Everything You Need To Know About Liver Transplantation

If you have end-stage chronic liver disease, your liver must be failing to do its function. Your hepatologist must have told you to get a liver transplant. The process may seem complicated and worrying. Here, we have addressed some of the concerns associated with a liver transplant.

What is a Liver Transplant?

A liver transplant can be described as a surgical procedure that replaces a non-functional liver with a portion of the liver from a healthy donor. This is known as a living donor transplant. Another type called the orthotopic transplant involves taking a healthy liver from a deceased individual. In a split-type liver transplant, the deceased donor’s liver is used for two recipients, commonly an adult and a child. The donor’s liver is split into the right lobe which is given to the adult and a left lobe donated to a child.

Do I Really Need a Liver Transplant?

You must be wondering if you actually need a liver transplant. But, in most cases, your hepatologist will suggest a liver transplant only after all possible treatment options have been exhausted. If you still feel unsure, you can get a second opinion from another liver specialist. This can expose you to more options. However, a liver transplant is the recommended solution for treating chronic liver failure.

The most common reason behind chronic liver failure is cirrhosis which can be caused by several conditions like alcoholic liver disease, Hepatitis B and C, hemochromatosis, Wilson’s disease, and non-alcoholic fatty liver disease.

What Happens in a Liver Transplant?

Before the Transplant

The doctor will first analyze the severity of your illness and how urgently you need the transplant. After considering all factors, your doctor will put you on the waiting list for a liver transplant. The wait time for a donor’s liver varies greatly. You may have to wait for days or months before a suitable donor is found. While you wait, the doctor will try to treat the effects of your liver failure. Once a suitable donor has been identified, your healthcare team will notify you.

Preparing for the Surgery:

• Ask your hepatologist to explain the liver transplant procedure so that you feel comfortable with the process.
• You may be provided with a consent form. Read the form properly before signing it.
• If you are on the waitlist for a deceased donor liver transplant, your healthcare team will ask you to come to the hospital immediately when a matching donor liver is found. It is best you connect with an accreditated hospital that has well-developed facilities for the transplant.
•  You should avoid drinking or eating anything as soon as you find out about the availability of donor liver.
• If you are on the waitlist for a living donor transplant, your surgery will be scheduled about 4-6 weeks in advance. However, you should abstain from eating or drinking at least 8 hours before the operation.
• You will be given a sedative before the surgery to make you relaxed.

During the Transplant

Once you reach the hospital for the operation, you will be given general anesthesia. This will put you in a sleep-like state and the surgeon can begin the procedure.

After sterilizing the surgical site, the surgeon will make an incision across your stomach. The size and location of the incision vary according to the surgeon’s approach.

After cutting off the blood vessels attached to the liver, the diseased liver will be removed.  Then the liver from the deceased donor will be implanted and attached to your bile ducts and blood vessels. The blood flow to the transplanted liver is restored and the surgical incision will be then stitched. The procedure can last for around 12 hours.

For the Donor

If you are a donor for a liver transplant, your healthcare team will schedule the surgery after discussing it with the recipient. During the operation, the anesthesiologist will administer general anesthesia to prepare you for the surgery. The liver transplant surgeon will make an incision depending on the kind of liver graft that has to be removed. There are many factors to be considered when deciding the portion of the liver that will be removed such as the weight of the recipient and the size of the donor’s liver. After deciding, the surgeon will remove the donor piece and send it for transplantation. Your doctor will then suture the incision to finish the operation. After the procedure, you may be required to stay in the hospital for a week.

After the Transplant

You will be taken to the ICU for recovery. Here, the doctor will monitor your vitals and see if the transplant is working or not. You may need to stay in the hospital for 1-2 weeks. After you have recovered, you can go home.

Avail Liver Transplantation Across the World

Conclusion

The number of patients who require a transplant far outweighs the available donors. Many hospitals and NGOs worldwide are working day in and day out to bridge this gap. Since the liver has a regenerative capacity, the donor’s liver can grow back to its normal size after the surgery. Similarly, the transplanted liver in the recipient will also eventually grow to the right size. This makes liver transplant a promising approach to treating liver failure.

Reference Links:

• https://www.mayoclinic.org/tests-procedures/liver-transplant/about/pac-20384842
• https://www.healthline.com/health/liver-transplant-survival