Liver Transplantation Aug 09, 2014
Liver transplant is a surgical procedure to remove the diseased liver and replace it with a healthy liver from a donor. Read more to know, how a transplant can transform life The liver is a vital organ and it has several key functions to perform - it helps to filter and dispose toxic materials from the blood, fuels the body with the energy it needs to function, wards off viruses and infections, produces blood-clotting factors, regulates sex hormones, cholesterol levels and vitamin and mineral supplies in the body. In liver cirrhosis or liver failure, all these vital functions are affected. When the liver reaches a critical stage of damage, the only successful treatment that improves chances of survival is a liver transplant. Liver disease is the most common cause of death after heart disease, stroke, chest infections and cancer. Liver transplant involves replacement of patient’s diseased liver by a new liver which is derived either from a brain dead but heart beating donor i.e. a cadaver (Cadaveric or Deceased- Donor Liver Transplant or DDLT) or from a living donor (Living Donor Liver Transplant or LDLT). Liver from a cadaver is a complete liver while that from the living donor is only half of it. Liver is a unique organ in human body and has a special capacity of regeneration. It has been seen that even 70 per cent of liver can be safely removed without any untoward consequences because of the capacity of regeneration. The remaining liver rapidly grows and restores the full functional capacity required for the normal functioning of the body. Owing to this unique property a part of the healthy liver can be safely removed from a voluntary donor and can be utilised to replace a diseased liver in a patient without causing any harm to either the donor or the patient. The remaining half of liver in the donor and recipient grows back to achieve full functional recovery within three to four weeks. Any person above the age of 18 years can legally donate a part of his/her liver, however in India, as per Human Organ Act 1996, liver donation is restricted to family members (brother, sister, father, mother, son, daughter) or close relatives (uncle, aunt, cousin, brother-in-law, sister-in-law, grandparents). Medically, the liver donor should have a compatible blood group (same blood group as patient or O group), should not be more than 55 years of age and should be medically fit and psychologically sound. All voluntary liver donors are evaluated thoroughly to look for medical and surgical fitness. In India, cadaveric liver transplantation is less popular owing to lack of cadaveric organ donation. Awareness regarding organ donation is still in its infancy making living donor liver transplant the only option for many patients.Liver transplant is a major surgery and overall risk to life from undergoing a liver transplant is about 5-10 per cent. Approximately 90 per cent of transplant recipients survive one year post surgery. Long term success rate (15-20 years) of liver transplant is 55-60 per cent. Most of the patients lead a normal, healthy and productive life following a liver transplant. However the individual outcome depends on patient factors and cannot be generalised. Patients of liver transplant have to receive life- long immunosuppressive medication (medicines to prevent rejection of liver). Patients have to take special care such as hygiene, avoiding direct sunlight, etc for prevention of infections and skin cancers. Donor can usually be discharged within 10 days and patients within two to three weeks time. Donors may resume their normal activity within three to four weeks and resume their jobs within six weeks time and patients within four to six months. No special precautions are needed for donors after about four to six weeks and they lead a normal life thereafter.
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