By Dr Saravana.K
A liver transplant is a surgical procedure to remove a diseased liver and replace it with a healthy liver from a donor. It uses livers from deceased donors, though a liver may also come from a living donor. If you have a family member or friend who is willing to donate part of his or her liver to you, talk to your transplant team about this option.
Liver transplant is a treatment option for people who have end-stage liver failure that can’t be controlled using other treatments and for some people with liver cancer. Liver failure can occur rapidly, in a matter of weeks or it can occur slowly over months and years.
It has many causes, including alcoholic liver disease; early-stage liver cancer; or Hepatitis B and C.
Surgery carries a risk of significant complications, including bile duct complications; bleeding; failure and rejection of donated liver; or infection.
After a liver transplant, you’ll take immunosuppressants for the rest of your life to help prevent your body from rejecting the donated liver. These medications can cause a variety of side effects.
If indicated, your doctor may refer you to a transplant centre to undergo evaluation for liver transplant. The transplant centre team conducts a wide variety of tests to determine whether to place your name on the waiting list for a new liver. It includes:
Imaging tests – ultrasound of your liver
Heart tests to determine the health of your cardiovascular system
A general health exam, including routine cancer screening tests, to evaluate your overall health
Nutrition counselling with dieticians
Psychological evaluation to determine whether you fully understand the risks of a liver transplant
Meetings with social workers who assess your support network to determine whether you have friends or family to help care for you after transplant
Addiction counselling to help people with alcohol, drug or tobacco addictions to quit
Financial counselling to help you understand the cost of a transplant and post-transplant care.
Once these are completed, the transplant centre’s selection committee meets to discuss your case. It determines whether a liver transplant is the best treatment for you and whether you’re healthy enough to undergo a transplant. If the answer to both questions is yes, then you’re placed on the transplant waiting list.
Your wait for a donor liver could be days, or it could be months.
As you wait for a new liver, your doctor will treat the complications of your liver failure to make you as comfortable as possible. Complications of end-stage liver failure are serious, and you may be frequently hospitalised.
After your liver transplant, you can expect to:
Possibly stay in the intensive care and hospital unit for a few days to weeks.
Have frequent check-ups as you continue recovering at home
Expect six months to a year of recovery before you’ll feel fully healed after your liver transplant surgery. You may be able to resume normal activities or go back to work a few months after surgery.
Your chances of a successful liver transplant and long-term survival depend on your particular situation. In general, about 72 per cent of people who undergo liver transplant live for at least five years.