Liver transplant



What is a liver transplant?

A liver transplant is  surgery which is performed on the liver. During this procedure any damaged or diseased section of the liver is removed and replaced with a healthy organ. Although a fairly common process, this operation may carry some risks.
The following information will help you get acquainted with the process of liver transplantation as well as the reasons, procedure and complications involved.

When is a liver transplant needed?

When your liver stops functioning adequately, the condition is known as liver failure. Our body requires the liver for many important functions such as  metabolism, protein production, storage functions, bile production, blood clotting proteins and removal of toxins. Our body cannot perform these essential functions without a healthy functioning liver.

This type of liver failure can occur suddenly ,  acute liver failure which may be a result of infection or  complications from interactions of  certain medicines. It can also be the result of a long term process. In chronic liver injuries such as  cirrhosis, the liver reaches a point where it can no longer function adequately. The only hope for  long term survival for the patient is for a  liver transplant.

Causes of Liver Failure

Here are a few common causes which result in liver failure:

• Chronic hepatitis with the presence of cirrhosis of the liver
Alcoholic cirrhosis
• Primary biliary cirrhosis (this is an autoimmune condition where the immune system attacks the bile ducts)
• Primary sclerosing cholangitis ( scarring of the bile ducts within and outside the liver which leads to bile accumulating within the liver)
• Biliary atresia ( a congenital condition where the bile ducts are occluded)
• Wilson’s disease (copper build up in the body)
• Hemochromatosis
• Liver cancer

Types of liver transplant

There are three types of transplants which can be performed to replace a diseased liver:

1. Organ donation from a deceased person.

2. Liver donor liver transplant: This can be possible when a portion of the liver can be removed and transplanted from an immunologically similar donor. The liver has a very high regenerative ability. This is why the transplanted portion and the remaining donor’s liver can regrow back to a normal size.

3. Split donation: Our liver comprises of two portions- one big and one small. By using the process of split donation, it is possible to help two recipients by using only a single deceased person’s liver. Each portion can easily regrow back to the normal size in both the transplanted individuals.

Tests before the procedure

The following tests should be performed in a person before a transplantation operation can be performed. This helps evaluate the compatibility for a transplant.

• Assessing previous hospital records such as  X-rays, biopsy reports and doctors notes to check the progression of the diseased liver
• CT scan of the abdomen
• Doppler ultrasound to check the blood vessels supplying the liver
• Pulmonary function tests to check lung ability  during the surgery
• Blood tests such as  blood grouping, clotting function, biochemical profile to check liver damage. AIDS and hepatitis testing are also included.
• A MELD score can help determine which patient on the waiting list is deserving of a liver transplant

Complications of liver transplantation

These are two of the most important complications of cirrhosis and a liver transplant:

1. Rejection: Our immune system is programmed to fight foreign invaders and it does so by recognizing antigens which are not present in the body. Because the transplanted liver has foreign antigens in its cells, our body recognizes it as an invader and attacks the transplanted organ. This can be an acute or chronic process. This is why anti-rejection medication and immuno-suppressants are given following a transplant.

2. Infection: The down side to giving medication to turn down your immune system against the transplanted liver is that it also decreases your natural defenses against infection. However this problem diminishes with time and can be tackled with the help of medicines.

Post-transplant life

According to statistics by NHS Blood and Transplant, 86% of transplanted livers can function efficiently one year after a surgery.
Life expectancy after a transplant can however be influenced by the following factors:

• Age
• General well-being
• The cause for liver transplantation
• Complications developing after liver transplant like diabetes or kidney failure