Health Advice: Liver Transplantation

 

What does the liver do?

The liver is responsible for many of the body’s metabolic and manufacturing functions including:

  1. The metabolism of carbohydrates into glucose (sugar) so your body can use it for energy
  2. Detoxification (cleaning) of harmful substances from the body, this includes alcohol, drugs including the products from what you eat and drink
  3. Production of bile, a yellow-green substance that helps your body absorb fats
  4. Metabolism and production of proteins, including proteins that aid in blood clotting
  5. Maintenance of normal balance of hormones
  6. Filtering blood to remove bacteria and other particles
  7. Storage of minerals and vitamins for your body’s use later on
  8. Host defense to assist in fighting infection 

Symptoms of chronic liver disease:

  • Fatigue
  • Weakness 
    • Ascities (water in the abdomen)
    • Jaundice (yellow color of skin and eyes) resulting from abnormal bile clearance
    • Clay colored stool and dark urine
    • Itching
    • Vomiting of blood
    • Easy bruising
    • Encephalopathy (confusion) and lack of sleep at night resulting from accumulation of toxins in the blood and frequent infection of ascities 

    What is acute (fulminant) liver failure?

    Fulminant liver failure is potentially life threatening. The toxins accumulate in the blood and cause the brain to swell. If not treated quickly with a liver transplant, patients can die.

     

    What are the indications for liver transplant and what is the success rate?

    When the risk of surgery outweighs the risk of not having a transplant, transplantation is indicated.

     

    What is the duration of liver transplantation surgery?

    From the time you move into the operation theatre until the completion of surgery it takes about 8 to 10 hours. 

    How do I get a liver?

    You can get liver either from a brain dead donor or from a living person who is willing to share with you a part of their liver. 

    How do I get a live donor?

    Live donor is a person who is attached or related to you and is willing to share a part of their liver with you. They have to be a healthy adult (>19 years of age) and less than 50 years of age of compatible blood group type. 

    How safe is live donor liver transplant?

    The data from all over the world estimates the risk for the donor to be around 0.2% to 0.3%. The remnant liver of the donor will grow back to almost its full size in about 6 weeks. The piece of the liver the recipient gets will also grow to meet his requirement.

     

    What is the quality of life for live donor after the surgery?

    The donor stays in the hospital for about 1 week. They take about 3 to 4 weeks to recover fully and get back to work. There is no long term risk and there is no need to take any medications. 

    Which is better? Live donor or Cadaver donor liver transplant?

    The outcomes are comparable. Live donor liver transplant can be planned and performed when the recipient is medically optimized so that the outcomes are optimal. While in cadaver donor liver transplant, we will not be able to predict the timing. Demand is more and supply is less.

     

    What are the complications?

    Immediate post operative complications are bleeding, bile leak, and hepatic artery thrombosis. Bleeding most often settles on its own with appropriate medical management. Sometimes we may have to re-explore to control bleeding. Bile leak can be treated with ERCP but sometimes may require re-operation. Hepatic artery thrombosis (HAT), if identified early, will need re-exploration to take out the clot and to reanalyze it. If it continues to clot, most of them will require urgent re-transplantation. Fortunately, HAT is very rare. 

    How long will I have to take medicines?

    You will need to take medicines for rest of your life. These medicines (immune suppressants) help your body get used to the new liver. In the first three months, you will have a lot of medicines. Our aim is to get it down to one medicine at the end of one year.

    Liver Transplantation at Apollo Hospital, Chennai.

    Apollo Hospitals Chennai is a pioneer in organ transplantation in India. Apollo Hospitals has to its credit the first successful liver transplantation in India. The Centre for Liver Disease & Transplantation at Apollo Hospitals Chennai is a ‘Centre for excellence’ in the treatment of liver, biliary and pancreatic disorders. It comprises of a multi-disciplinary group offering comprehensive evaluation and multi-modality treatment options ranging from medical optimization of chronic liver disease to minimally invasive and laparoscopic surgical treatment of liver, biliary and pancreatic tumors as well as living donor and cadaveric liver and multi-organ transplantation.  

A healthcare initiative by AsiaMed Connect in partnership with Apollo Hospitals Group- For free online medical consultation, send your queries to consultationamc@gmail.com

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