Liver Transplant or Hepatic transplant is recognized as a surgical process of completely replacing a malfunctioned liver that stopped working properly with a healthy liver recently extracted from a deceased or a living donor. Liver Transplant operations are highly delicate and require the assistance of specialized surgeons to flawlessly operate the patient who is suffering incurable liver disorders which is beyond any form of treatment. This surgical procedure is the last-resort when every other treatment fails to find a solution that can restore the functioning of a rotting liver. Fortunately, our medical science is developed enough to accurately perform such complex surgeries as people who have had liver transplant are living a perfectly normal life. It is the only treatment for patients suffering end-stage chronic and severe acute liver diseases. The patient at this stage will gradually die without a transplant

What is liver?

A liver fundamentally purifies blood and detoxifies chemicals and metabolites from your body which is crucial for longevity and responsible for synthesizing proteins and produces biochemical necessary for digesting food. This organ is simply found in vertebrates in the upper right quadrant of abdominal cavity, rests just below the diaphragm. It is an essential tool in regulating glycogen storage, decomposition of red blood cells, support metabolism and hormone production. The liver is a reddish brown wedge-shaped organ with four lobes of unequal size and shape with the usual mass of 1.44 to1.66 Kg and has a thickness of around 15 cm, making it one of the heaviest and largest organs of the human body.

1. It removes toxic content from the body
2. Prevent infection and preserve immunity
3. Processing medications, nutrients and hormones
4. Synthesizing proteins
5. Produces biochemical for digestion.

Causes for Liver Transplant

Primary reason for Liver transplant simply consist end-stage liver disease or sudden failure of liver.

Severe liver diseases leads to the prevention of liver functioning that can happen from many causes. Medical science has introduces many symptoms that helps you identify liver diseases that may require immediate surgical operations. Cirrhosis is the most reason in adults for the foundation of severe liver diseases. During cirrhosis, the liver gradually rots and fails to work properly due to chronic injury; it replaces healthy liver tissues with scarred tissues. Generally, the causes that may severely affect your liver functioning include viruses like hepatitis B and C, excessive consumption of alcohol, autoimmune diseases, metabolic disorder, alcoholically built liver fat, leakage of fluid in body, gallstones, and hereditary liver diseases. In case of children, biliary atresia is the most common for liver failure which is rarely occur in newborn infants.

Medical examination

The medical team examining liver conditions will also consider other factors like medical history and series of tests before launching the surgical procedures like liver cancer, history of tuberculosis, HIV, overall physical and mental well-being, blood tests, to clarify whether the transplant is necessary and could it be done safely. The most vital factor depends on the responsive strength of the patient whether if he/she is capable of enduring the surgery or not. Surgery can also be undertaken before the end-stage only when the patient’s illness is found unbearable for him to survive the major surgery. A surgical treatment of such gravity requires a patient’s health to be capable to withstand a major surgery because if not, then surgery will be carried out in the early stage for an expected outcome.

Once you become eligible for liver transplant, you will be placed on a national waiting list. Every patient will be given a score card based on the factors like critical conditions, blood type, body size, etc. patients with higher score will shortly get their transplant while with less severe conditions will have to wait longer. Rarely, some patient waits for much longer period due to unavailability of suitable donar whose liver matches on every parameter of patient’s liver structure.

Blood tests for liver transplant:

1. LFT, liver function test
2. ALT, alanine aminotransferase
3. AST, aspartate aminotransferase
4. Alkaline Phosphatase
5. Bilirubin
6. Albumin
7. Ammonia
8. Hepatitis A, B, C
9. Prothrombin Time (PT)
10. Partial Thromboplastin Time (PTT)

Transplant procedure

The procedure includes removal of malfunctioned liver and implantation of a healthy one. It is a complex process which requires disconnection of blood vessels from the previous lever and then, connecting them to a healthy one in order to keep blood flow intact. The structures needed to be bonded with liver are inferior vena cava, the portal vein, the hepatic artery, and the bile duct. Here the steps included in the surgery:

1. Making a cut to the abdomen
2. Evaluation of the organs parts that needed to be removed.
3. Mobilization of the native liver
4. Disassociation of vital structures like inferior vena cava, the portal vein, the hepatic artery, and the bile duct.
5. Removal of the infected liver.
6. Stitching new liver with connecting blood vessels to restore blood circulation in the new liver. Next, arterial flow is re-established by sewing the donor’s and recipient’s hepatic arteries. Finally, biliary drainage is achieved by sewing the donor’s and recipient’s common bile ducts.
7. Ensuring the perfect blood circulation
8. Stitching the abdominal incision.

Risks

Chances of rejection may be inferior which is recorded barely 5%, but unfortunately, if the new liver does not function efficiently and rapidly, then the patient immediately require another transplant in order to survive. Several complications will be developed due to anti-rejection medications, infections, blood clots, Bile leak, Biliary Stenosis, diabetes, high blood pressure, high cholesterol, etc.
Immunosuppressions, Post-Transplant Lymphoprolipherative Disorder (PTLD), opportunistic cancer, recurrent disease, rejection, are some of the major surgical complications of liver transplant.

Benefits

A majority of people who have undertaken liver transplant survive the surgery and do well after hospital discharge. Almost 90% infants as well as adults accept the newly implanted liver and live a healthy life.

Post-operative care

Surgeons and hepatologists will examine your progress through blood tests. This continuous around 1 year as the survival rate of liver transplant patients after a year is over 88%.