Saturday, September 17, 2011

Cadaver Donor Liver Transplant

In the case of a cadaveric donor organ, the transplant center receives a liver offer from ORBO for a specified patient. . The patient is then notified and admitted to the hospital. While the donor team is procuring the donor liver, the recipient team begins to prepare the patient. The diseased liver is removed and the healthy liver is put in its place. The operation usually takes 6-8 hours. After the operation the patient begins taking medications to prevent the new liver from being rejected by the body. Complete recovery may take several weeks. The quality of life for transplant patients usually improves dramatically with most leading healthy, normal lives.
Such donation is possible from a brain dead person whose family wishes to donate the person's organs before discontinuing life support. This situation arises only in a hospital ICU in a person after brain injury in an accident or in someone who has suffered fatal brain hemorrhage etc. In these circumstances, the whole liver can be used for an adult, and a part of it for a child. After removal from the donor (a process called liver retrieval) the liver can safely be kept preserved outside the body in special preservation solutions for 12-15 hours. Allocation of such organs is strictly according to blood group which must match, time on waiting list and urgency of requirement.
There are different sources of donor livers. Usually the liver is obtained from a cadaveric donor (a person diagnosed as "brain dead" but whose other organs and systems are functioning properly). Due to a continuous shortage of donor livers and the high incidence of liver disease, the waiting time is increasing every year. Hundreds of people die each year while waiting for a cadaveric liver to be offered.
One of the biggest problems is the unavailability of compatible cadaveric donor livers.
A major factor in patient survival following transplantation is the degree of hepatic decomposition and associated debility at the time of transplantation. However, outcomes of liver transplantation have markedly improved due to effective immunosuppressant, improved surgical preservation techniques, and enhanced strategies to treat postoperative complications. 
An important flaw with this kind of transplantation is that the impact of transplantation on pulmonary gas exchange is more pronounced in patients receiving organs from cadaveric donors. This difference may arise from longer cold ischemia times present in the cadaveric donor group.

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