Liver transplant surgery is a medical procedure by which an injured or diseased liver is removed and a new healthy liver is replaced on it. Many people in the world lead normal life after liver transplant surgery. When liver become inflamed or injured due to any disease and cannot able to perform its function properly, then liver transplant surgery must need to replace a new liver. Family members or any individual who are unrelated but make a better match, then may be able to donate a portion of liver. This transplant procedure is called living transplant. Person who donates a portion of liver can live better and healthy lives with the remaining liver.
When liver transplant needed?
Liver transplant surgery is normally considered when the liver is no longer able to perform its function properly; this condition is also called liver failure. Normally the liver failure can occur suddenly that is called acute liver failure, as a result of liver inflammation or liver infection. The liver failure can also be the final result in chronic liver disease. The following condition can result in chronic liver failure and as a result liver transplant surgery needed:
- Liver cancer.
- Acute hepatic necrosis.
- Chronic hepatitis with cirrhosis.
- Biliary atresia.
- Metabolic disease.
- Autoimmune hepatitis.
- Wilson’s disease.
- Alpha-1 antitrypsin deficiency.
Risks of liver transplant surgery procedure
Some complication can happen in any types of surgery. Some complication from the liver transplant may include:
- Blockage of new blood vessels to the new liver.
- Leakage of bile.
- Blockage of bile duct.
- Initial lack of function of the new liver.
After the liver transplant surgery the new liver may not perform its function for a brief time. Sometime the new liver can also be rejected. The rejection is a normal reaction of body to a foreign tissue or object. So when a new healthy liver is transplanted into a recipient, the immune system of the body discover it as a foreign particle not realizing that that the new liver is beneficial for body and attack the transplanted liver. To avoid these problems and allow the new organ into body, some medication must be taken for trick the immune system to accepting the new transplant liver and not attacking it as a foreign particle.
Can anyone with the liver problems get a transplant?
Each liver transplant surgery center has a rule about who can the capacity of liver transplant. You cannot able to have a liver transplant if you have the following conditions:
- Cancer outside the liver.
- Serious heart or lung disease.
- An alcohol or drug abuse problem.
- A severe infection.
- Trouble following your doctor’s instructions.
- No support system.
Some tests that are required before liver transplant surgery
You must need to bring all of previous doctor’s records, liver biopsy, X-ray and a record of medication that was prescribed you before liver transplant. Some medical tests that must require before liver transplant surgery are including:
- Computed tomography, in which uses X-ray and also a computer to create a picture of liver and showing its size and shape.
- Doppler ultrasound technique may use to determine if the blood vessels to and from the liver is open.
- Echocardiogram technique is used that help to check the condition of heart.
- The pulmonary function studies that help to determine the lung ability to exchange carbon dioxide and oxygen.
- Blood tests are very useful to determine the blood types, blood clotting ability, biochemical status of blood and also liver function.
- Hepatitis and AIDS testing are also included into blood test.
Liver transplant surgery procedure
Liver transplantation requires staying in hospital. Liver transplant surgery procedure may vary and depend on your condition.
Normally liver transplant surgery procedure performs in following process:
- At first you have to asked to remove your present clothing and then given a gown to wear.
- An intravenous line will be started into your hand and arm. Then additional catheters will inserted into your neck are wrist to observe the status of your blood pressure, heart.
- Then you will be positioned on the operating table.
- If there is long or excessive hair at the site of operation, then you have to clip off.
- Then a catheter will inserted in your bladder to drain urine.
- When you are sedated, then anesthesiologist will put in a tube in your lungs, as a result your breathing will be controlled by a ventilator.
- The skin on the surgical site will be cleansed by an antiseptic solution.
- Then doctor will make a slanting incision under the ribs on the both side of abdomen.
- Then the doctor will separate the diseased liver carefully from the surrounding organs.
- The attached veins and arteries will be clamped to stop the blood flow into the diseased liver.
- Depending on the severe factor, different surgical technique may use to remove the defect liver.
- Then the diseased liver will be detached after it has been cut from blood vessel.
- Then the doctor will visually examine the donor liver or the portion of liver.
- Then the donor liver will be connected to the blood vessel. Flow of blood to the new will be established and checked for bleeding in the suture lines.
- Then the new healthy liver will be connected into the bile duct.
- The incision will be closed with surgical staples.
Liver transplant criteria
Liver transplant criteria mean some requirement that is needed during liver transplant. Liver transplant is considered when become failure or no longer able to do its function. When acute liver failure occurs due to any infection or complication, liver transplant is require that time. For liver transplant some criteria must follow, those are called liver transplant criteria.
Liver transplant criteria for adult
Liver transplant is an accepted therapeutic modality for last stage of liver disease.
- The patient’s liver problems are not expected to recur and origin disability within 5
- The patient is not declining and the transplant is likely to extend life for at least five years and the transplant will restore the patient to a range of physical and social function suitable for the activities of daily living.
- The patient does not have participation of a major organ system which would preclude surgery or show a poor potential for rehabilitation.
- The patient’s psychological assessment, and family support, social situation indicate a reasonable expectation that the patient will adhere strictly to the hard long-term medical regimen which will be required post-transplant
- The patient has no intake alcohol or substance abuse problems, has signed a compliance agreement, has completed at least six months of documented treatment moreover sobriety, and has undergone psychological evaluation
- Severe fatigue.
- Unacceptable quality of life.
- Recurrent variceal bleeding.
- Intractable ascites.
- Recurrent or severe hepatic encephalopathy.
- Spontaneous bacterial peritonitis.
- Hepatorenal syndrome.
- Development of small hepatocellular carcinoma on hepatic imaging.
Patient selection liver transplant criteria
- Severe fatigue
- Unacceptable quality of life
- Recurrent variceal bleeding
- Intractable ascites
- Recurrent or severe hepatic encephalopathy
- Spontaneous bacterial peritonitis
- Hepatorenal syndrome
- Development of small hepatocellular carcinoma on hepatic imaging
Test before liver transplant
Some tests that are require before liver transplant process those also called liver transplant criteria. Liver biopsy, X-ray, and some test required. You must need to bring all of your previous doctor report. After observe previous doctor report, some new diagnostic studies is required during liver transplant. Those are also liver transplant criteria.
- Computed tomography is required to determine liver transplant criteria. Here use X ray and also a computer to view a picture of liver and showing it size and shape.
- Ultrasound is required to determine liver transplant criteria. It is needed to determine if blood vessel to and from your liver open.
- Echo cardiogram is also required to evaluate the heart.
- Blood test is also required to determine blood types, biochemical status of blood, blood clotting ability. AIDS test and hepatitis are also determined by blood test.
Inclusion liver transplant criteria
- AIDS or HIV positivity is major liver transplant criteria.
- Irreversible brain damage.
- Multi-system failure that is not correctable by liver transplantation.
- Malignancy outside the liver (not skin cancer).
- Infection outside the hepatobiliary system.
- Active alcohol or substance abuse is another liver transplant criteria.
- Advanced cardiopulmonary or other systemic disease.
Factors that may increase the risk of liver transplantation including:
- Advanced age.
- Advanced chronic renal failure.
- Chronic hepatitis B virus infection.
- Hepatocellular carcinoma.
- Hypoxemia from intrapulmonary shunts.
- Massive ascites.
- Portal vein thrombosis.
- Prior portosystemic shunt surgery.
- Prior biliary tract surgery.
- Severe malnutrition.
- Severe abdominal atherosclerosis.
Other major liver transplant criteria
Other major liver transplant criteria are given below:
Age must be keep upper 17 and lower 75 predict for liver transplant. Over age is risk for liver transplant.
Oboes people are more risk for liver transplant. Healthy fit persons are more predict than oboes person.
It is another liver transplant criteria. Patient must keep far from active infection for better transplant.
Patient must avoid alcohol.