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 and when the failure is too severe to respond to medication liver transplantation may be an option.
As liver transplantation is a major surgical procedure, the patients and the family have quite a lot of concern areas.
The information contained herein is of general nature and should not be construed as specific medical advice. Please consult your doctor for more details.
What does my liver do?
What are the signs of liver problems?
Some signs of liver problem are
- Feeling weak and sick in your stomach and losing appetite
- Muscle wasting (becoming skin and bones)
- Fluid build-up in the abdomen (ascites)
- Yellow skin and eyes (jaundice)
- Forgetfulness, confusion or coma (encephalopathy)
- Swollen hands / legs
- Bruising, bleeding easily and nose bleeds
- Blood in vomitus, bloody / black bowel movements
What is Liver Transplantation?
Liver transplantation is surgery to remove a diseased liver and replace it with a healthy one. This kind of surgery has been done for four decades. Across the world thousands of people have had liver transplants and now lead normal lives.
Being tired and losing your appetite can be signs of liver problems. Liver transplants can help adults and children.
What are the reasons for needing a liver transplant?
In adults, the most common reason for liver transplantation is Liver cirrhosis. Cirrhosis is caused by many different types of liver injuries that destroy healthy liver cells and replace them with scar tissue. Cirrhosis can be caused by viruses such as hepatitis B and C, alcohol, autoimmune liver diseases, build-up of fat in the liver, and hereditary liver diseases. Sometimes the cause of liver cirrhosis is not known.
In children, the most common reason for liver transplantation is billiary atresia. Bile ducts, which are tubes that carry bile out of the liver, are missing or damaged in this disease and obstructed bile causes cirrhosis. Bile helps digest food.
Other reasons for needing liver transplantation are certain liver cancers, benign liver tumours and hereditary diseases.
Sudden or rapidly developing liver failure may sometimes affect children and adults. The common causes are certain viral illnesses and reaction to some medicines like excess dose of pain killers and even certain herbal / traditional medicines. A liver transplant can save life if undertaken at the right time.
How will I know whether I need a liver transplant?
Based on your sickness and liver disease status, your doctor may recommend you to the liver transplant unit for further evaluation. You will meet the liver transplant team. The team is usually led by a liver transplant surgeon and includes liver specialists (hepatologists), nurses, and other health care professionals. The transplant team will arrange blood tests, x rays, and other tests to help make the decision about whether you need a transplant and whether a transplant can be carried out safely.
Other aspects of your health like the condition of your heart, lungs, kidneys, immune system, and mental health will also be checked to be sure you’re strong enough for surgery.
Can anyone with liver problems get a transplant?
You cannot have a transplant if you have
How long does it take to get a new liver?
If the transplant team recommends that you need a transplant, you will be counselled regarding your options of living donor liver transplant or cadaver liver transplant.
If you have a living donor in your family, your waiting time could be as short as one week. The living donors and donated livers are tested before transplant surgery. The testing makes sure the liver is healthy, matches your blood type, and is the right size so that it has the best chance of working in your body.
In case you do not have a living donor, your name will be placed on a waiting list with your consent. Your blood type, body size and how sick you are, plays a role in deciding your place on the list. Currently, the sickest people are at the top of the list, so you may have to wait your turn.
While you wait for a new liver, you and your doctor should talk about what you can do to stay strong for the surgery. You will also start learning about taking care of a new liver.
Where do the livers for transplantation come from?
Whole livers come from people who are brain dead (heart beat still present). These people are on breathing machines in various hospital ICUs. This type of donor is called a “cadaveric donor”. Alternatively a healthy person in the family can donate a part of his or her liver for the patient with liver failure. This kind of donor is called a ‘living donor’. More information on living donor liver transplantation is included in latter part of this article.
Financial resources / Health Insurance
You should check to be sure that you will be able to cover the cost of liver transplantation and prescription medicines. You will need certain medicines after the surgery and some for the rest of your life.
What happens in the hospital?
When the liver is available, you will be prepared for the surgery. If your new liver is from a living donor, both you and the donor will be in surgery at the same time. If your new liver is from a person who has recently died, your surgery will start when the new liver arrives at the hospital.
The surgery can take from 6 to 14 hours. While the surgeon removes your diseased liver, other doctors will prepare the new liver. The surgeon will disconnect your diseased liver from your bile ducts and blood vessels before removing it. The blood that flows into your liver will be blocked or sent through a machine to return to the rest of your body. The surgeon will put the healthy liver in place and reconnect it to your bile ducts and blood vessels. Your blood will then flow into your new liver.
You will stay in the hospital for an average of 2 to 3 weeks to be sure your new liver is working. You will take medicines to prevent rejection of your new liver and to prevent infections. Your doctor will check for bleeding, infections and rejection. During this time you will start to learn how to take care of yourself and use your medicines to protect your new liver after you go home. In the hospital, you will slowly start eating again. You will start with clear liquids, then switch to solid food as your new liver starts to work.
Know more about Liver Transplantation continues in Part -2 – Click Here
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