What Happens Before & After Liver Transplant Surgery

India’s first successful living donor liver transplant happened in 1998. Since then, the number of such operations has risen admirably in the country. However, the fact remains that the number of patients on waiting lists is far more than the actual number of surgeries carried out. There is a need for around 25,000 liver transplants per year, but the year 2014 saw only 1,400 transplants.

A liver transplant is usually a last resort option to save a life. If you or your loved one is facing the issue, then it is vital to know about this procedure. This action ensures that the chances of successful outcomes go up substantially.

This post will take a look at everything you need to know about a liver transplant.

Why is a Liver Transplant surgery needed?

You may need a transplant because any issue with the organ can prove to be life-threatening. You may be recommended a liver transplant if you are having end-stage liver disease or chronic liver failure. The most common cause of end-stage liver disease is a severe case of cirrhosis. It happens when healthy tissues of the liver replace the scar tissues. It prevents the liver from working the way it should. Some other diseases that may be responsible for end-stage liver disease are:

• Biliary atresia
• Acute hepatic necrosis
• Metabolic diseases
• Viral hepatitis
• Autoimmune hepatitis
• Primary liver cancer

Not only adults but children too sometimes require a liver transplant. A rare tumor known as Hepatoblastoma can cause pediatric liver cancer.

Who is not suitable for this procedure?

You may be exempted from this surgery if you have the following:

• Chronic or current infection that is not treatable
• Metastatic cancer
• Severe heart and health problems
• Other conditions that are not treatable after a transplant
• Severe alcohol consumption

What are the two types of Liver Transplant?

The two types of liver transplant are:

Orthotropic Approach

It is the most common type of liver transplant surgery. Here the recipient’s liver is removed and replaced with the liver of the donor. The operation starts by removing the diseased liver from the four main blood vessels that hold it in place in the abdomen. The donor’s liver is then connected, and the restoration of blood flow begins.

Heterotrophic Approach

Here, the surgeon leaves the problematic liver as is. He will then sew the liver of the donor into a site outside the liver.

How is the donor matched?

There are more recipients than donors for a liver transplant as we saw at the beginning of this post. Therefore, health experts have developed a score that is ‘Model for End-Stage Liver Disease’ (MELD). It is an algorithm to assess the severity of chronic disease and to prioritize patients for transplantation.

After the diagnosis of liver disease by a gastroenterologist, the patient is given a referral to a transplant center. There are many tests are conducted to determine if the patient is a candidate for transplantation. Then with the severity of the disease, the MELD score is used to rank the patient on the waiting list. The higher the severity of the disease, the highest in the ranking. In other words, the patient with the most severity is likely to get the donor liver first.

There are also other qualification points for a liver transplant. If the patient has liver disease from drug abuse like alcoholism, the ongoing abuse will make the patient ineligible for transplantation. If the patient is recovering from the addiction, he/she may be a candidate for transplantation, depending on their situation.

What are the different types of donors?

There are commonly two types of the donated liver that is an organ from a living donor and an organ from a deceased donor.

You can donate a part of your liver to a friend or a loved one, as the liver has a fantastic capability of regenerating. The liver can return to its full weight within a few weeks of donation, and in a healthy donor, it is back to standard size. A donation from a deceased donor is known as a cadaveric liver and comes from a deceased individual.

What to expect from the transplant?

Before surgery

After meeting the staff, the transplant center will evaluate you. The evaluation will include a review of your medical records, imaging studies, blood tests, and other tests to determine if you are well enough to tolerate the transplant.

Once a donor’s liver is made available, the transplant takes place within 12 to 18 hours in the recipient. You should always be ready at any moment to go to the transplant center for the operation. Also, make sure the transplant team knows how to reach you at all times.

During surgery

After giving the general anesthesia to the patient, the surgical procedure begins with a large incision in the abdomen that exposes the liver. A healthy liver is large, and a diseased liver much larger. Therefore, a full-size incision is used rather than minimal invasive techniques.

After Surgery

In the surgical ICU, most patients recover well from a liver transplant. They are allowed to wake slowly from anesthesia and are likely to remain on the ventilator for hours or days until they regain strength.

In 10 to 14 days, most patients can go home and return to their normal activities in three to six months. The first few months after the operation, there would be frequent follow-up appointments, and it will gradually decrease as the patient heals.

To conclude

These were a few essential pointers to know for liver transplant procedures. Since it is a major surgery, being better informed certainly helps for people suffering from this condition.