Liver Transplant

When one’s Liver no longer functions adequately enough to keep them alive, or Liver disease has progressed onto higher stages and one’s liver is damaged beyond repair, then Liver transplant is recommended.

It is a surgical procedure performed to remove part of a diseased or injured liver and replace it with a whole or a portion of a healthy liver from another person (dead or alive), called the donor. Since the liver has regenerative properties, a transplanted segment can grow to normal size within a matter of few weeks.

• Living Donors: from one’s own family, or someone who is blood group compatible. It is called Living Donor Liver Transplant (LDLT).
• Deceased Donors: from a brain-dead person whose family has agreed for donation. It is called Deceased Donor Liver Transplant (DDLT).
• The transplanted Liver then continues to function in the new body – the host body – under cover of immuno-suppressants.

Reasons for Liver Transplant:

Evaluation will include assessment of your:

• Alcohol related Liver diseases
• Chronic Hepatitis, including hepatitis B and Hepatitis C. These Hepatitis predominate as the cause of liver transplant in developed countries.
• Autoimmune Hepatitis Disease caused by abnormality of the immune system
• NASH, or Non-alcoholic Steatohepatitis, a disease caused by buildup of fat in the liver
• Some genetic conditions, including Wilson disease, where dangerous levels of copper build up in the liver, and Hemochromatosis where iron builds up in the liver
• Vessel Diseases - Budd Chiari Syndrome
• Bile duct Diseases - Primary biliary cholangitis, Primary sclerosing cholangitis, and biliary atresia
• Primary liver cancer, meaning cancers that originate in the liver, such as hepatocellular carcinoma, is amenable to liver transplant. Unfortunately, in most cases, individuals are diagnosed late, making transplant impossible.

Evaluation of Liver Transplant Candidates:

For a patient to be considered for Liver Transplant, the first step is a referral for the same by their Liver physician / GI physician / Medical Gastroenterologist. Then, the patient is evaluated to see if they are a suitable candidate. The evaluation includes assessing the patient’s:

• Liver disease and other conditions they may have
• Mental and emotional health
• Other vital metabolic support systems
• Ability to adhere to the complex medical regimen required after transplant
• Likelihood of surviving the transplant surgery

• Physical exam
• Detailed medical history
• Psychological and social evaluation
• Diagnostic tests to evaluate the status of heart, lung and other organs
• Imaging studies, such as CT scans and ultrasound, to assess the liver and blood flow through various vessels
• Multiple blood tests to determine blood type, kidney and liver function, check for other infectious and/or inherited diseases
• HIV, Hepatitis, drug and alcohol screening

Liver Transplant Surgery: