Liver transplantation is a procedure in which a person's diseased liver is replaced with all or part of a healthy liver from another person, called a donor.

When is a liver transplant necessary?

The liver is your largest internal organ... It weighs about 3 pounds in an adult.. It is located just below the diaphragm on the right side of the abdomen..

Liver failure can occur suddenly as a result of viral hepatitis, drug damage, or infection.. Such a condition is called acute or complete liver failure.

Learn more: What is the treatment of fatty liver?

It can also be the result of a long-term (chronic) problem... Conditions that can lead to chronic liver failure include:

• Chronic hepatitis with cirrhosis
primary biliary cholangitis; A rare disease in which the body's immune system destroys the bile ducts.
• Sclerosing cholangitis, ulcer and narrowing of bile ducts inside and outside the liver, which causes bile to flow back.
biliary atresia; A rare liver disease that affects infants
• Excessive consumption of alcohol
Liver cancers such as hepatocellular carcinoma
• Wilson's disease, which leads to the production of abnormal levels of copper in the body, including in the liver
• Hemochromatosis, in which the body contains more iron than usual
• Alpha-1 antitrypsin deficiency, the abnormal structure of a protein called alpha-1 antitrypsin in the liver, which leads to cirrhosis.

Learn more: What is the treatment of liver adenoma?

How are people selected for a liver transplant?

If doctors have ruled out other treatments for your disease and believe you are healthy enough to undergo surgery, they may recommend a liver transplant....They will refer you to a transplant center....where you will talk to specialists and have tests to see if you can have a transplant.

Each center has different rules about who can perform transplants.... You may not be eligible to link if you have any of the following:

• Severe infection
• Diseases caused by alcohol or drug use
Cancer outside the liver
• Serious heart or lung disease

You or your companions should also pay attention to and follow the doctor's orders after surgery, including the medications you should take for the rest of your life.

Liver transplant team

A team of experts will support you every step of the way.... Team members include:

• liver specialist
• A transplant surgeon
• A transplant coordinator, usually a nurse who specializes in the care of liver transplant patients. This person will be your main point of contact with the transplant team.
• A social worker to share your support network with family and friends, career and financial needs
• A psychiatrist who can help you deal with issues like anxiety and depression that may come with a transplant.
• Anesthesiologist
• An addiction counselor for help with alcohol or drug abuse
• A financial advisor will act as a key solution for you and your insurance company

What tests are necessary before liver transplantation?

Bring all of your medical records, x-rays, liver biopsy slides, and medication records to the liver transplant evaluation. The team may do tests such as the following:

• CT, which uses x-rays and a computer to take pictures of the liver... CT and chest x-rays are also taken to evaluate the heart and lungs.
• Doppler ultrasound to observe the presence or absence of blood vessels inside and outside the liver.
• Echocardiogram to check the heart
• Pulmonary function tests to evaluate the rate of oxygen and carbon dioxide exchange in the lungs
• Blood test to get more information about blood and liver function... You will also be screened for HIV, other viruses (such as herpes and Epstein-Barr), and hepatitis.

How does the liver transplant waiting list work?

If you meet the criteria for a transplant but are not in line to donate, the center will put you on a waiting list.. These patients are listed based on blood type, body size, and medical status (the extent of their illness)... Each patient is given a priority score based on three blood tests (creatinine, bilirubin, and INR).

Read more: Treatment of types of liver syndrome

Patients with the highest score and patients with acute liver failure have the highest priority for liver transplantation.... If the condition worsens, their score increases and their priority for transplantation increases.... In this way, the transplants reach the people who have the highest priority.

Determining the waiting time for Jagger is difficult.... Your liaison is always ready to discuss and negotiate where you are on the waiting list.

Where is the transplanted liver taken from?

The liver may be taken from a living or deceased donor.

Live donation

In a living donor liver transplant, the doctor removes a part of the liver from a healthy person and transplants it to the person....within a few weeks, both parts of the liver return to normal.

Deceased Donor

The deceased donor may have been in an accident or suffered a head injury....These people's hearts are still beating, but because their brains are permanently disabled, they are legally dead..The donor is usually in the intensive care unit..The team turns off life support in the operating room during the transplant.

The identity of the donor and the details of their death are confidential.

Depending on the patient's condition, a "domino" liver transplant may be performed.... This is when a young person with metabolic liver disease receives a liver from a healthy donor.... But instead of discarding the young person's liver, doctors give it to an older patient with a sicker liver.. It helps a wide range of people who are organ donors.

Who can donate a liver transplant?

A living donor may be a relative, spouse, friend or a 'well-wisher'....they do thorough medical and psychological testing to minimize risks....blood type and body size are very important for matching....a donor under 60 is the ideal choice.

Hospitals screen potential donors for liver problems or other illnesses, including:

• Liver disease
• Excessive use of alcohol or drugs
• Cancer
• Infections
• Hepatitis
• HIV

What happens when a compatible liver transplant is found?

When a potential donor is found, the transplant coordinator will contact you....After you are told to go to the hospital, you should not eat or drink anything....After you go to the hospital, you will probably have blood tests, an EKG, and a chest X-ray....You may also meet with an anesthetist and a surgeon....If the donor liver comes home...

During the liver transplant procedure What happens?

A liver transplant usually takes 6 to 12 hours....surgeons remove your liver and replace it with a donor liver..because a transplant is a major operation, surgeons insert several tubes into the body..these tubes are needed to help the body do certain things during the operation and for several days afterward.

What are the side effects associated with a liver transplant?

Liver transplant is a complex procedure that may have complications immediately after surgery or years later.

Disclaimer

The body's immune system destroys anything that attacks the body....but it cannot tell the difference between the transplanted liver and unwanted invaders such as viruses and bacteria....therefore the body's immune system may attack the new liver....this process is a phenomenon

It is called link rejection. About 64% of liver transplant patients experience organ rejection, most of which occur in the first 90 days. Anti-transplant rejection drugs are prescribed to prevent immune attack.

Learn more: What is a liver abscess?

Infection

Drugs that prevent the body from rejecting the new liver weaken the immune system....These drugs are called immunosuppressants....These drugs make you more likely to get an infection....This problem goes away with time.

Liver functional problems

About 1% to 5% of new livers do not work as well as they should or at all....If the problem does not improve quickly, a second transplant may be necessary.

Dangers of surgery

Complications caused by surgery include:

• Clot formation in the artery that carries blood from the heart to the liver (so-called hepatic artery thrombosis) or in the vein that carries blood from the intestine, pancreas, and spleen to the liver (portal vein thrombosis)
Leakage of bile from the bile ducts and into the stomach
• Tricking of bile ducts
• Bleeding
• Surgical wound infection

The return of the disease

Some diseases that lead to liver failure can still affect or destroy the new liver. These diseases include:

• Hepatitis C
Primary sclerosing cholangitis
• Fatty liver disease

Cancer

People who receive organ transplants are 25 percent more likely to develop skin cancer than other people... Immunosuppressive drugs can also increase the risk of other cancers, including a rare disease called post-transplant lymphoproliferative disorder (PTLD).

See more: Best Gastroenterologist

What are anti-rejection drugs?

You must take at least one immunosuppressant for the rest of your life. This drug may be a combination of a calcineurin inhibitor (CNI) such as cyclosporine (Neoral) or tacrolimus (Prograf).. a glucocorticoid such as prednisone (brand names Medrol, Prelone, Sterapred DS); and a secondary agent such as azathioprine (Imuran), aerolimus (Afinitor, Zortress), mycophenolate mofetil (CellCept), or sirolimus (Rapamon).

These drugs may have serious side effects....In addition to increasing the chance of infection, they may also lead to:

• osteoporosis
• Diabetes
• Increased blood pressure
• High cholesterol (treatment of high cholesterol with proper nutrition)
Kidney damage
• weight gain

Other medications and supplements can affect how these medications work....Talk to your doctor before taking anything new or if you are concerned about side effects.

When can you go home after a liver transplant?

The average hospital stay after a liver transplant is 2 to 3 weeks.... Some patients are discharged sooner, but others need to stay longer.

Nursing staff and transplant coordinators will quickly prepare you for discharge after you are transferred from the intensive care unit (ICU) to the general ward... They will give you a discharge handbook that outlines many things you need to know before you go home.

You will learn how to take new medications and how to measure blood pressure and pulse, as well as the signs of transplant rejection and infection.. and you will learn to call the doctor when it is necessary and important.

Many people have to be readmitted to the hospital, especially in the first year after transplant, usually for treatment of transplant rejection or infection.

After liver transplant

Aftercare

Your first visit will probably be about 1-2 weeks after you leave the hospital....you will meet with the transplant surgeon and the transplant coordinator....a social worker or a member of the psychiatric team may also be present....then you will be followed up at 3, 6, 9, and 12 months after your transplant, and then once a year for the rest of your life.

The primary care physician should be informed of the time of transplantation and the time of discharge... Although the transplant center will handle most transplant-related problems, the primary care physician will still be an important part of a person's medical care.

Self-care

Some lifestyle changes can maintain your overall health after a liver transplant:

• Eat a healthy and balanced diet... limit salt, cholesterol, fat and sugar... A nutritionist can help you prepare a meal plan.
• Don't drink grapefruit or grapefruit juice...these can affect how some immunosuppressants work.
• Do not consume unpasteurized milk products or raw eggs, meat or fish.
• If you have a history of alcohol use disorder, do not drink alcohol and do not use it in food.
• Exercise regularly.
• Do not smoke.
• Reduce your contact with things like dirt, mosquitoes, ticks, rodents, reptiles, birds, and water from lakes or rivers that may carry germs.
• If you are planning to travel (especially to a developing country), talk to your care team at least 2 months in advance about how to reduce your risks.

Prospects of liver transplantation

Your outlook after a liver transplant depends on many things, including the condition that caused your liver to fail. About 88% of patients live at least one year and 73% live at least 5 years after transplant.

For more information on liver transplantation, you can consult with GCORP LLC trainees.