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LIVER TRANSPLANT
Liver Transplant
Liver Transplant is performed to replace a diseased liver with the donor’s healthy liver. A liver transplant uses livers either from a deceased donor or from a living donor. The liver transplant procedure may take up to 12 hours. The patient will often require a large amount of blood through a transfusion. Liver transplant is usually reserved as an option for those who have significant complications due to end-stage chronic liver disease.
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Types of Liver Transplant
- Deceased Donor Liver Transplant:
In a deceased donor liver transplant, the donor may be a victim of an accident or head injury. While their brain has stopped working and they are brain dead, their heart would be still beating.
- Living Donor Liver Transplant:
A living-donor liver transplant is a procedure where a portion of the liver from a healthy donor is removed and placed into someone whose liver is no longer functioning properly. The transplanted liver portion grows and restores normal liver functions in the recipient.
- Auxiliary Liver Transplant:
In the auxiliary liver transplant, a part of the healthy donor is transplanted into the recipient. The patient’s infected liver remains intact until the auxiliary piece regenerates and performs normal liver functions so that a diseased liver can then be removed.
Basic Tests before A Liver Transplant
- Doppler Ultrasound:
Doppler ultrasound is the modality of choice for evaluating post-liver transplant patients for vascular complications. Awareness of the normal postoperative Doppler findings and timely identification of various vascular complications are important for improving the result of liver transplantation.
- Pulmonary Function Tests (PFTs):
Pulmonary Function Tests are performed to determine the lung’s ability to exchange oxygen and carbon dioxide. Pulmonary Function Tests (PFTs) are routinely done in patients during the evaluation period before liver transplantation.
- Echocardiogram (ECG):
An echocardiogram is performed to diagnose and determine the extent of valve conditions, identify the presence of tumors in the heart, evaluate blood flow through the heart, and determine the presence of abnormalities in the heart structure.
- Computed Tomography (CT):
Computed tomography uses X-rays and a computer to generate images of the liver showing its shape and size.
- Model for End-Stage Liver Disease (MELD):
Patient’s blood type and their MELD score decide their position on the liver transplant waitlist. MELD score is a series of blood tests performed to measure how the liver works. The higher the MELD score, the higher the patient will be on the list.
How a Liver Transplant is Performed?
Liver transplant surgery is performed using general anesthesia. The surgeon makes a long incision across the abdomen to access the liver. The location and size of the incision vary according to the surgeon’s approach and the patient’s anatomy. The surgeon replaces the diseased liver with the donor’s liver in the body. Then, the surgeon connects the blood vessels and bile ducts to the donor’s liver. The transplanted liver portion in the body and the portion left behind in the donor’s body regenerate rapidly, reaching normal volume within several weeks.
Why do you need a Liver Transplant?
You require a liver that functions properly. If it doesn’t function properly, you may undergo a transplant. If you detect a chronic liver failure (end-stage liver disease) then the liver transplant is recommended to you. This can be caused by several liver maladies.
Cirrhosis is one such as liver disease. It can cause the liver to malfunction. This can happen when the healthy tissue is replaced with a defected one.
Acute hepatic necrosis happens when the liver fails to function. This is a condition where dangerous infections are caused by medications.
- Viral Hepatitis: Hepatitis B or C is prevalent causes.
- Metabolic diseases: Disorders that alter the chemical actions in cells induced by the liver.
- Primary liver cancers: These are cancerous tumors that begin in the liver.
- Autoimmune hepatitis: Redness or inflammation or swelling of the liver. This happens when your immune system is not strong.
Preparation:
- How do I get prepared for a Liver Transplant?
Depending on your health the treatment plan will be designed. You can ask the team for any queries you have. Then, you need to permit the doctor to do the surgery by signing a consent form. You will be advised not to eat at least 8 hours before the surgery. Before the surgery is done, you will be given medications to help you relax and for being prepared for the transplant. These were some of the preparation you need to do before undergoing a transplant.
- Complications of the Procedure:
The liver transplant comes with certain complications. The treatment procedure can include some risks,
- Risks involved are,
- Bile duct complexities,
- Contracting of the bile ducts
- Bleeding
- Blood coagulation
- Failure or rejection of a donated liver
- Infections
The liver problems may recur in the long term.
Side Effects of Medications:
To make sure your body accepts the donated liver you are required to take medications throughout your life.
These medications can cause some side effects:
- Bone thinning
- Diabetes
- Diarrhea
- Headache
- High blood pressure and cholesterol
As your immune system is suppressed there is a chance you may get some infections. To prevent infections you need to take additional medications.
What happens after the Liver Transplant?
To check if the new liver is functioning properly or not, the Transplant team will constantly monitor the complexities that may arise. You have to stay in the ICU till you satisfy the doctors. After this, you will stay in the hospital for an additional couple of days for further processing and healing.
After the treatment, you have to go for frequent checkups at the hospital to check your health. You need to undergo several blood tests which will keep decreasing as time passes.
You need to consume medications throughout your life. Medications may also include preventing infection as your immune system will go down. Some medications will help to reduce the risks and other complexities.
It will take some 6 months to completely have a normal life. You can continue your daily work after a few months as advised by the doctor. Maintain a healthy diet that will be given to you by the dietician team.
Exercise and Diet:
To keep your body and liver healthy, we will provide you with a diet plan. It will take some time for the liver to adjust to the body. This regime will make sure you don’t gain excess weight. A wholesome diet will overcome other complications as well. You need to maintain calcium and fiber in your body. Include fresh fruits and vegetables. Sustain a low-salt diet to maintain the cholesterol level. You can incorporate lean meats, fish, whole-grain bread, cereals, and poultry. Avoid alcohol. Drink a lot of water and other fluids to stay hydrated.
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