Liver Transplant

A surgical procedure to remove a diseased liver and replace it with a healthy liver from a donor is called liver transplant.

In most cases, the livers are formed deceased people but it might also come from a living person.

The number of available livers is smaller compared to the number of people waiting for new livers which mean that liver transplant is reserved for patients who are very ill.

Here are the most common reasons to undergo a liver transplant.

If a person has a liver failure that cannot be treated with other medicines or treatment, a liver transplant can be used.

Liver failure can be acute – can occur rapidly in weeks, or chronic – can occur slowly over months and years.

The causes of liver failure are:

• alcoholic liver disease
• liver cirrhosis
• early stage liver cancer
• nonalcoholic fatty liver disease
• primary biliary cirrhosis
• hemochromatosis
• Wilson’s disease
• primary sclerosing cholangitis
• cystic fibrosis
• biliary duct atresia

The possible risk of liver transplant include:

• bleeding
• bile duct complications
• failure of donated liver
• blood clots
• rejection of donated liver
• infection
• memory and thinking problems

To help prevent your body from rejecting the donated liver, your doctor will prescribe medications that you will take for the rest of your life.

These medications can cause side effects such as:

• diabetes
• bone thinning
• headaches
• diarrhea
• high cholesterol
• high blood pressure

In order to prepare for the procedure, your physician will refer you to a transplant center to undergo evaluation for a liver transplant if you have a chronic liver failure.

The center will conduct a series of tests and procedures to check if your name can be put on the waiting list for a new liver.

Some of the possible tests include:

• imaging tests such as ultrasound
• laboratory tests such as urine and blood tests to check your organ’s health
• general health exam to check your overall health
• heart tests to check your cardiovascular system
• psychological evaluation so your doctor will know if you fully understand the risks and benefits of a liver transplant
• nutrition counseling with dieticians for your nutritional status
• addiction counseling if you are addicted to drugs, tobacco or alcohol
• meeting with social workers to determine if you have any families and friends that will take care of you after the liver transplant
• financial counseling if you fully understand how much the liver transplant as well and if it is covered by the insurance

The committee will discuss your case once the consultations and tests were completed if you are healthy enough to receive a transplant and if a liver treatment is best for you.

You will be placed on a waiting list if the answers to both are yes. Your prognosis is sometimes called your Model for End-Stage Liver Disease (MELD) score.

If you have a high score on MELD, you will likely to receive liver first. The waiting could take up to months. Your doctor will treat the complications of your liver failure as you wait for a new liver.

There are also livers that come from living donor. Talk to your doctor if one of your family member or close friend wants to donate their liver to you.

Here’s what you can expect before, during, and after your liver transplant procedure.

If a liver is available for you, your doctor will contact you. You will be admitted and undergo tests to make sure you are healthy. You will be given general anesthesia.

To access your liver, your doctor will make a long cut in your abdomen. The surgeon disconnects your liver's blood supply and the bile ducts and then removes the diseased liver.

The blood vessels and bile ducts are reattached and at the same time, the donor liver will be placed in your body. To close the incisions made in your abdomen, your doctor will use staples or stitches to close them.

After the procedure, you will be admitted to the ICU to be continuously monitored by a team. If you are receiving a liver from a living donor, your doctor will transplant a portion of the donor's liver in your body.

The donor will be operated first to remove the portion of the liver, then remove your damaged liver and place the donated one in your body. The surgeon can now reattach the bile ducts and blood vessels to the new liver.

The transplanted liver portion in your body and the portion left behind in the donor's body regenerate rapidly.

After the transplant, your doctor will ask you to:

• stay in the ICU for a few days so they can monitor your health and check for complications and test your liver
• have regular follow-ups as you continue to recover and you might also undergo blood tests
• take prescribed medications for a lifetime such as immunosuppressants for your immune system so it will not attack your new liver, and also other medications to fight off complications

Understanding the results of your liver transplant will be made possible by your doctor.

The recovery time will be for a few months up to one year. You can ask your doctor if you can go back to your normal activities after three to six months.

About 72 percent of people who undergo liver transplant live for at least five years generally.

It means that in every 100 people who had a transplant, only about 72 of them will live for five years, and 28 of them will die before reaching the fifth year.

The five-year survival rate is about 78 percent for liver transplants using living donors.