Liver Transplant SurgeryLiver is necessary for survival. It is one of the most vital organs which is the largest gland in human body. Liver does detoxification, protein synthesis, and production of biochemicals necessary for digestion.
Human liver is a reddish-brown coloured organ weighing around 1.4–1.6 kgs, with four lobes of unequal size and shape. The liver overlies the gallbladder and to the right of the stomach.
Liver performs more than 500 functions. Currently to compensate for the absence of liver function in long term there is no way, although in short term liver dialysis can be used.
Some of the important functions performed by a liver are as follows. It processes digested food from the intestine & controls the levels of fats, amino acids and glucose in the blood. Immunity against infection is provided by it; hence infections are more likely if the liver is damaged. Liver cleanses the blood of particles and infections including bacteria thus detoxify, by metabolizing and/or secreting, drugs, alcohol, and environmental toxins. It contributes manufacturing bile juice that aids in the small intestine the process of digestion of lipids. It is responsible for iron, vitamins and other essential chemicals storage. It breaks down food and turns it into energy. Also numerous hormones in the body are regulated , manufactured and broken down by it. It produces enzymes and proteins which are responsible for most chemical reactions in the body, for example those involved in blood clotting and repair of damaged tissues.
Even if 70% of it is removed all liver functions remain normal (provided the remaining 30% is healthy). Hence, large portions of cancerous liver can be removed without causing harm or compromise to liver function in persons with cancer of the liver. Similarly, from the donor for transplantation purposes more than half the liver can be removed, without causing any serious harm to the donor or any other derangement of liver function. After large portions of it are removed the liver is the only organ in the body which can regenerate itself. Within a few weeks Small remnants of liver grow back to normal size. Thus it is safe to remove large portions of liver from living donors and persons with liver tumours. Since they soon grow to normal size half livers transplanted into liver failure patients are very successful.
Liver TransplantationFor more advanced stages of cirrhosis Liver Transplant Surgery is only the treatment option and can be done by donation by a close relative or by a brain dead person with matching blood group
Indications for a Liver Transplant SurgeryFor a Liver transplant surgery generally a patient who is assessed to have a life expectancy of less than a year& suffering from liver cirrhosis is considered. A liver doctor should be consulted at the earliest by Patients who are suffering from severe liver disease. The earlier the problem is diagnosed and treatment is started the medical treatment or the liver transplant surgery (as per doctor’s recommendation) would be more effective. Timely treatment therefore, is very important for good results. For a patient who is in a reasonable health condition If a liver transplant surgery is done timely, with a good donor liver then there are high chances of success. Black stool, blood vomiting, water in the abdomen, drowsiness and mental confusion, excessive bleeding from minor wounds,Jaundice,Kidney dysfunction, Excessive tiredness, Low hemoglobin and other blood counts are Some of the symptoms of liver failure due to cirrhosis.
ProcedureA liver transplant surgery for both the recipient and the donor starts with a detailed evaluation and a battery of tests. to establish definite diagnosis, determine the severity of liver disease and the urgency of the transplant The evaluation of the recipient is done in three phases. The vital organs functioning is properly checked.
Donor and other family members are counselled about the procedure, hospital stay, the likely course after surgery, follow up and aftercare before the liver transplant procedure the patient in order to understand the process thoroughly and help them to make up their mind.
There are two types of Liver Transplant Surgery1. Cadaveric donor (deceased donor) liver transplant
2. Living Donor Liver Transplant
The liver is taken from a Cadaveric Donor for transplantation in a Cadaveric Donor Liver Transplant. A Cadaveric Donor refers to a brain dead person. In this case a person whose family wishes to donate the person's organs before discontinuing life support makes donation possible. Since in India there is long waiting list for Cadaveric Cadaveric transplants are not practical for overseas patients. Such donors may extend to several months since cadaveric organs are not frequently available.
The donor is a living and active person in a Living donor Liver Transplant surgery. From a close relative of the recipient in this case the liver donation is possible. In India majority of the transplants currently performed are living donor liver transplants due to a lack of cadaveric donors. In this procedure, a portion of the patient's relative's liver is removed and is used to replace the diseased liver of the patient. Only living donor liver transplants are recommended For Overseas patients, which requires when they come for a transplant to bring a healthy, willing donor (a close relative or family member only) with them.
Note: the donor must be a close relative or family member only in a Living Donor Liver Transplant Surgery. The Liver Transplant Team after studying the various aspects and performing a series of medical tests will determine the suitability of the donor for the donation.
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