Wednesday, August 10, 2011

LIVER TRANSPLANT

Liver transplantation is a life-preserving surgical procedure wherein a dysfunctional or diseased liver is replaced with either a whole healthy liver or a portion of it, donated by a compatible donor. Liver transplant has become a well-accepted option for patients with liver failure. Liver transplant centres check for compatibility between donor and recipient based on blood type and liver size. Donors may either be a relative or friend of a recipient or individuals who are declared brain dead and whose next of kin have consented for organ donation.


Which diseases are most commonly treated with Liver transplants ?
Liver transplantation in adults is most commonly used in case of chronic viral hepatitis C and B, autoimmune hepatitis, primary biliary cirrhosis (PBC), primary sclerosing cholangitis (PSC), alcoholic liver disease, and liver cancer. In children, it is largely resorted to in case of biliary atresia (failure of the bile ducts to develop and drain bile from the liver)

Does transplantation work for Liver cancer patients?
Most cancers of the liver actually begin in other organs or tissues and spread or metastasize to the liver. Such cancers cannot be cured by a transplant. However, other tumours like Hepatocellular carcinoma which are confined to the liver may be treated with radio frequency ablation, chemo-embolization, resection or liver transplantation depending on the size, number and location of the tumours. Small, early tumours have an acceptable chance of responding favourably to liver transplant.

Does alcohol-induced liver disease respond well to liver transplant?
Fortunately, in case of cirrhosis, the liver may regenerate as a result of abstinence from alcohol. However, if even prolonged abstinence and medication does not restore normal liver condition, then transplantation may have to be considered.


In a liver disease, at what stage is transplantation considered?
Liver transplant may be considered only in case of advanced liver disease with impaired and non-reversible liver function. This begins with assessment of the patient by the specialist or family doctor who then refers the patient to the transplant team. Comprehensive medical evaluation by tests and interviews helps confirm the need for transplantation. All family members are intensely involved during the decision making process,

How long does a recipient have to wait for a transplant?
Generally the sickest patients are given priority further based on severity of the liver disease (via a MELD score- Model for End Stage Liver Disease). Assistance from a qualified health professional is essential especially in case the patient and family find it difficult to cope with the pressures.

How successful can a liver transplant be?
The success rate, as reflected by acceptance of the liver by the patient and its normal functioning, depends on various factors but can be as high as 90 per cent.

Post- liver transplant care
Patients having undergone a liver transplant are moved to the Intensive Care Unit or ICU put on a mechanical ventilator that supports breathing and closely observed for symptoms of any infection. Functioning of the transplanted liver is frequently monitored by various tests. After one to three days in the ICU they are transferred to a step-down transplant unit where intravenous medication is provided. After progressive improvement supported by physiotherapy, the patient may leave the hospital in about 10 to 14 days. For the subsequent 2 weeks or so, the patient is required to attend the outpatient clinic at the transplant centre for close monitoring of liver function, for which it is preferred that the patient stays close to the centre. Return to a good quality of life is generally seen within 3 to 6 months of surgery in case of most patients

Does anti-rejection medication have any side effects?

Anti-rejection medication is required to be administered for life by all liver transplant patients, starting with a high dose after surgery and subsequently tapering off. An appropriate anti-rejection medication available is suggested by the physician which primarily suppresses the body’s immune system thus allowing the body to accept the new organ without attacking it. A rejection episode (like increased blood pressure-due to effect of the medication on the kidneys) is generally observed in many patients but almost 90 per cent of such cases are reversed with minimum alteration in the medication and close monitoring.

What are the chances of recurrence of the original disease?
Often the original disease may return and cause similar harm to the liver. Hepatitis C, for example, cannot be eradicated by a liver transplant and may recur within a year of transplant. Hepatitis C patients are now administered anti-viral therapy after the transplant. In Hepatitis B patients, the transplant is done after having controlled the infection well with anti-viral medication. The immune-suppressants in the anti-rejection medication help slow down the progress of autoimmune diseases like PBC, PSC and autoimmune hepatitis which are known to recur after transplant. In those cases where a liver transplant has failed once, another transplant may be required.

How is lifestyle after a transplant?
A normal, healthy lifestyle with renewed energy and an enhanced quality of life is generally observed in most patients. They begin to enjoy normal activities and exercises, woman are able to conceive without any complications

1 comment:

  1. Nice post. Thank you for sharing the useful information of the liver transplant. You also tell me the side effects of this surgery. I also know that there are the risk of any surgery. The liver conditions is one of common diseases all over the world. I need to know more about this disease and want to prevent it. Anyway, thanks a lot.

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