All About Liver transplant

Your Ultimate Guide to Know Everything About Liver Transplants

A liver transplant is a surgical surgery that replaces a failing or non-functioning liver with a healthy one from a donor. The liver is a critical organ that performs essential body activities like detoxification, metabolism, and protein synthesis. When it fails to work, the body cannot survive without medical assistance.

When Do You Need a Liver Transplant?

A liver transplant is often advised when the liver has been significantly damaged and cannot be repaired with existing procedures. Common conditions requiring a liver transplant include:

1. Chronic Liver Disease:

• Hepatitis B or C can cause cirrhosis.
• Alcohol-related liver illness.
• NAFLD (non-alcoholic fatty liver disease).

2. Acute liver failure:

• Caused by medication toxicity, such as an acetaminophen overdose.
• Viral hepatitis causes abrupt liver failure.

3. Inherited Liver Conditions:

• Wilson’s Disease.

4. Liver Cancer:

Some examples of hepatocellular carcinoma that have not progressed beyond the liver.

Types of Liver Transplants

Liver transplants are classified into two groups based on the origin of the donor liver:

• Deceased Donor Liver Transplant:

The liver is obtained from a donor who has just died and whose family has agreed to organ donation.

• Living Donor Liver Transplant:

A healthy liver is harvested from a living donor (often a family member or acquaintance). Following surgery, both the donor and the recipient’s livers regenerate.

Who is a Eligibile for a Liver Transplant?

Before being placed on a transplant list, applicants are thoroughly evaluated, including:

• Medical Assessments: To determine the severity of liver disease and overall health.
• Psychological evaluation: To determine mental readiness and support systems.
• Lifestyle Factors: Patients must avoid alcohol and narcotics.

Doctors utilize the MELD (Model for End-Stage Liver Disease) score to prioritize patients based on the urgency of their condition.

What to expect before a liver transplant surgery?

Cadaver donor liver transplant: The transplant team will examine blood tests, imaging tests, and other factors to determine the severity of the disease, the urgency of the transplant, and placement on the cadaver liver transplant waiting list. Priority to obtain a cadaver or deceased donor while on the waiting list is determined by a score system: End-Stage Liver Disease (MELD) for adults and Pediatric End-Stage Liver Disease (PELD) for children under the age of 12.

A high score implies that the person need an urgent transplant. Patients with high MELD or PELD receive donated livers first. In the case of liver cancer or other severe liver diseases, the organ transplant center (OTC) can seek additional points for MELD or PELD in order to obtain a cadaver donor quickly.

In cases of Acute hepatic failure patients are ranked higher on the waiting list depending on their severity for cadaver donor liver transplant when the MELD or PELD grading system is not used. If patients do not receive a donor, doctors will administer medications to manage the consequences of End-Stage Liver Disease and alleviate symptoms to keep them comfortable.

Living donor liver transplantation: It is an alternate option for patients who are waiting for a deceased-donor liver. This will assist patients in avoiding future issues from liver disease while waiting for a deceased donor.

Lobe selection for a living donor transplant is determined by the donor’s organ anatomy, blood group, and age. Immediate family members can donate their liver. Living donors must undergo comprehensive evaluation prior to a liver transplant to verify they are a match for the organ recipient.

Maintaining health: It is critical for patients waiting for a liver transplant to adhere to medication and food requirements, exercise regularly, stay healthy, follow up with the transplant on a regular basis, and be prepared for transplant surgery when the time comes.

What to expect during a liver transplant surgery?

Cadaver-donor liver transplant: If a deceased donor is available, the organ transplant center will notify patients to be admitted to the hospital. Following a comprehensive evaluation to determine the patient’s overall condition, the transplant team will perform liver transplant operation.

During surgery, a liver transplant surgeon removes the diseased liver from the recipient using a procedure known as hepatectomy (liver resection) surgery and replaces it with the liver from the deceased donor. Surgery can last up to 8 to 10 hours. Following successful surgery, the patient will be transferred to the intensive care unit.

Living donor liver transplant: It is critical to evaluate the living donor prior to surgery. Following rigorous examination, the transplant team performs hepatectomy surgery (liver resection) on the healthy part of the donor’s liver and replaces it with the recipient’s damaged liver.

Following surgery, the liver regrows within 15 to 20 days in both the donor and the recipient, achieving normal volume.

What to expect after a liver transplant surgery?

Most people will need to stay in the hospital for up to 15 to 20 days following transplantation for monitoring. A person who has received a liver transplant requires regular follow-up to check their progress.

Recovering from a liver transplant can take a long period, but most patients will be able to resume many of their regular activities within a few months.

What are the Risks and Complications Associated With Liver Transplants?

While liver transplants have a high success rate, there are some potential risks:

• Bleeding and infection.
• Organ rejection.
• Immunosuppressive medications’ side effects include high blood pressure and diabetes.

Recovery After a Liver Transplant

The recovery process involves:

1. Immediate Post-operative Care

a) Hospital Stay:

• After a liver transplant, patients usually stay in the hospital for 7-14 days. This comprises 1-2 days in the intensive care unit (ICU) and the remaining days in a standard hospital room.
• Doctors and nurses regularly monitor vital signs, liver function, and overall health. Patients may have multiple tubes and drains, including intravenous lines for fluids and drugs.
• Catheters are used to empty pee.
• Drainage tubes are used to drain excess fluids from surgical sites.

b) Pain Management:

Surgical procedures often result in pain. Patients are given drugs to assist them control their discomfort, which improves mobility and speeds up healing.

c) Breathing Exercises:

Patients are encouraged to practice breathing exercises with devices such as a spirometer to help prevent lung infections.

2. Post-Surgery Medications

a) Immune suppressants:

Patients must take immunosuppressive medications, such as:

• Tacrolimus Cyclosporine
• Mycophenolate Mofetil

These drugs inhibit the immune system, lowering the chance of organ rejection while increasing vulnerability to infection.

b) Additional medications:

• Antibiotics and antivirals: used to prevent infections.
• Painkillers: are used to relieve discomfort after surgery.
• Antihypertensive medications: To control blood pressure if necessary.
• Anti-ulcer medications: Used to avoid stomach troubles caused by immunosuppressants.

3. Physical recovery at home

a) Rest and Mobility

• To avoid issues such as blood clots, patients are recommended to rest at first but gradually increase their physical activity.
• Walking short distances several times every day improves circulation and develops muscles.

b) Wound Care

• Keep the surgery incision dry and clean.
• Follow the healthcare team’s precise recommendations for changing the dressing.

c) Diet and Nutrition

• A well-balanced, nutrient-dense diet improves liver function and overall healing. The key recommendations include:
• Low-sodium diets help to prevent fluid retention.
• High protein consumption is beneficial for repairing and maintaining muscle mass.
• Avoiding alcohol To protect the liver.
• Staying hydrated is essential.

d) Physical restrictions

• Avoid heavy lifting and hard activity for at least 6-8 weeks.
• Refrain from driving until the doctor clears you, which is normally after 3-4 weeks.

4. Psychological and Emotional Recovery

a) Coping with

• Stress: Anxiety, depression, or mood swings are common after a major surgery. Counseling or joining a support group can be helpful. Family and friends should offer emotional support during this time.
• Addressing Cognitive Issues: Some individuals report memory or focus issues as a result of the operation or drugs. These symptoms normally improve with time.

5. Follow-Up Care and Monitoring 

a) Regular Medical Check-Ups

• Frequent follow-ups are required to evaluate liver function, detect problems, and alter medications. Tests usually include:
• Blood tests to determine liver enzymes, bilirubin, and drug levels.
• Imaging studies, such as ultrasounds, are used to check the liver.

b) Screening for Complications

• Rejection: Symptoms include fever, tiredness, jaundice, and abnormalities in liver function tests.
• Infections: Patients on immunosuppressants are more likely to become infected. Early signs, like as fever or sore throat, should not be overlooked.
• Complications involving the bile duct: Bile leaks or obstructions may necessitate additional treatments.

Life After a Liver Transplant

Following healing, patients can resume a regular and active lifestyle. Success rates are high, with many recipients living for decades after transplantation. Key components of maintaining health are:

• Regular exercise.
• Stress Management.
• Staying aware and informed on vaccines.

How Can You Find the Right Liver Transplant Center?

Choosing an experienced and renowned transplant institution can have a major impact on results. Search for facilities with:

• Skilled transplant surgeons.
• High success rate.
• Comprehensive after-transplant care.