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What Is A Liver Transplant? An Overview Of The Procedure

A liver transplant is an important treatment in which a healthy liver from an organ donor is used to replace a sick or damaged liver. When alternative treatments are ineffective for individuals with end-stage liver disease, especially in cases of acute liver failure, this surgery is usually recommended. The largest internal organ in the human body, the liver carries out several functions, such as digestion, blood purification, and food processing. Its correct operation is therefore necessary for a healthy lifestyle.

A liver transplant requires removing the damaged liver and carefully joining the new liver to the patient’s bile ducts and blood arteries. Especially, the liver’s amazing ability for regrowth makes it possible to receive transplants from both living and deceased donors. After the treatment, patients are frequently placed on medication to assist the immune system in preventing organ rejection and are evaluated through follow-up appointments to examine their overall health.

• Jaundice: Yellowing of the skin and eyes 
• Ascites: Fluid buildup in the belly 
• Hepatic encephalopathy: A condition that affects the brain 
• Bleeding: Bleeding in the upper or lower gastrointestinal tract 
• Fatigue: Severe fatigue or feeling tired 
• Bruising or muscle loss: Frequent bruising or loss of muscle mass 
• Sexual drive: Diminished sexual drive 
• Dark urine or pale stools: Dark urine or pale grey stools 
• Enlarged liver: An enlarged liver 
• Portal hypertension: A condition that affects the liver 
• Esophageal varices: A condition that affects the liver 
• Unexplained dyspnea: Unexplained dyspnea with low oxygen levels

A liver transplant is a procedure to replace a diseased or damaged liver with a healthy one. The most common reasons for a liver transplant include : 

• Cirrhosis: Cirrhosis, or scarring of the liver that impairs its function, is the most frequent cause of liver transplants in adults. Long-term alcohol use, non-alcoholic fatty liver disease, or infections with hepatitis B or C can all lead to cirrhosis. 

• Biliary atresia: A transplant from a living donor is frequently used to treat biliary atresia, the most prevalent cause of liver transplants in children.

• Autoimmune hepatitis:  AIH can lead to liver cirrhosis and failure, even with long-term treatment. 

• Primary biliary cirrhosis (PBC): Patients with PBC and decompensated cirrhosis may need a liver transplant. 
• Hemochromatosis: Iron accumulates in the liver in hemochromatosis, a hereditary disorder.
• Wilson’s disease: A hereditary disorder in which the liver accumulates copper.

There are three types of liver transplants: 

• Deceased Liver Transplant: The most typical kind of liver transplant is a deceased liver transplant. The liver is extracted from a donor who passed away recently. This is typically from a donor who has committed to donate their organs before passing away and who is free of any diseases or illnesses that could spread to the receiver.

• Living donor transplant: The recipient of a living donor transplant is a willing, living individual. The donor undergoes the procedure initially, during which the surgeon removes either the liver’s left or right lobe.

• A split type of liver transplant: A liver from a recently dead person is transplanted to two recipients in a split donation. This is feasible if a child and an adult are the next appropriate recipients. The left and right lobes of the donated liver will be separated. The youngster will typically receive the smaller left lobe, while the adult will often acquire the larger right lobe.

When liver functions are impaired to the point where the body cannot repair them, a liver transplant is required. A liver transplant may be curative for children and adults with liver failure brought on by primary hepatic tumours, chronic liver disease, or generalised illnesses.

Once more, the severity of the disease and the patient’s age determine the reasons for a liver transplant.

Some common reasons for a liver transplant : 

• Liver failure: Liver failure occurs gradually due to illness, infection, or alcohol, or rapidly due to inflammation and liver tissue death.

• Liver diseases: These include viral hepatitis, autoimmune hepatitis, nonalcoholic fatty liver disease, and liver cancer.

• Cirrhosis: This is the permanent and end stage of liver scarring that occurs when the liver can no longer repair itself.
• Polycystic liver disease: Poor quality of life and liver enlargement are two consequences of polycystic liver disease.

• Surgical replacement of a failing liver : 

A liver transplant involves removing a diseased liver and replacing it with a healthy one from a donor. This surgery is essential for those with severe liver conditions and requires accurate surgical techniques to ensure the liver is correctly connected to blood vessels and bile ducts.

• Vital for those with end-stage liver disease : 

Liver transplants are crucial for patients with end-stage liver disease, where the liver can no longer function properly. Conditions like cirrhosis, hepatitis, and liver cancer often lead to this stage, where medical treatments fail, making a transplant the only available option for survival.

• Uses either a deceased or living donor’s liver : 

Liver transplants can be performed using a liver from a deceased donor or a portion of a liver from a living donor. Living donor transplants are scheduled faster, while deceased donor livers are allocated based on factors like urgency, size, and compatibility.

• Connects to blood vessels and bile ducts : 

The transplanted liver must be carefully connected to the recipient’s blood vessels (hepatic artery, portal vein, and inferior vena cava) and bile ducts. These connections ensure proper blood flow and bile drainage, essential for the transplanted liver to function.

• The liver can regenerate in living donors : 

The liver has an incredible ability to regenerate, making it possible for living donors to donate a portion of their liver. Both the donor’s remaining liver and the transplanted section grow back to near full size within months, ensuring proper function for both.

• Requires lifelong medication for the immune system : 

To prevent the immune system from rejecting the new liver, transplant recipients must take immunosuppressive medications for life. These drugs reduce the risk of organ rejection but come with side effects, requiring close monitoring and regular medical follow-ups.

A liver transplant is performed when the liver fails to function properly due to extensive damage or failure. This approach is particularly recommended for patients with chronic liver diseases such as cirrhosis, which can result from conditions like hepatitis B and C, alcoholic liver disease, or nonalcoholic steatosis. Also, patients with cancerous liver growth or inherited conditions that affect liver function may need a transplant.

In cases of sudden liver failure, which happens quickly due to things like drug toxicity or infections, a liver transplant might be the only way to save a patient’s life. Unlike chronic liver failure, which develops over months or years, acute liver failure occurs suddenly and requires immediate intervention. By restoring normal liver physiology, liver transplantation can significantly enhance the quality of life for individuals suffering from both chronic and acute liver failure, effectively halting the progression of related complications.

Before undergoing liver transplant surgery, patients must go through a comprehensive pre-operative preparation process that includes:

1. Medical Assessments: This involves a series of blood tests, imaging studies, and liver function tests to evaluate the patient’s overall health and liver condition.
2. Psychological Evaluation: Ensuring the patient is mentally and emotionally prepared for the surgery.
3. Donor Matching: Identifying a suitable donor, which can be either a living or deceased individual.
4. Pre-Surgery Preparation: Patients may need to adhere to specific dietary restrictions and receive necessary vaccinations.

The surgical procedure for a liver transplant typically follows these steps:

1. Donor Operation (for Living Donors): If the liver is sourced from a living donor, a portion of their healthy liver is removed. This part of the liver can regenerate over time.
2. Recipient Operation:
   • Removal of Diseased Liver: The surgeon makes a large incision in the abdomen to remove the failing liver.
   • Implantation of New Liver: The donor’s liver is then carefully connected to the recipient’s blood vessels, including the hepatic artery, portal vein, and inferior vena cava, as well as the bile ducts.
   • Verification: Surgeons check that the new liver is functioning correctly, ensuring there are no leaks or blockages.

After the liver transplant surgery, patients are moved to an intensive care unit (ICU) for close monitoring, which includes observing liver function and vital signs. Post-operative care involves:

• Immunosuppressive Therapy: Patients are required to take medications that suppress the immune response, minimising the risk of rejection of the new liver.
• Gradual Recovery and Physical Rehabilitation: This phase is crucial for helping patients regain their strength and mobility.
• Long-Term Follow-Up: Regular check-ups and tests are necessary to monitor the health of the transplanted liver and the patient’s overall condition.

Patients with severe liver disorders or liver failure may need a costly yet life-saving liver transplant. During this procedure, patients’ quality of life and survival can be increased significantly by replacing a failing liver with a healthy one from a deceased or living donor.

The level of difficulty of the procedure requires fine pre-operative tests, exact surgical methods, and careful post-operative management, which includes immunosuppressive medication for the rest of one’s life to prevent organ rejection.

While liver transplants can be life-changing, they require ongoing medical management to ensure the long-term health of the patient and the transplanted organ. As advancements in medical science and organ transplantation continue to evolve, the future looks promising for individuals with severe liver conditions, offering renewed hope for a healthier life ahead.

Sahyadri Hospital stands out as a preferred choice for liver transplants, offering expert care through its renowned team of hepatologists and transplant surgeons. With decades of experience and advanced technology at their disposal, Sahyadri ensures each patient receives personalised treatment throughout every stage of the transplant journey. From pre-operative evaluations to post-operative care, the hospital’s focus on precision and patient well-being helps deliver outstanding outcomes. Our medical team’s proficiency and dedication, combined with cutting-edge facilities, provide an unmatched level of care for those in need of liver transplants.

Sahyadri Hospital is recognized for its medical talent and caters to the needs of patients requiring life-saving liver transplants with great care. The hospital offers a holistic approach, which benefits the patients embarking on the procedure and those who have finished the process. In case you or your loved one has been diagnosed with liver-related disease, do not hesitate – to contact Sahyadri Hospitals immediately to find out how their specialist team can offer the best treatment and a shot at renewed health.

1. What is a liver transplant?
   A liver transplant is a surgical procedure that replaces a damaged liver with a healthy one from a donor.
2. Who needs a liver transplant?
   Patients with end-stage liver disease, cirrhosis, or acute liver failure may require a liver transplant.
3. What are the types of liver transplants?
   There are orthotopic, living donor, and split liver transplants.