A liver transplant is a surgical procedure involving the removal of the liver that is damaged and replacing it with a healthy liver from a deceased or living donor. It is recommended in case of end-stage chronic liver disease, liver failure, or liver cancer, when other treatment methodologies may not work. It can also be a treatment option for patients with sudden liver failure of a previously healthy liver.
There are a lot of cases where people suffering from end-stage liver diseases are not able to get treated or undergo a transplant. Especially, for people with advanced liver cancer, where cancer has spread beyond the liver into other organs or in case of liver failure, where the general condition of the patient is unsuitable, or their other body parts such as kidneys, heart, and lungs are functioning sub-optimally which means they are weak and might not be able to withstand the trauma and stress of major surgery. In such cases, preventive medications and palliative care is best suggested.
Here are some questions answered by Dr. Arvinder Singh Soin Chairman Institute of Liver Transplantation and Regenerative Medicine, Medanta.
Where does a liver for a transplant come from?
In most cases, a healthy liver will come from an organ donor who has just died. Sometimes a healthy living person will donate part of their liver. However, the Covid-19 pandemic has been placing an increasing burden on liver transplants worldwide. Patients with liver transplants need special care starting from pre-operative preparation, surgical intervention, and post-operative care.
Hence, liver transplantation programs may have to revise the existing strategies in selecting donors and recipients for transplants. Re-designing service provision, restructuring of outpatient care, careful screening and selection of donors and recipients, and performing transplants with limited resources will have to be initiated in the post-Covid era for long-term recovery.
Signs and Symptoms
If signs and symptoms of liver disease do occur, they may include:
- Skin and eyes that appear yellowish (jaundice)
- Abdominal pain and swelling
- Swelling in the legs and ankles
- Itchy skin Dark urine colour
- Pale stool colour
- Chronic fatigue Nausea or vomiting
- Loss of appetite
- A tendency to bruise easily
Causes of Chronic Liver Injury
Liver disease has many causes:
- Hepatitis A
- Hepatitis B
- Hepatitis C
- Immune system abnormality
- Autoimmune hepatitis
- Primary biliary cholangitis
- Primary sclerosing cholangitis
- Wilson’s disease
- Alpha-1 antitrypsin deficiency
- Cancer and other growths
Liver transplant survival rate?
The success rate of live donor liver transplants depends on the kind of centres and doctors working on the case as well. For example, at an established centre, the success rate for a liver transplant is over 90%, and over 80% of patients survive and live a normal life 10 years and more after transplant.
Precautions after a liver transplant?
The risk of Covid-19 is higher in transplant patients and adequate precautions need to be undertaken for health and safety, especially amidst the current pandemic. This is because transplant patients are immunocompromised because of immunosuppression medicines. Following are the precautionary measures that a recipient should undertake for undergoing a liver transplantation procedure:
- Avoid close contact with anyone who is sick
- Avoid touching your eyes, nose, and mouth
- During coughing or sneezing, practice proper etiquettes by covering the nose and then wash your hands
- Keep your house clean
- Wash hands frequently with soap and water for at least 20-30 seconds before and after eating and other routine activities
- Avoid crowded places like restaurants, bars, sports venues, etc.
- In case there are positive cases around you, stay home and work from home as much as possible
- Clean all fruits and vegetables properly and eat well-cooked food
Problems after a liver transplant?
Some complications such as infection, rejection, disease recurrence are common after liver transplantation and, if untreated, can lead to graft failure and increased morbidity and mortality.
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