Liver Transplant – Why Is It Done?
The liver which is located below the diaphragm on the right side of the abdomen, is the largest internal organ of our bodies, with the weight of about 3 pounds in adults.
Liver transplant or hepatic transplantation is a surgical operation that replaces the diseased liver with a healthy liver from a liver donor. Liver transplantation is needed in case of a liver failure occurring because of metabolic disorders, alcohol abuse (alcoholic liver disease) or chronic liver diseases such as liver cancer, cirrhosis, biliary atresia, hepatitis B, hepatitis C. The liver has an outstanding ability to repair itself in response to any injury. However, repeated injury and repair cycles over many years scar the liver permanently. The end stage of this scarring is called cirrhosis, and this is the point where the liver can no longer repair itself.
According to a study published in the American Journal of Transplantation in 2018, people who have a liver transplant have 89% of life expectancy after one year. The five-year survival rate is 75%. Although the rates are high, sometimes the transplanted liver can fail, or the original disease may come back. It’s very important that your surgeon monitors your recovery to detect any problems and examining your regular blood tests.
Here we have prepared a short guide includes the most important facts about the life-saving liver transplantation procedure. We hope it will be beneficial for whom wants to understand the whole process better.
Liver Transplant Surgery – How Is It Performed?
Liver transplant surgery generally takes between 6 to 12 hours. During the operation, the surgeon removes the non-functioning liver and replaces it with the healthy donor liver. As this is a major procedure, the surgeon needs to place several tubes in your body in order them to help your body carry out certain functions during the operation and for a few days after it.
There are two common types of liver transplantation:
Orthotopic Transplant: It is the most common type of liver transplant procedure in which a liver is replaced with a whole healthy liver taken from a deceased donor. The surgeon will make an incision in the patient’s abdomen and remove the liver. Then he/she will place the healthy liver and close the incision.
Living Donor Transplant: In living donor transplantation, the donor is usually chosen from a close family member. The surgeon replaces the patient's liver with half of the donor's liver (either left or right side). Because the right side of the liver is bigger, it is recommended for adult patients whereas the left side is recommended for children. Living donor liver transplantation is challenging but necessarily increasing. Because patients need lifelong aftercare after liver transplant surgery, it is important for the healthcare team to understand the basic medical problems, indications, and risks related to the whole process of liver transplantation.
Liver Transplant Waiting List
As in kidney transplant and any other organ transplant surgery, when you need a liver transplant, your name is written to the national waiting list. Your place in the liver transplant queue is defined depending on your MELD (The Model for End-Stage Liver Disease) score criteria. This individual score determines how urgently you need a liver transplant. This score is calculated by the results of some laboratory tests such as Bilirubin, INR (Prothrombin Time Test) and Creatinine.
If you are accepted suitable for a liver transplant, you'll need to wait for a healthy donor liver to become available, which may take several months or more. Waiting for a liver transplant takes 150 days for adult patients and 75 days for children on average.
However, some circumstances may shorten your liver waiting time. If one of your close family members have the same blood type as you, he/she may be a live donor for you. The liver transplant from a live donor neither increases nor decreases the cost of the liver transplant. The cost still includes the whole treatment expenses.
Liver Transplant Risks and Complications
The biggest risk of liver transplantation is transplant failure. This condition occurs when your immune system recognizes the new liver as being foreign and harmful to your body and does not accept it. This condition is also called as liver or hepatic graft rejection. Other long-term liver transplant complications and risks may include:
- Post-traumatic hepatectomy
- Bile duct leaks
- Shrinking of bile ducts
- Blood clots
- Mental confusion or seizures
- Thrombosis of the hepatic artery occurred within 15 days after liver transplantation
Liver Transplant Side Effects
Side effects of liver transplant generally emerge because of medications for anti-rejection of the transplanted liver and may include:
- High blood pressure (hypertension)
- Hair loss
- High cholesterol
- Upset stomach
- Bone thinning
Liver Transplant Recovery
Recovering from a liver transplant generally needs a two to three weeks of hospital stay. Some patients may be discharged in less time, while others may need much longer stay, depending on any complications that may arise afterward. It is important to be prepared for both possibilities. In your liver transplant recovery time, your doctor will make thorough monitoring and evaluation of your healing process. You will take a number of medications to prevent transplant failure after your surgery; some of the medications may be taken a lifetime.
You may be able to do your normal activities and go back to work a few months after your liver transplant surgery. Fully recovering from liver transplantation may take six months or more.
This content is edited by Flymedi Medical Editors in April 2019.