About The Procedure
When a patient’s liver completely stops working, the condition is known as liver failure. It is during this time the patient might need a liver transplant. Liver failure can occur due to multiple reasons. A few of them are viral hepatitis, drug-induced injury, or infection. This is called acute or fulminant hepatic failure.
However, there are also conditions that can cause chronic liver failure, which are:
1. Chronic hepatitis with cirrhosis
2. Primary biliary cholangitis, a rare condition in which your immune system destroys your bile ducts
3. Sclerosing cholangitis, scarring, and narrowing of the bile ducts inside and outside your liver, causing bile to back up
4. Biliary atresia, a rare liver disease that affects newborns
5. Alcohol overuse
6. Liver cancers such as hepatocellular carcinoma
7. Wilson’s disease, which causes unusual levels of copper throughout your body, including your liver
8. Hemochromatosis, in which your body has too much iron
9. Alpha-1 antitrypsin deficiency, an unusual build-up of a protein called alpha-1 antitrypsin in your liver, resulting in cirrhosis.
Why Is The Liver Transplant Procedure Conducted?
A patient undergoes a liver transplant when his/her liver fails to function normally. It is primarily conducted on patients who are suffering from chronic liver failure. Chronic liver failure occurs over months and years in a patient.
The most common cause for chronic liver failure is a condition known as cirrhosis. During liver cirrhosis, the normal tissues of a liver get scarred resulting in failure of the organ. Liver cirrhosis is the most common reason for a liver transplant.
Major causes of cirrhosis leading to liver failure and liver transplant include:
· Hepatitis B and C.
· Alcoholic liver disease, causes damage to the liver due to excessive alcohol consumption.
· Non-alcoholic fatty liver disease, a condition in which fat builds up in the liver, causing inflammation or liver cell damage.
· Genetic diseases affecting the liver, include hemochromatosis, which causes excessive iron build-up in the liver, and Wilson’s disease, which causes excessive copper build-up in the liver.
· Diseases that affect the bile ducts (the tubes that carry bile away from the liver), such as primary biliary cirrhosis, primary sclerosing cholangitis and biliary atresia. Biliary atresia is the most common reason for liver transplants among children.
Different Types Of Liver Transplant
There are two types of liver transplant options for a patient:
1. Living donor
2. Cadaveric
In the first type, a part of the liver is removed from a healthy living donor and transplanted into the patient. For both the cases, the part of their liver grows in a few weeks. This type of donor is usually a blood relative, friend, spouse, or stranger. All of them are first asked to go through a series of check-ups and tests to ensure there is minimal risk involved.
In the second type of liver transplant, the donor is usually a victim of a cerebral vascular accident or a head injury which includes continuous bleeding in the head. The cadaveric donors are those who have suffered irreversible injuries and are either declared brain dead or cardiac dead.
How Is A Liver Transplant Conducted?
Before the transplant – Both donor and the recipient must go through a series of tests before the transplant to ascertain the benefits and the potential risks involved. Matching criteria for the donor with the recipient are based on age, blood type, organ size, and a few more.
During the procedure- During the transplant, the surgeon removes the unhealthy or dead liver from the recipient’s body and implants the new liver from the donor after making an incision in the abdomen. Then the surgeon connects all the blood vessels and the bile ducts to the new liver inside the recipient’s body. The new portion of liver in the patient’s body starts to regrow at its normal rate in a few months.
After the procedure- The discharge process starts once the patient is shifted to a regular ward from an ICU after the transplant. The first appointment for the patient post the transplant is usually scheduled after two weeks of discharge. Later, regular follow-ups will also be fixed at intervals of six to nine months to ensure there are no additional complications. Patients are also advised to return for check-ups during their first anniversary of transplant as well.
Risks Involved In A Liver Transplant
There are often chances of a few complications resulting from liver transplants in patients. Some of them are:
1. Rejection – There are high chances that the patient’s immune system will attack the newly transplanted liver inside the body. This process is known as rejection. Almost 60 percent of patients suffer from rejection episodes. This is why anti-rejection medicines are prescribed to patients after a liver transplant.
2. Infection – Most commonly, the anti-rejection medicines taken by the patient result in the weakening of the immune system. These drugs are called immuno-suppressants and as a result, the patient becomes more prone to external infections.
3. Liver function problems – There are instances when the implanted liver doesn’t function normally as it should in around one to five per cent of patients, and in such cases, a second transplant may be required.