Understanding Liver Transplantation

Understanding Liver Transplantation

The liver is a vital organ which filters the blood coming from the digestive tract, before circulating it to the rest of the body. It detoxifies chemicals, metabolizes drugs and also synthesizes proteins required for building muscles, fighting infections and blood clotting.

What is Liver Transplantation and when is it needed?

Liver transplantation is a surgery performed to remove a diseased liver and replace it with a healthy one. A liver transplant is considered when the liver no longer functions adequately (liver failure). In adults, the most common reason for liver transplantation is cirrhosis and in children, it is biliary atresia. The other situations are viral hepatitis, liver cancer and hereditary diseases.

The Transplant Team

Specialists from a variety of fields are needed to determine if a liver transplant is appropriate. The team includes:

• Liver specialist (Hepatologist)
• Transplant surgeons
• Transplant coordinator
• Nutritionist
• Physiotherapist
• Psychiatrist
• Anesthesiologist

Checklist for an ideal hospital for liver transplantation

• Meticulous aseptic measures are required for surgery and hence separate OT facilities with laminar flow.
• State-of-the-art technology for liver surgery such as the 640 slice CECT angiography and volumetry, Argon Beam are used in combination with tools of liver resection like CUSA and Water JetTM.
• Blood Bank facility available round the clock
• Specialised Pathology and Immunology facilities for the investigation of patients of liver transplantation – both donors and recipients.
• Dedicated Hepatobiliary Critical Care Unit, a Hepatobiliary physician on call, Anesthesia staff and a specialised Nursing team.

Liver transplantation surgery

Living donor liver transplant involves removing a segment of liver from a healthy living donor and implanting it into a recipient. This is possible because of the large functional reserve capacity of the liver (70%) and its amazing capacity to regenerate. Both the donor and recipient liver segments grow to normal size in a few weeks.

In deceased donor liver transplant, the donor is a patient whose brain has permanently and irreversibly stopped working. The liver is donated, among other organs, with the consent of the next of kin.

A liver transplant operation usually takes 6 to 10 hours. The diseased liver is removed and replaced with the donor liver. The surgeon disconnects the diseased liver from the bile ducts and blood vessels before implanting the new liver.

Subsequent post-transplant care at the hospital and at home involves use of medicines to ensure normal function and prevent rejection. Patients typically return to their work, social and familial lives following a successful liver transplantation.