|
What is liver transplantation?
Liver transplantation is surgery to remove a
diseased liver and replace it with a healthy one.
This kind of surgery has been done for more than
38 years. Many people have had liver transplants
and now lead normal lives.
Who needs a liver
transplant?
Persons with one or
more of the following problems should seek expert
advice regarding liver transplant. The transplant
doctor can then suggest if liver transplant is
appropriate.
Those with end-stage
chronic liver disease complicated by tiredness,
fatigue, weight loss, repeated attacks of blood in
the vomit or stool, low serum albumin or prolonged
prothrombin time, hospitalization for intractable
(which keeps accumulating inspite of medicines)
ascites, infection in the ascites (spontaneous
bacterial peritonitis or SBP), attacks of
excessive drowsiness, mental confusion or coma or
excessive jaundice.
Those with severe
acute liver failure which is not improving with
medicines. Acute liver failure is said to be
present when the duration of illness is a few days
or weeks. It may be caused by Viral Hepatitis,
Wilson’s disease, drug overdose,
Budd-Chiari syndrome (obstruction to the hepatic
veins or IVC draining the blood from the liver) or
some unknown causes. The illness is characterized
by worsening coma, jaundice, prothrombin time
(PT), liver tests (SGOT / SGPT / Alk phos, GGT)
and kidney function, and falling blood glucose
levels.
How the
surgery is conducted?
The surgery
can take from 4 to 14 hours. While the surgeon
removes your diseased liver, other doctors prepare
the new liver.
The surgeon will
disconnect your diseased liver from your bile
ducts and blood vessels before removing it. The
blood that flows into your liver will be blocked
or sent through a machine to return to the rest of
your body. The surgeon will put the healthy liver
in place and reconnect it to your bile ducts and
blood vessels. Your blood will then flow into your
new liver.
How
Liver gets affected?
In cirrhosis
of the liver, scar tissue replaces normal, healthy
tissue blocking the flow of blood through the
organ and preventing it from working. Cirrhosis is
the eighth leading cause of death by disease,
killing about 25000 people each year. Also the
cost of cirrhosis in terms of human suffering,
hospital costs, and lost productivity is high.
What Causes of
Liver cirrhosis?
Alcoholic
Liver Disease:
Alcoholic liver
disease in early stages is preventable and the
progress of disease can be halted by stopping
alcohol.
Viral hepatitis:
Hepatitis may be caused by many
viruses, each with a different presentation and
prognosis. Hepatitis B is caused by the infectious
Hepatitis B virus (HBV). The hepatitis B virus is
primarily found in the blood of infected
individuals. Transmission of HBV takes place via
blood transfusion, percutaneous introduction (i.e.
needlestick injury).
Drugs,
toxins and metabolic diseases:
Drug- induced hepatitis is rare and is caused by
toxic exposure to certain medications, vitamins,
herbal remedies, or food supplements. Usually, the
toxicity occurs after taking the causative agent
for several months.
What is
rejection?
Rejection occurs when
your body's natural defenses, called the immune
system, damage the new liver. Your immune system
keeps you healthy by fighting against things that
don't belong in your body, such as bacteria and
viruses. After a transplant, it is common for your
immune system to fight against the liver and try
to destroy it.
To keep your body from
rejecting the new liver, you will take medicines.
These drugs, such as steroids, cyclosporine,
tacrolimus, sirolimus, and mycophenolate mofetil,
are called immunosuppressants. Immunosuppressants
weaken your immune system's ability to reject your
new liver.
What are the
symptoms of Liver Disease?
In the
early stages, the patients with cirrhosis suffer
from non-specific complaints like exhaustion,
fatigue, loss of appetite, nausea, weakness,
weight loss and itching. The disease may progress
and the patient may develop complications like
swelling over feet (Edema) or swelling of abdomen
(Ascites), higher tendency for bruising and
bleeding, yellowing of the skin and eyes
(jaundice), altered mentation, neglect of personal
appearance, unresponsiveness, forgetfulness,
trouble concentrating, or changes in sleep habits
(Encephalopathy) due to Toxins in the blood or
brain.
How is it treated?
Treatment of cirrhosis usually consists of
eliminating the underlying cause, if possible, to
avoid further damage, and preventing or treating
complications. Care is mostly supportive, often
including a specialized diet, diuretics (water
pills), vitamins, and abstinence from alcohol. For
some patients, a liver transplant is now a
feasible option.
Can anyone
with liver problems get a transplant?
You cannot have a transplant if you have:
- cancer in another part of your body
- serious heart, lung, or nerve disease
- active alcohol or illegal drug abuse
- an active, severe infection
- inability to follow your doctor's
instructions
Where do the livers for transplants
come from?
Whole livers come from
people who have just died. This type of donor is
called a cadaveric donor. Sometimes a healthy person
will donate part of his or her liver for a
particular patient. This kind of donor is called a
living donor.
All living donors and
donated livers are tested before transplant surgery.
The testing makes sure the liver is healthy, matches
your blood type, and is the right size so it has the
best chance of working in your body.
How can take care after the surgery?
After you leave the transplant center
at the hospital, you will see your doctor often to
be sure your new liver is working well. You will
have regular blood tests to check that your new
liver is not being damaged by rejection, infections,
or problems with blood vessels or bile ducts. You
will need to avoid sick people and report any
illnesses to your doctor. You will need to eat a
healthy diet, exercise, and no alcohol,
especially if alcohol was the cause of damage to
your own liver. You should use medicines, including
ones you can buy without a prescription, only if
your doctor says they are safe for you. It is
important to do what your doctor says to take care
of your new liver.
What kind of
diet should I follow?
Most people can
go back to eating as they did before. Some medicines
may cause you to gain weight, and others may cause
diabetes or a rise in your cholesterol. Meal
planning and a balanced low-fat diet can help you
remain healthy.
Can I exercise?
Most people can engage in physical activity
after a successful liver transplant |
