Liver Transplant

Liver transplant Treatment Hospitals in India

Liver Transplant

Liver transplant or hepatic transplant is the replacement of a diseased liver with the healthy liver from another person (allograft). Liver transplant is a treatment option for end-stage liver disease and acute liver failure, although availability of donor organs is a major limitation. The most common technique is orthotropic transplantation, in which the native liver is removed and replaced by the donor organ in the same anatomic position as the original liver.

 Liver transplantation or hepatic transplantation is the replacement of a diseased liver with the healthy liver from another person.

Liver Transplant

Liver transplantation is the replacement of a diseased liver with a healthy liver from another person. The liver may come from a deceased organ donor or from a living donor. Family members or individuals who are unrelated but make a good match may be able to donate a portion of their liver. This type of transplant is called a living transplant. Individuals who donate a portion of their liver can live healthy lives with the remaining liver.

An entire liver may be transplanted, or just a section. Because the liver is the only organ in the body able to regenerate, a transplanted portion of a liver can rebuild to normal capacity within weeks.

The donor liver is transported in a cooled salt-water (saline) solution that preserves the organ for up to 8 hours. The necessary tests can then be done to match the donor with the recipient.

The new liver is removed from the donor through a surgical cut in the upper abdomen. It is placed into the patient who needs the liver (called the recipient), and attached to the blood vessels and bile ducts. The operation may take up to 12 hours.

Reasons for the procedure

A liver transplant may be recommended for people who have end-stage liver disease (ESLD), a serious, life-threatening liver dysfunction. ESLD may result from various conditions of the liver.

The most common liver disease for which transplants are done is cirrhosis. Cirrhosis is a long-term disease of the liver in which a fiber-like tissue covers the organ and prevents toxins and poisonous substances from being removed. Other diseases that may progress to ESLD include, but are not limited to, the following:

1. Acute hepatic necrosis: This is the death of tissue in the liver.
2. Biliary atresia: A condition in which the bile ducts are absent or have developed abnormally.
3. Metabolic disease: Conditions that affect the chemical activity in cells that are affected by the liver.
4. Liver cancers: These are primary tumours (that start in the liver) that have not spread outside the liver.
5. Autoimmune hepatitis: A chronic inflammation of the liver, resulting in liver cell damage and destruction.

 

Causes of Acute Liver Failure

• Acetaminophen overdose: Taking large amount of acetaminophen is the most common cause of acute liver failure.
• Prescription medications: Some prescription medications, including antibiotics, no steroidal anti-inflammatory drugs and anticonvulsants, can cause acute liver failure.
• Herbal medications: Herbal drugs and supplements have been linked to live failure, as some kill cells in the liver.
• Hepatitis: Hepatitis A, hepatitis B and hepatitis E can cause acute liver failure. They lead to liver damage or cirrhosis
• Toxins:Eating poisonous wild mushrooms: A kind called Amanita phalloides, also known as death cap, contains toxins that damage liver cells and lead to liver failure within a couple of days
• Autoimmune hepatitis: A disease in which immune system attacks liver cells, causing inflammation and injury.
• Metabolic disease: Genetic disease prevents body from removing disease, it builds up and damages the liver.

 

Symptoms of Liver Disease and Liver Failure

Liver failure may be tough to diagnose at first, as liver failure symptoms are often similar to liver diseases. Early symptoms may include:-

• Fatigue
• Nausea
• Diarrhoea
• Loss of appetite

As these symptoms become more serious can leads to liver failure. These symptoms includes: -

• Jaundice
• Vomit of Blood
• Urine turning dark
• Blood in stool
• Swollen belly
• Mental confusion

 

Risks of the procedure

• As with any surgery, complications can occur. Some complications from liver transplantation may include, but are not limited to, the following:
• Bleeding
• Infection
• Blockage of the blood vessels to the new liver
• Leakage of bile or blockage of bile ducts
• Initial lack of function of new liver

The new liver may not function for a brief time after the transplant. The new liver may also be rejected. Rejection is a normal reaction of the body to a foreign object or tissue. When a new liver is transplanted into a recipient’s body, the immune system reacts to what it perceives as a threat and attacks the new organ, not realizing that the transplanted liver is beneficial. To allow the organ to survive in a new body, medications must be taken to trick the immune system into accepting the transplant and not attacking it as a foreign object.

Contraindications for liver transplantation include, but are not limited to, the following:

• Current or recurring infection that cannot be treated effectively.
• Metastatic cancer: This is cancer that has spread from its primary location to one or more additional locations in the body.
• Severe cardiac or other medical problems preventing the ability to tolerate the surgical procedure.
• Serious conditions other than the liver disease that would not improve after transplantation.
• Noncompliance with the treatment regimen..
• Alcohol consumption

There may be other risks depending on your specific medical condition. Be sure to discuss any concerns with your doctor prior to the procedure.

Liver donor requirements
Any member of the family, parent, sibling, child, spouse or a volunteer can donate their liver. The criteria for a liver donation include:

1. Being in good health
2. Having a blood type that matches or is compatible with the recipient’s
3. Being between 18 and 60 years old
4. Being of similar or bigger size than the recipient
5. Before one becomes a living donor, the donor must undergo testing to ensure that the individual is physically fit.

 

Technique:
The most commonly used technique is orthotropic transplantation, in which the native liver is removed and replaced by the donor organ in the same anatomic location as the original liver. The transplant operation can be conceptualized as consisting of the hepatectomy (liver removal) phase, the anhepatic (no liver) phase, and the post implantation phase. The operation is done through a large incision in the upper abdomen. The large majority of liver transplants use the entire liver from a non-living donor for the transplant, particularly for adult recipients. A major advance in paediatric liver transplantation was the development of reduced size liver transplantation, in which a portion of an adult liver is used for an infant or small child. Further developments in this area included split liver transplantation, in which one liver is used for transplants for two recipients, and living donor liver transplantation, in which a portion of a healthy person’s liver is removed and used as the allograft. Living donor liver transplantation for paediatric recipients involves removal of approximately 20% of the liver.