Curious About Liver Transplantation
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Curious About Liver Transplantation

A liver transplant is a surgical procedure in which a part of a healthy liver from a deceased or living donor is replaced for a liver that is not functioning properly for some reason.

Functions of the Liver

The liver is the largest organ in the body and has important responsibilities. These responsibilities

  • Processing nutrients, medications, and hormones as needed
  • Producing bile, which helps absorb fats, cholesterol, and fat-soluble vitamins
  • creating proteins that help blood clot
  • Removing bacteria and toxins from the blood
  • Preventing infection and controlling immune responses

Liver transplants are generally known to be a treatment option for people with serious health problems due to chronic liver disease. It is also seen as a solution in rare cases of sudden failure of a previously healthy liver. Liver transplantation also treats some cancers that originate in the liver.

The number of people listed for liver transplant is greater than the number of livers from an existing donor. A living donor liver transplant is an alternative way to wait for a deceased donor liver. Live donor liver transplantation relies on the ability of a portion of the human liver to be regenerated shortly after surgical removal.

Curious About Liver Transplantation

Liver failure may develop rapidly or involve a long process. Liver failure that appears suddenly within a few weeks is called acute liver failure. Acute liver failure is a rare condition that is usually the result of complications from certain medications. Although liver transplantation is seen as a solution for acute liver failure, it is mostly used to treat chronic liver failure.

Chronic liver failure, in contrast to acute, occurs slowly over months or years. The origin of chronic liver failure is due to several conditions. The most common cause of chronic liver failure is scarring of the liver (cirrhosis). When cirrhosis occurs, scar tissue replaces healthy liver tissue and impairs the liver’s proper function.

Common causes of cirrhosis leading to liver failure and thus liver transplantation can be listed as follows:

  • Hepatitis B and C disease
  • Liver disease that causes liver damage due to excessive alcohol consumption
  • Disorders that cause fat to accumulate in the liver, inflammation, or liver cell damage
  • Hemochromatosis and Wilson’s disease
  • Diseases that affect the bile ducts (primary biliary cirrhosis, primary sclerosing cholangitis and biliary atresia)

Biliary atresia is the most well-known reason for liver transplantation, especially in children.

What Are the Risks of Liver Transplantation?

Liver transplantation has some risks and these risks can be listed as follows:

  • Leaks from the bile duct
  • Bile ducts begin to narrow
  • Bleeding and blood clots
  • Infections
  • Rejection of donor liver
  • Experiencing mental confusion
  • Side effects of drugs that prevent rejection of the donor’s liver (thinning of the bones, diabetes, diarrhea, headache, high blood pressure and cholesterol)

Evaluation for liver transplant

In order to be able to have a liver transplant, you will be subjected to some evaluations. It is important whether you are healthy enough to have the surgery and your ability to use lifelong medications after the transplant. If you have any medical conditions that may hinder the success of the transplant, it should be determined. Besides that, there are tests, procedures and consultations you have to pass. Blood and urine tests, liver ultrasound, and heart tests are done to check the health of the cardiovascular system. In addition, routine cancer screenings can also be done. You can get nutritional counseling to ensure that your meals are healthy, and you can get psychological support for the success of the transplant process and to prevent anxiety. In addition to these situations, it is also helpful to seek addiction counseling if you have harmful habits such as alcohol and cigarettes.

After these tests are complete, the transplant center’s committee meets and comes to an opinion on whether a liver transplant is the best treatment for you. After that, you queue for your new liver on the waiting list. The waiting time for a donor liver differs. Some people may wait days, while others may wait longer. While you wait for a new liver, your doctor will treat any complications caused by your liver failure, making you as comfortable as possible.

LIVE LIVER DONORS

A liver transplant with a small piece of liver from a healthy, living person accounts for a small percentage of liver transplants performed each year. Liver transplantation from a living donor is a good alternative to waiting for a liver from a deceased donor and the success rate is considered the same as a non-living donor. The first step is to find a healthy living donor who can safely survive a major surgical procedure. The donor’s age, blood type and organ size are also important factors in the realization of the transplant. Living liver donors generally consist of close family members or friends of the liver transplant candidate. If you have a family member or friend who would like to donate some of their liver to you, share this option with your transplant team.

DOMINO LIVER TRANSPLANT

A less common form of liver transplant from another living donor is called a domino liver transplant. In a domino liver transplant, liver is taken from a living donor who has a disease called familial amyloidosis. Familial amyloidosis is a very rare disease in which the internal organs of the body are damaged as a result of the accumulation of an abnormal protein. A donor with familial amyloidosis receives a liver transplant to treat her condition. Then, the donor liver can be given to you in a domino liver transplant, as the liver is still working fine. You may eventually develop symptoms of amyloidosis, but these symptoms often take decades to develop. Doctors usually select recipients who are over the age of 55 and are not expected to develop symptoms. After your transplant, doctors follow you for signs of the condition.

How is Liver Transplant Performed?

If you are informed that you can receive the liver of a deceased donor, you will be asked to come to the hospital immediately. You will undergo a series of examinations to make sure you are healthy enough for surgery.

Liver transplant surgery is performed using general anesthesia, so you will be anesthetized during the procedure. The transplant surgeon makes a long incision in your abdomen to reach your liver. The location and size of your incision depends on the surgeon’s approach and your anatomy.

The surgeon removes the diseased liver and places the new liver in your body. It then connects your blood vessels and bile ducts to the donor liver. Depending on your situation, the surgery can take up to 12 hours. Once your new liver is in place, the surgeon uses stitches and staples to close the incision. You will then be transported to the intensive care unit to begin recovery.

If you are receiving a liver from a living donor, your surgery is planned in advance. The surgeon first performs surgery on the donor and removes the part of the liver reserved for transplantation. Then the surgeon removes the diseased liver from your body and places the donated liver in your body. It then connects your blood vessels and bile ducts to the new liver.

The transplanted liver part in your body and the part left behind in the donor’s body are rapidly renewed and reach their normal volume within a few weeks.

Post-liver transplant process

Possible conditions after your liver transplant are as follows:

You will likely stay in the intensive care unit for a few days. Doctors and nurses keep you under control to monitor for signs of complications. They also often test your liver function for signs that the new liver is working properly.

You spend 5 to 10 days in the hospital. Make frequent checkups as you continue to recover at home. Your transplant team will design a control program for you. You may have blood tests a few times a week at first, then less frequently over time.

You will likely use drugs for the rest of your life. Medicines called immunosuppressants prevent your immune system from attacking your new liver. Other drugs reduce the risk of other complications after the transplant. You can return to your daily activities and work a few months after the surgery. Your condition after a liver transplant depends on many factors, including what caused your liver failure. About 88% of patients survive at least one year after transplant, while 73% live at least 5 years. For more detailed information about liver transplantation, consult your nearest health institution or your doctor.

See more details please visit https://tr.wikipedia.org/wiki/Karaci%C4%9Fer

Bibliography: https://www.medicalpark.com.tr/karaciger-nakli/hg-2534

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