LIVER TRANSPLANT SURGERY
Liver transplant is surgery to replace a diseased liver with a healthy liver.
The donated liver can come from:
• A donor that has recently died without any liver injury. This type of donor is known as a cadaver donor.
• At times, a healthy person will donate part of his or her liver to a person with a diseased liver. For instance, a parent may donate to a child. This kind of donor is called a living donor. The liver can regrow itself. Both people regularly end up with fully working livers after a successful transplant.
The donor liver is transported in a saline solution that preserves the organ for up to eight hours. The required tests can then be done to match the donor with the recipient.
The new liver is taken out from the donor through a surgical cut in the upper abdomen. It is placed into the recipient and attached to the blood vessels and bile ducts. The operation may take up to 12 hours. The recipient will regularly need a large amount of blood through a transfusion.
Why the procedure is done
A healthy liver does more than 400 jobs every day, including:
· Making bile, which is important in digestion
· Making proteins that aid in blood clotting
· Eliminating or changing bacteria, medicines and toxins in the blood
· Storing sugars, fats, iron, copper, and vitamins
· The most common reason for a liver transplant in children/ infants is biliary atresia
The most common reason for a liver transplant in adults is normally cirrhosis. Cirrhosis is scarring of the liver that prevents the liver from working properly. It can worsen to liver failure. The main causes of cirrhosis are:
· Longstanding infection with hepatitis B or hepatitis C
· Long-term alcohol abuse
· Cirrhosis due to non-alcoholic fatty liver disease
Other illnesses that may lead to cirrhosis and liver failure may include:
· Autoimmune hepatitis
· Hepatic vein blood clot (thrombosis)
· Liver damage from poisoning or medicines
· Problems with the drainage system of the liver like primary biliary cirrhosis or primary sclerosing cholangitis
· Metabolic disorders of copper or iron (Wilson disease and hemochromatosis)
Liver transplant surgery is usually not recommended for people who have:
· Certain infections like tuberculosis or osteomyelitis
· Difficulty taking medicines several times each day for the rest of their lives
· Heart or lung disease (or other severe diseases)
· Family history of cancer
· Infections like hepatitis, that are considered to be active
· Smoking, alcohol or drug abuse or other dangerous lifestyle habits
Risks for any anesthesia are:
· Difficulty in breathing
· Reactions to medicines
Risks for any surgery include:
· Heart attack or stroke
Liver transplant surgery and management after surgery have major risks.
There is an increased risk for infection because you must take medications that suppress the immune system to avoid transplant rejection. Signs of infection may include:
Before the Procedure
Your doctor will refer you to a transplant center. The transplant team will make sure that you are a good candidate for a liver transplant. You will make a few visits over some weeks or months. You will have blood drawn and x-rays taken.
If you are the person getting the new liver, the following tests will be carried out before the procedure:
· Tissue and blood typing to ensure your body will not reject the donated liver
· Blood or skin tests to check for infection
· Heart tests like an EKG, echocardiogram, or cardiac catheterization
· Tests to check for early cancer
· Tests to check your liver, gallbladder, pancreas, small intestine, and the blood vessels surrounding the liver
· Colonoscopy, depending on your age
You may choose to look at one or more transplant centers to decide which is best for you.
· Ask the center how many transplants they do every year, and their survival rates. Then compare these numbers to those of other transplant centers.
· Inquire about support groups they have available and the travel and housing arrangements they offer.
If the transplant team thinks you are a good candidate for a liver transplant, you will be placed on a national waiting list.
· Your place on the waiting list is based on a number of factors. Main factors include the type of liver problems you have, how severe your disease is, and the probability that a transplant will be successful.
· The amount of time you spend on a waiting list is normally not a factor in how soon you get a liver, with the likely exclusion of children.
While you are waiting for a liver, do these:
· Follow any diet the transplant team recommends.
· Do not drink alcohol.
· Do not smoke.
· Keep your weight in the appropriate range. Follow the exercise program your doctor recommends.
· Take all medicines prescribed for you. Report changes in your medications and any new or deteriorating medical problems to the transplant team.
· Follow-up with your regular doctor and transplant team appointments that have been made.
· Ensure the transplant team has your correct phone numbers, so they can call you immediately if a liver becomes available. Make sure that, no matter where you are going, you can be contacted quickly and easily.
· Make sure everything is ready ahead of time to go to the hospital.
After the Procedure
If you received a donated liver, you will probably need to stay in the hospital for a week or more. After that, you will need to be closely followed up by a doctor for the rest of your life. You will have regular blood tests after the liver transplant.
The recovery period is about six to twelve months. Your transplant team may ask you to stay close to the hospital for the first three months. You will require regular check-ups, with blood tests and x-rays for many years.
Some people who receive a liver transplant may reject the new organ. This implies that their immune system sees the new liver as a foreign substance and tries to destroy it.
To avoid rejection, almost all transplant recipients must take medicines that suppress their immune response for the rest of their lives. This is called immunosuppressive therapy. Though the treatment helps prevent organ rejection, it also puts people at a greater risk for infection and cancer.
If you take immunosuppressive medicine, you need to be frequently screened for cancer. The medicines may also cause high blood pressure and high cholesterol, and increase the risks for diabetes.
A successful transplant requires close follow-up with your provider. You must always take your medicine as directed.
Hepatic transplant; Transplant - liver; Orthotopic liver transplant; Liver failure - liver transplant; Cirrhosis - liver transplant
The information provided herein is for patient general knowledge only and should not be used during any medical emergency, diagnosis or treatment of any medical condition. Duplication for personal and commercial use must be authorized in writing by Surjen.com
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