Liver Transplant  

Liver Transplant

The liver is a vital organ that performs hundreds of jobs in the body. This delicate organ processes toxins and drugs to maintain healthy blood sugar levels regulates blood clotting, and much more. The liver requires a steady supply of oxygen and nutrients to function properly. It is so important that the body will regrow it if part of the liver is removed.

The liver is a very important organ that performs several vital functions. It controls the majority of chemical levels in the blood, excretes bile to aid in the removal of waste materials from the body, aids in digestion by breaking down food into usable nutrients, regulates blood clotting, cleans toxins from cells, and helps form red blood cells. The liver also breaks down medications so that they can be metabolized safely by other organs and cleanses toxins from cells by storing them as ammonia until they can be expelled through urine or bowel movements.

What Is A Liver Transplant?

A liver transplant is a procedure through which a person who has end-stage liver disease and/or acute liver failure receives a new liver from a donor. During surgery, the diseased liver will be removed and replaced with a healthy liver or a segment of a liver from the donor person. A liver transplant is an effective treatment for end-stage liver disease because it is considered to be curative. When you suffer from a liver disorder, it is more than likely that your body has already tried to naturally fight against it.

Liver Transplantation

However, if the liver disorder keeps progressing and there is no medical treatment that has brought success, then you may qualify for a liver transplant. When a candidate suffers from some of the next liver ailments there is a need for a liver transplant:

  • Hepatitis B
  • Hepatitis C
  • Liver cancers
  • Wilson’s disease
  • Hemochromatosis
  • Acute liver disease
  • Polycystic disease
  • Autoimmune hepatitis
  • Alcoholic liver disease
  • Primary biliary cirrhosis
  • Formerly failed liver transplant
  • Fatty liver disorder or Non-alcoholic steatohepatitis

Signs and Symptoms of Liver Failure

The symptoms related to liver failure may include the following:

  • nausea
  • fatigue
  • itching
  • jaundice
  • weakness
  • weight loss
  • muscle loss
  • vomiting blood
  • loss of appetite
  • blood does not clot
  • passing black stools
  • bleeding in the stomach
  • forgetfulness or confusion
  • ascites, the buildup of fluid in the abdomen

Stages of Liver Failure

Stages of Liver Failure

The initial stage of liver failure is a mild stressful condition that may last for several months. This involves mainly the accumulation of a certain amount of toxins and waste products in the body. The second stage includes symptoms relating to impaired protein metabolism and decreased levels of vitamins like vitamin K, folic acid and B12. In some patients there is an increase in blood clotting which can lead to bleeding from small cuts or larger bleeds in the intestines.

Types Of Liver Transplant

A liver transplant can be carried out in mainly three ways which are:

  • Deceased Donor Liver Transplant: It is a universal truth that one can get an organ only in case of death. In general, whole organ donation is not a viable option for international patients. However, there are some special situations where patients need to be transplanted urgently and cannot wait for their matched donor. Transplanted livers are from people who were registered donors who passed away. For DDLT, one has to list for awaiting liver transplant list and will be notified only a couple of hours before the liver is available.
  • Living Donor Liver Transplant: A half (or hemi) liver transplant is the most common type of living donor liver transplant. Since the liver can regenerate, this small amount of tissue can grow up to the size of a dime within six months. At least 25 people have received livers from living donors who had only donated 50 percent of their organs.
  • Split donation: A recently deceased person’s liver is removed, split into two pieces, and transplanted into two different people. The liver will grow back to normal size, and since the organs come from a donor with a similar blood type, the recipients are not rejected by their new liver.

Recommendation For Liver Transplant

Liver Donor

A liver transplant is recommended when the liver no longer functions adequately to keep a person alive. A successful liver transplant is a life-saving procedure for people with liver failure. Liver failure can happen suddenly, as a result of infection or complications from certain medications, or it can develop slowly over months, years, or decades. Chronic liver failure is usually the result of cholangitis, which is a condition in which healthy liver tissue has been replaced with scar tissue making the liver unable to carry out its normal functions.

Pre-Liver Transplant Evaluation

The Liver Transplant evaluation process is an extensive one. It requires that you undergo multiple examinations, tests, and procedures to determine if you are a suitable candidate for transplantation. Some of these are:

  • General health test: It includes a cancer screening test to see the overall health.
  • Laboratory test: It includes blood and urine test to evaluate the health of the organs, including the liver.
  • Imaging test: It includes the ultrasound of the liver.
  • Heart test: It determines the cardiovascular health of the person.
  • Nutrition counseling with the dietician: It is done to access the nutrition status before and after the transplant.
  • Psychological evaluation: Here issues such as depression, anxiety, and whether the person fully understands the risks of liver transplant is evaluated.

Antibody Test:

Your doctor will need to check your blood for antibodies. You may have these antibodies in your blood if you’ve had a blood transfusion, pregnancy, or transplant. If these are present, it can cause problems with liver transplants – not only finding a donor, but also a rejection of the often-wanted organ itself.

A Good Liver Donor

There are many areas that affects the condition of a good liver donor such as:

  • Same blood group.
  • The donor must be between 18 to 50 years old.
  • The donor must not be obese or have fatty liver.
  • The donor should be in good physical and mental health.
  • Biological siblings are usually the best donors alive because of matching.

Liver Transplant Surgery

Liver transplant surgery includes four main types. These are:

Process Of Liver Transplant

Transplanting of the liver includes various processes such as mentioned below:

  • Sewing: Once the new liver is attached, all blood vessels and bile ducts are connected before closing the incision.
  • Incision: Here the abdominal area is opened up to access the liver.
  • Transection: It includes the cutting of the structure attached and removal of native, diseased liver.
  • Adequate Control: It must be ensured that there is adequate control of bleeding and closure of the incision.
  • Abdomen Evaluation: The evaluation is done to prevent liver transplant complications.
  • General Anesthesia: The patient is given dose of general anesthesia to block and numb the pain.
  • Mobilization of The Native Liver: It includes mobilization of the native liver and isolation of important structures such as veins and arteries.

Complications In Liver Transplant

Liver transplantation is the ultimate treatment for patients with end-stage liver disease and acute liver failure. Some of the main problems associated with liver transplants include:

  • Bile Leakage
  • Bleeding (hemorrhage)
  • Loss of kidney function
  • The new liver is rejected by the body
  • An increased risk of picking up infections
  • Problems with blood flow to and from the liver
  • An increased risk of certain types of cancer – particularly skin cancer
  • The new liver does not work within the first few hours (primary non-function), requiring a new transplant to be carried out as soon as possible

Post-Liver Transplant Evaluation

After the surgery, the patient is taken to the recovery room for a few hours before being taken to the intensive care unit (ICU). They are closely watched in the ICU for several days, and their vitals are monitored. Blood samples will be taken often to check the new liver. The doctors will also check that the kidneys, lungs, and circulatory systems are all working. Anti-rejection medicines will be administered and closely watched to be sure that the patients are getting the right dose and the right mix of medicines. When they feel ready, they will be moved from ICU to a normal ward. Patients will learn how to take care of themselves when they go home.

Benefits Of Liver Transplant

A liver transplant procedure may be the best solution for patients with serious complications caused by end-stage liver disease. This surgery can help them maintain an active lifestyle and a longer life. However, one day you may require this surgery as well, especially if your condition worsens.

Living-donor liver transplantation is a surgical procedure that removes a portion of the liver from a donor, who remains healthy, and replaces the liver with a recipient. Living-donor liver transplantation can save the patients from a long organ waiting list and the surgery can be scheduled as per the convenience of both the patient and donor.

Survival Rate of Liver Transplant

With an 80% success rate for liver transplantation in India, you can be assured of exceptional quality and holistic care. About 80% of our patients who underwent live donor liver transplantation saw an increased life expectancy by 10 years, while about 90% saw their life expectancy increase by 5 years.

Best Hospitals in India For Liver Transplant

Choosing a hospital for a liver transplant in India is a difficult task. Although there are many hospitals in the country, not all of them have the modern equipment and facilities required for successful operation. However, you must ensure that the hospital provides world-class healthcare and is equipped with the latest medical technology. The best hospitals which can be considered for liver transplant are:

  • Sahyadri Hospitals – Pune
  • Fortis Hospitals – Mulund
  • Artemis Hospitals – Gurgaon
  • Medanta The Medcity Hospital – Gurgaon
  • Gleneagles Global Health City – Chennai
  • Fortis Memorial Research Institute – Gurgaon

Cost Of Liver Transplant in India

The average liver transplant cost in India ranges from USD 21000 (INR 1628666) to USD 30000 (INR 2326666). Sometimes, it might cost you up to USD 38000 (INR 2947110). As overall cost depends on the complexity of the surgery, the patient’s medical condition, the surgeon’s experience, and the hospital’s status. A liver transplant is an operation that involves the removal of a diseased liver, and the insertion of a healthy one. This is a major surgery that requires the use of high-tech instruments, medicines, and medical consumables along with a highly trained medical staff.

FAQs

The body’s immune system can recognize the transplanted liver as ‘alien’ and trigger a series of reactions against it. This may lead to damage to the transplanted liver. We strongly advise that you do not donate or ask any family or friends to donate their liver in the event of your death.

Yes, it comes back to its shape and size in about 1 to 8 weeks.

When considering a liver transplant, or if you're a living donor hoping to donate your liver, it's important to know what the recovery process will be like. Many donor patients report feeling tired and weak but their energy levels usually return to normal in several weeks. Other common symptoms include some abdominal pain, which can be treated with medications. A full check-up should be conducted roughly two weeks after surgery.

After your liver transplant, you and your doctor will discuss the medications required to prevent organ rejection. These must be taken exactly as prescribed, in the correct amounts, and at the correct times. Missing medication doses or abruptly stopping them can result in rejection and organ failure.

You cannot donate if you are 65 years of age or older and have a serious illness, diabetes has caused substantial organ damage, obesity, and hepatitis B is a severe and aggressive liver disease.

Transplanted livers last an average of ten years before they need to be replaced. The procedure takes between six and twelve hours, during which time your donor liver will be removed and your own will be replaced. Surgeons will need to insert multiple tubes in your body because a liver transplant is a significant procedure.

As you recover, the body must go through the process of healing. The body uses cells, proteins, and nutrients in the blood to repair damaged tissues. This process can be slow including simple activities like walking, deep breathing to ensure the lungs stay healthy to prevent pneumonia, a well-balanced diet and exercise to build up the muscles weakened by illness.

Yes, you will be given medicines to help your body accept the new kidney. The amount of anti-rejection medicines that you take will decrease after a few months from the surgery. However, some immuno-suppressive medicines are necessary for a long time and must be taken regularly and strictly as per the prescription without failure.

When we hear the word "India," most of us think, "Oh no! Not cheap!" But that's not necessarily the case when it comes to liver transplant surgery. Compared to other developed countries, the liver transplant cost in India is highly cost-efficient (50% less than in western countries). This is the reason why patients from all over the world travel to India for liver transplant surgery.

When a liver transplant is done, the body may regard it as somewhat outsider and reject it to avoid this immunosuppressant are given.

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