Liver Transplant: All You Need to Know About it

Indilens Health Team: Liver is a vital organ in the human body, a literal power house, it plays a crucial role in the digestive system. It has more than 500 functions in the body which include purifying the blood. Simply put, a healthy liver means a healthy body.

Sustained and chronic insult to the liver will damage it permanently. This will result in a life-threatening situation, and the patient must undergo liver transplantation. In Liver transplantation, the damaged liver is removed completely and replaced with a healthy one through surgery.

Liver damage in the beginning may go undetected unless blood tests are done in time.  If recognized early, it may be possible to prevent further damage by correcting life style, using antiviral drugs and by quitting alcohol. This section will take you through causes of liver disease, describe the symptoms and detail the treatment options that are available. As liver transplant is needed in most cases of end stage liver damage, we feel it is important to be aware of this treatment option as a new liver has the potential of turning death to life.

Know the Causes:

• Generalised scarring of the liver, which is called Cirrhosis, is the last stage of chronic liver damage.
• Viral attacks of viruses like Hepatitis B and C can infect the liver, thereby leading to liver failure. This can become a serious condition if it is not treated well in time.
• Excessive and regular intake of alcohol for a long interval of time causes liver damage.
• In the modern era, fatty liver from a sedentary life style, overweight and coexisting diabetes may lead to Non Alcoholic Steatohepatitis (NASH) and cirrhosis.
• There are many other causes and a liver specialist will often be able to tell you what has caused the liver damage.

What are the Symptoms?

• Fatigue is one of the commonest symptoms of liver disease together with ankle swelling of both legs.
• Abdominal symptoms such as right sided pain around the costal margin, acid reflux, bloating in the abdomen, nausea, and vomiting may be present. However these are very nonspecific and may have many other causes.
• Body changes including itchy skin, yellow eyes, bad breath, redness of palms and red spots and change in weight.
• Gum bleeding, blood vomit, black stools often appear in late stages.
• Overweight patients with or without diabetes should be screened for presence of liver disease.
• An ultrasound report of fatty liver may be the first indication of serious liver disease. A modest weight loss will oten correct the fatty change in liver.

If you have read the list and feel that your body has been showing these symptoms, then we advise you to visit any of the liver hospitals in Delhi like Max Healthcare and consult a doctor about your condition.  If you are aware or you have been told that you have advanced liver disease, then you must consider the possibility of liver transplant and collect as much as information.

Broadly, liver transplant operation can be of two types.

1. Deceased Donor Liver Transplantation (DDLT)

In this type of liver transplantation, a diseased liver is replaced with a healthy liver from a donor who has recently died. Patients had to go through few tests to make sure they are fit enough for the transplant. Following the tests, the patients get enrolled into the waiting list of the transplant center.

As soon as a family has given consent, the recipient is asked to get admitted and the surgery has to be performed within 6 hours otherwise the cadavaeric liver will get damaged.

2. Living Donor Liver Transplantation (LDLT)

LDLT involves a transplant in which a healthy liver is donated to the patient by a living person, mostly a relative of the patient. A part of the patient’s damaged liver is replaced with the healthy one which later grows to its normal size due to the regeneration capacity of the liver. This type of transplantation is highly successful as it is a planned surgery and eliminates waiting list for organ availability. There have been concerns about donor safety but many large centres such as the Max team have now reported no mortality after 2000 consecutive donations.

Liver Transplant is a serious operation and critical attention to detail before and after surgery is necessary for a successful outcome. A good hospital and caring team plays an essential role and therefore one should choose a team very carefully. The team in Max Hospital, Saket has experience of over 2500 liver transplant operations.

The Transplant Surgery

The surgery usually takes between 12 to 16 hours. If the recipient’s condition is stable, admission can be planned one day before the planned surgery. However, quite often the recipient’s condition is critical and will need to be stabilized by few days of admission. Both the donor and the recipient have undergone extensive work up prior to their transplant. Permission from The Hospital Government Ethical Committee must be taken prior to transplantation by interviewing and conseling the pair.

Postoperative care

The donor is taken out of anesthesia after the completion of surgery. The recipient is moved to the intensive care unit where he usually stays for another 2 weeks.  During this period, the functioning of the graft is monitored by blood tests and ultrasound examinations. Antirejection medicines are given to the patient so that the new liver is accepted by the body. The side effects of these medicines need to be monitored and include monitoring of kidney function and development of unusual infections.  Most recipients are discharged at the end of 3 weeks but liver function need to be monitored at regular interval  in the first year after transplant. At the end of 6 weeks, life becomes normal for the patient and they can go back to work.