Liver Transplant Case Study
Mr. Azhar Iqbal,54, from Lahore, Pakistan, with a history of hepatitis C-related liver cirrhosis, was diagnosed with hepatocellular carcinoma in 2018. Azhars’s son, Bilal Ahmed, sent an inquiry to MediGence to get an opinion on his father’s condition as doctors in Pakistan had denied suggesting any treatment. He shared all the relevant medical reports with the cornered team when they asked to get an opinion from Dr. Subhash Gupta, a renowned specialist at Max Hospital. Mr. Azhar visited India for treatment. After a few days, there was a significant reduction in the tumor in the portal vein and the left lobe of the liver. It was decided that it is now fully safe for the patient to undergo transplant surgery.The liver transplant surgery was conducted at Max Hospital on October 10, 2018. Azhar stayed at the hospital for 11 days and was discharged on October 26th. The donor and the recipient recovered well after the surgery. Mr. Azhar was stable and even physically active after being discharged from the hospital.
Read the full story – Successful Liver Transplant Surgery in India
Liver Transplant Overview
A liver transplant is a surgical procedure that involves the removal of a liver, that no longer functions properly (called liver failure), followed by its replacement with a healthy liver from any deceased donor or a part of a healthy liver from any living donor. A liver transplant is generally a treatment option for people with significant complications because of any end-stage chronic liver disease. This procedure might also be a treatment option in cases of sudden failure of a healthy liver. The total number of people waiting for a liver transplant mostly exceeds the number of easily available deceased donor livers. Getting a portion of a healthy liver from a living donor is an effective alternative to waiting for a liver from a deceased donor. Living-donor liver transplant is feasible because the liver has the ability to regenerate and regain its normal size shortly after the removal of a part of the organ.
Do we have any affordable Medical Packages for such Liver transplants?
There are numerous packages available for a liver transplant but only a few come with excellent benefits. You should always explore different packages available in the market and do a comparative study before choosing any. Liver transplant package at MediGence is worth buying as it comes with huge discounts and offers several additional benefits, such as free telemedicine consultation, no cancellation charges, pick and drop facility, treatment at world-class hospitals, tour for 2, accommodation and food arrangements, etc.
Liver Transplant Package
Why should I look for a Liver transplant Package?
A liver transplant package comes with multiple benefits, cost-effectiveness being one of them. Huge discounts are given on these packages, which help you save money. The package also offers you the best hospital for liver transplant with many additional benefits that guarantee a smooth medical journey. Some of the benefits of the Liver transplant Package include airport transfers, hotel stay, free teleconsultation, visa assistance, city tour for 2, cancellation anytime with a complete refund, priority appointments, 24/7 Patient Care & Assistance, complementary medicine voucher, etc.
Liver Transplant Package Cost
The cost of a liver transplant package starts from $24,000, which is lower than the hospital starting price ($26,000). This is because huge discounts are offered to patients. The package cost may vary from one country to another.
Countries where Liver Transplant Surgery Packages are easily available
Here are some countries where the best Liver Transplant Surgery Packages are available. These countries have world-class hospitals with modern equipment and the latest infrastructure and the best doctors.
Which is best? – Direct consultation from the hospital or booking any medical package for treatment.
Booking any medical package for treatment is always the best option compared to direct consultation from the hospital. A medical package offers attractive discounts ensuring affordable treatment. Whereas direct consultation from the hospital costs more due to various costs associated with their services.
How to know about liver diseases you are suffering from?
Below are some signs and symptoms of liver disease:
- Yellowish skin and eyes (jaundice)
- Abdominal swelling and pain
- Swelling in the ankles and the legs.
- Pale stool color
- Chronic fatigue
- Itchy skin.
- Dark urine
- Vomiting or nausea
- A doctor diagnoses liver failure based on your medical history, symptoms, and the results of tests.
How to choose the best doctors for treating Liver Disease.
Choosing the best doctor is critical for treating Liver Disease. There are a number of ways of choosing a good doctor. You can look for doctors’ credentials on various online resources. You can also look for doctors’ reviews on various portals. Getting feedback from your relatives or friends about a doctor is also a good option. You can visit the website of MediGence, which has a number of world-class and verified liver transplant doctors from across the world. You will get complete information about doctors, which helps you make decisions.
Conditions treated by Liver Transplant Surgery
Some conditions that may require Liver Transplant Surgery are:
- Hepatitis B and C.
- Alcoholic liver disease
- Nonalcoholic fatty liver disease
- Genetic diseases affecting the liver, including hemochromatosis
- Diseases affecting the tubes that carry bile
- Biliary cirrhosis, biliary atresia, primary sclerosing cholangitis
- Acute Liver Failure
- Autoimmune Hepatitis
- Caroli Disease
- Hepatopulmonary Syndrome (HPS)
- Hepatocellular carcinoma (or liver cancer)
- Cholangiocarcinoma (or bile duct cancer)
- Primary Biliary Cirrhosis
- Congenital Hepatic Fibrosis
Liver Transplant Types
There are three different types of liver transplant:
- Orthotopic transplant: It is the most common type in which the whole liver is taken out from a deceased donor. During the surgery, the surgeon makes a small incision in the abdomen and then removes the diseased liver. The donor liver will be placed in position and the incision is finally closed with surgical staples or dissolvable stitches.
- Living donor transplant: In a living donor transplant, the donor is a living individual. The surgeon removes the healthy liver from the donor and then transplants it into the recipient’s body after removing the diseased liver. After transplantation, the transplanted part will regenerate itself quickly.
- Split liver transplant: This involves the transplantation of a liver from a deceased person to two recipients. This is usually possible when the suitable recipients are a child or an adult. The donated liver is split into the right and left lobes.
- Auxiliary liver transplantation: It is a variety of liver transplants in which the recipient’s own liver isn’t completely removed.
Life span with and without a Liver Transplant
Generally, around 75% of people who have liver transplant live for a minimum of five years. It means for every hundred people who get a liver transplant for some reason, nearly 75 will live for nearly five years and 25 people will die within five years. A liver may keep working even when part of it is removed or damaged. But if it begins to shut down fully, a condition called liver failure, a person can survive for just a day or two unless they get emergency treatment.
How much and which part of the liver is needed for the transplant?
A whole liver might be transplanted, or only part of one. In most cases, a healthy liver comes from a living or deceased donor. In some cases, a healthy living person donates part of their liver. During transplantation, around 40% to 60% of the donor’s liver is generally removed. For donor safety during living donor liver transplantation, the left lobe is used in most cases for the graft.
What happens in liver transplant surgery Procedure?
You will undergo an exam in order to make sure that you are fit for the surgery. A liver transplant is done using general anesthesia. The surgeon generally makes a long incision in your stomach to access the liver. The location, as well as the size of the incision, will vary depending on your own anatomy and your surgeon’s approach. The surgeon will remove your liver and then place the donor liver in the body. The surgeon connects the blood vessels as well as the bile ducts to the donor’s liver. Surgery will usually take up to twelve hours, depending on your overall condition. Once the new liver is put in place, the surgeon uses staples and stitches to close the incision. You are then shifted to the intensive care unit to start recovery.
In the case of a living liver transplant, your surgery is scheduled in advance. Liver transplant surgeons remove a portion of the liver for transplant. They remove your liver and transplant the donated liver part into your body. Then, they finally connect the blood vessels as well as the bile ducts to the new liver.
Also Read– What is the Process of the Liver Transplant
Is Surgery for a Liver transplant complicated or risky?
Liver transplant surgery has a risk of complications. There are several risks associated with the surgery itself and with drugs required to prevent rejection of the donor liver post-transplant. Long-term complications might include liver disease reappearing in the transplanted liver. Risks associated with liver transplant surgery include bile duct complications, including:
- Bile duct leakage or shrinking of the bile duct.
- Failure of a donated liver
- Blood clot
- Mental confusion/seizure
- Rejection of the donated liver
Also Read– What are the Pros and Cons of Liver Transplant
When should one go for Liver Transplant?
Patients who need a liver transplant can have a wide range of symptoms, including jaundice, ascites (accumulation of fluid in the abdomen), bleeding in the upper and lower gastrointestinal tract, and hepatic encephalopathy (or confusion or coma). A liver transplant might be recommended if you are affected by end-stage liver disease (such as chronic liver failure). It is a life-threatening liver disease, which can be caused by many liver conditions. The reason for a liver transplant varies with the patient’s age and the severity of the disease.
Conditions required for Liver transplant
If your liver does not function properly, a liver transplant is the only option. To qualify for a liver transplant, you should meet certain criteria. To meet liver transplant criteria, a patient must have a liver, which is not functioning efficiently beyond the stage which can be repaired. Before a patient is considered for liver transplant, they will require a pre-transplant evaluation. The evaluation will help the transplant team to learn more about the disease. After the evaluation has been done, a committee will review the findings from the evaluations and tests. To be a living donor, an individual must meet certain requirements.
Also read– Things You Should Know About Liver Function Test
Risk of Liver Transplant Donor
It is crucial for donors to be aware of all the risks associated with liver donation. The evaluation helps find out if you are a good match with the recipient, or whether you are fit to donate. The living liver donation might cause bile leakage, intra-abdominal bleeding, narrowing of the bile duct, and in rare cases, inadequate growth of the remaining part of the liver. Some living-liver donors might get an infection at the surgery site. If this happens, the transplant team will observe your condition to tackle health issues. Living-liver donation may also cause organ damage. The donor can also get a hernia. The part of the liver that is left after donation could stop working and can be life-threatening.
Role of blood group incompatibility during liver transplant
Donors should have a compatible blood type that is suitable for liver donation. You do not need to have the exact blood type as the individual who requires a new liver, but you should be what is called “compatible.” If blood types aren’t compatible, the donor won’t be able to donate a liver to you. ABO-incompatible liver transplantation using conventional immunosuppression is considered a contraindication because of the high risk for antibody-mediated complications leading to graft loss.
Also check– Frequently Asked Questions (F.A.Q) For Donors and Recipients
Rate of Success in Liver Transplant process
Liver transplants are successful and most people generally return to their normal activities after the surgery. Generally, around 75% of people who have liver transplant live for nearly five years. Transplant surgery’s success depends on a good match with a donor, the age of the recipient, pre-existing conditions, type of technology used, type of surgery involved, Body Mass Index, Cause of liver failure, the severity of the liver failure, etc. The liver transplant success rate is around 95%. Unusually, people get back to their normal life within 3-6 months of the surgery. The survival rate of liver transplant patients is around 86% after one year and nearly 78% after 3 years of surgery. In most cases, patients who get the liver from a living donor typically have better short-term survival rates compared to those who get a liver from a deceased donor.
Patient Health condition after liver transplant surgery
Patients with successful liver transplants could live healthy lives. While younger people are able to return to work within six to eight weeks, elderly people would need a month or more. Liver transplant recipients require medications and monitoring in order to avoid the risk of rejections and infections. People can experience symptoms, such as increased blood pressure, hair loss, changes in mood, elevated blood sugar, kidney dysfunction, nausea, bone and muscle weakness, diarrhea, vomiting, and headache. The patient will stay in the intensive care unit for a few days after the surgery. They are likely to spend 5-10 days in the hospital.
Are there any Problems after a liver transplant?
Infections are very common after a liver transplant. Generally, the most common infections are urine or chest infections. Infections inside the liver transplant may be harder to treat. Some complications of liver surgery might include blocked blood vessels, leakage of bile, bleeding, infection, and the liver not working for a short duration right after the surgery. The new liver might be rejected by the immune system. Some liver diseases may return after a transplant.
Also read– Everything You Need To Know About Liver Transplantation
Life expectancy after Liver Transplant
Generally, around 75% of people who undergo liver transplant live for a minimum of five years. The long-term outlook for liver transplants is usually good. More than nine out of every ten people are still alive after one year, nearly eight in every ten people live a minimum of 5 years, and numerous people live for up to 20 years or even more. The life expectancy after liver transplantation depends on numerous factors, such as underlying diseases being cured by transplant surgery, the patient’s age, comorbidities, overall health, and response to post-transplant drugs.
How can I Prepare myself before Liver Transplant Surgery?
Your healthcare provider will fully explain the procedure to you. You will be asked to sign a consent form that shows that you give permission to do the surgery. For a planned transplant, you should avoid eating for eight hours before the surgery. It means not having any drink or food after midnight. If the liver is to come from a donor who has recently died, you should not drink or eat once you’re told a liver is available. You will be given medicine in order to help you relax before the surgery. Your healthcare provider may have other instructions for you based on your medical condition. Your doctor may recommend a range of pre-surgery evaluation tests depending on your sex and age.
Also check– Legalities of Organ Transplantation
Who can become a Liver donor?
Liver donors need to meet certain requirements to donate their organs. The donor can be a family member or friend. They have to be aged between 18 and 60, although the age range varies. A donor’s blood type should be “compatible” with that of the recipient. A donor’s kidneys, thyroid, and liver need to be working right. To make sure a donor is healthy enough to donate, they will have to have a physical exam. The donor should also be mentally healthy.
Watch this– Abdul Majid from Pakistan underwent Liver Transplantation in India
After the Life of the liver transplant donor
The donor’s remaining liver regrows and returns to its normal size, volume, and capacity within a couple of months after the surgery. Living liver donation has no direct impact on how long as well as healthy you will live. Liver donors are generally able to get back to normal life when they reach home after discharge. This generally takes one week after surgery. The liver of a donor will grow back in the first 2 weeks. Most complications, such as fever, nausea, or mild infection, might happen during the hospital stay.
What are the conditions for which the donor’s liver is matched with the transplant Recipients?
If anyone wants to donate part of their liver to someone undergoing a transplant, the two of them should be a good match. A donor does not need to have the exact blood type as the individual who needs the new liver, but they should be “compatible.” People with Type O blood are called universal donors and could donate to anyone. Correct matching based on donor-organ-recipient variables could avoid the wastage of liver grafts, decrease graft loss and improve outcomes. The donor must be in good mental and physical health and should be between 18 and 60 years old. For the liver to be a good match with a transplant recipient, the donor should also have a compatible body size. The body size generally determines the size of the liver because size is crucial for the liver to work well.
How common are liver transplants?
Liver transplant surgery is a common surgery. Liver transplants are generally successful and most people return to their normal daily activities afterward. More than 1800 liver transplants are currently performed annually in India. With technological advancements, the procedure has become faster, increasing hope for many patients. As per the American Liver Foundation, about 8,000 liver transplant surgeries are done in the US every year. A doctor might recommend a liver transplant for an individual with end-stage liver disease.
Does Health Insurance cover Liver Transplant?
Yes, a liver transplant is covered under health insurance. Health insurance policies state that they would cover the cost of the surgery and tests involved.
What kind of follow-up care is required during recovery?
In the 1st month after the procedure, donors must make it a point to follow up every five to seven days. The patient will begin taking anti-rejection medications right after surgery. After reaching home after the liver transplant, you must start doing muscle toning exercises and walking5 to 10 minutes every day. You will have to take medications known as immunosuppressants to prevent your immune system from attacking the new liver.
Satisfaction Level a year after Liver Transplant
Satisfaction level a year after liver transplant is high as survival rates for patients after the procedure exceed 90%. It may take up to a year to completely recover. A liver transplant may produce excellent results. Recipients can live a normal life for 30 years after the surgery. The procedure helps improve the overall quality of life.