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:
- Laboratory tests
- 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.