prove the relation
     
  • Pre transplant meeting where all transplant physicians, surgeons, radiologists, anesthesiologist would discuss whether patient and donor are suitable candidates for the procedure. If the patient is not fit it will be rejected and conveyed to the family, if the patient is fit, date will be given for the transplant.
     
  • The procedure is done under anesthesia.
     
Transplant Procedure:
  • Both donor and the recipient are admitted a day prior to surgery
     
  • Routine blood tests are done. Required blood and blood products are cross matched and kept ready.
     
  • On the day of procedure donor is taken up first followed by the recipient.
     
  • The damaged liver is carefully removed and the new liver( part of Living donor or whole liver of brain dead donor) is placed in its place.
     
  • The newly implanted liver will be connected to the blood vessels and bile duct.
     
  • The new liver starts working immediately and this will be know by good bile production and clearance of acids in the body etc.
     
  • Shifted to ICU with artificial ventilator support.
     
  • You will be closely observed in Intensive care unit for any bleeding, infections, rejection etc.
     
  • Shifted to the ward after 5-7 days of ICU stay.
     
  • A hospital stay of approximately 14 to 21 days is required to monitor the patient condition, monitor drug levels etc.
     
How long does the procedure take?
It is a lengthy procedure and it may vary from 8hrs to 15 hrs. 
What are the risks involved in liver transplantation surgery?
The liver transplant may have the following risk factors during transplantation:
  • Blood loss
     
  • Increased susceptibility to various infections
     
  • Chocking of the blood vessels in the newly transplanted liver
     
  • Leakage of the bile ducts
     
  • Blockage of the bile ducts
     
  • Improper functioning of the newly transplanted liver
     
  • Rejection of the body to the new liver
     
  • Blood clots
     
  • Kidney problems
Are there any side effects of anti-rejection medications?
Doctor will often prescribe medications to avoid rejection of the donated liver. These medications may cause the following side effects:
  • Thinning of the bones
     
  • Hypertension
     
  • Increased blood sugar (diabetes)
     
  • Severe headache
     
  • Diarrhea
     
What care do I need to take, after the liver transplant?
You may have to take care of the following things:
  • Keep the surgical site clean and dry and follow bathing instructions.
     
  • Avoid driving for 6-8 weeks
     
  • Restrict some of the other physical activities like rigorous exercise.
     
  • Stop drinking alcohol completely
     
  • Stop smoking
     
  • Take prescribed medications without skipping.
     
When to see a doctor immediately?
Visit your doctor immediately in case of the following:
  • Sudden raise in body temperature
     
  • Abnormal bleeding or drainage
     
  • Swelling and pain at the surgical site
     
  • Redness
     
  • Vomiting
     
  • Diarrhea
How much time will it take to get completely recovered?
It may take few weeks to few months to get back to normal routine depending on whether recovery is smooth or complicated. In general, 70 to 75 percent of people who had liver transplant are found to survive for 5 years after the procedure. Donors of “part of liver” might experience minor complications during 10-day hospital stay, but there are no long term problems.
*Disclaimer
*Disclaimer: This is not medical advice. The content is for educational purposes only. Please contact your doctor for any health care issues.