Liver transplant

Liver Transplant

Liver transplantation is the surgery performed to replace diseased liver with healthy liver from any organ donor.

Types of liver transplantation procedures:

  1. Orthotropic Transplantation – The whole diseased liver is replaced with healthy liver. It’s the most common liver transplantation procedure performed.
  2. Heterotrophic Transplantation Diseased liver is not removed. Additional donor liver is put at another site
  3. Reduced-Size liver Transplantation – Whole diseased liver is replaced by portion of healthy liver donated. This procedure is commonly performed for children.

Why it is needed?

Transplantation of liver is advised for patients who has last/ end stage of liver disease, but otherwise fit, fulfilling criteria for liver transplantation. Conditions in which liver transplantation is prescribed includes:

  • Liver Cirrhosis – caused due to chronic alcoholism or for some unknown reason
  • Chronic liver disease(Hepatitis) which leads to irreversible scarring of the liver and billiary system
  • Acute liver failure
  • Cryptogenic liver disease
  • Biliary atresia –incomplete development of bile duct, is common reason for transplantation in children

Advantages and Disadvantages

Advantages

  • Successful liver transplantation saves the lives of dying patients. Approximately 75-80% patients live for 3 or more years after transplantation
  • Patients can lead a completely normal life after transplantation

Disadvantages

  • It is very expensive
  • Long waiting period for healthy donor organ
  • Patient has to take immunosuppressive drugs lifelong. Transplantation may make patients more susceptible to develop infections.
  • Patients might suffer from different side effects due to steroids or medicines
  • Transplant rejection. It occurs in approx 2to 5% of all patients

Pre-operative and Post-operative Care

Preoperative preparation

  • Full-body physical examination
  • Blood test, liver and kidney function tests
  • Urinalysis
  • USG of the abdomen, CT scan
  • Relatives and patient are informed regarding the procedure, including risks and follow up care
  • Surgeon consultation week before to ascertain medicine required and medicines stopped
  • Have an arrangement with family and/or friends for help after surgery
  • Arrangement of blood transfusion, if required during or post-surgery
  • Preparation of  home as required for recovery after surgery
  • Do not drink or eat post after midnight, the night before surgery
  • Medical tourist is advised to plan maximum time for the trip

Post operative care

  • The patient is kept in ICU after surgery for 3-4 days. Vital signs are monitored. After patient stabilizes, he/she is shifted to room and monitored. 1-3 weeks of hospital stay is required
  • Liquid diet post-surgery then switched to low salt solids gradually
  • The patient is allowed to slowly walk then resume normal life gradually
  • Patients are instructed about dressing care, symptoms of infection or rejection before hospital discharge. Patients required to take extreme care for the first 3 months after surgery to avoid any infection