What is liver transplantation?
Liver transplantation is surgical procedure to remove a diseased or injured liver and replace it with a healthy one from another person, called a donor. The donor can be living in which case only a part of is taken. In case of deceased donor, the whole organ is transplanted.
What does the liver do?
The liver serves as an inspection organ. Every nutrient we consume passes through the liver. As every element in your blood stream is filtered here, it fight infections and cleans your blood. The bile produced in the liver helps break bilirubin which is a substance that comes from the breakup of hemoglobin in the dead red blood cells. The liver is the largest organ in your body. It is not possible to live a normal healthy life without a functional liver.
What are the signs and symptoms of liver problems?
The signs and symptoms of unhealthy liver and problems are:
- yellowing of the skin and the whites of the eyes, a condition called jaundice
- feeling tired or weak
- losing your appetite
- feeling sick to your stomach
- losing weight
- losing muscle
- bruising or bleeding easily
- bleeding in the stomach
- throwing up blood
- passing black stools
- having a swollen abdomen
- becoming forgetful or confused
What are the reasons for needing a liver transplant?
Anyone with a non-functional liver needs a transplant. In adults, the most common reason for needing a liver transplant is cirrhosis. Cirrhosis is chronic damage to the liver caused by many different types of diseases that destroy healthy liver cells and replace them with scar tissue.
Some causes of cirrhosis are
- long-standing infection with the hepatitis B or C virus
- consumption of too much alcohol over time
- the buildup of fat in the liver
- Autoimmune liver diseases occurs when the body immune system doesn’t recognize the liver as a part of your body and in turn attacks it.
- Hereditary liver diseases are passed from parents to children through genes.
In children, the most common reason for needing a liver transplant is biliary atresia. If in birth a condition, the bile ducts are missing, damaged, or blocked, there will be no passage of bile from the liver to the gallbladder and small intestine. When bile ducts are blocked, bile backs up in the liver and causes cirrhosis.
Other reasons for needing a liver transplant include
- Sudden liver failure, called acute liver failure
- Liver cancers that have not spread outside the liver.
How will I know whether I need a liver transplant?
Your need for a liver transplant will be decided by doctors. Your liver condition will be evaluated by a liver transplant team. The team will include experts like liver transplant surgeons, liver specialists, called hepatologist; nurses and other health care professionals. The transplant team will examine you with blood tests, X-rays, and other tests to help decide whether you would benefit from a transplant.
The transplant team will evaluate if
- Your heart, lungs, kidneys, and immune system are strong enough to recover form transplant of the liver
- You are mentally and emotionally ready to have a transplant
- If you have family members or friends who can care for you before and after the transplant.
After you are approved for a transplant, doctors help you decide your treatment by explaining the patient the detailed procedure and time of:
- operation and recovery
- long-term demands of living with a liver transplant, such as taking medicines for the rest of your life
Can anyone with liver problems get a transplant?
There are rules about who can have a liver transplant. A liver transplant is not possible if the patient has:
- cancer outside the liver
- serious heart or lung disease
- an alcohol or drug abuse problem
- a severe infection
- trouble following doctor’s instructions
- no support system
Who can provide livers for transplants?
Most livers for transplant comes from people who have just died. This type of donor is called a deceased donor. Sometimes a healthy living person will donate part of his or her liver to a patient, usually a family member. This type of donor is called a living donor. Both types of transplants usually have good results.
All donated livers and living donors are tested before transplant surgery. The testing makes sure the donor liver works as it should, matches the patient’s blood type, and is the right size, so it has the best chance of working in a new body. Adults usually receive the entire liver from a deceased donor. Sometimes only a portion of a whole liver from a deceased donor is used to fit a smaller person. In some cases, a liver from a deceased donor is split into two parts. The smaller part may go to a child, and the larger part may go to an adult.
What happens in the hospital?
When a liver is available for transplant, the person getting the transplant is quickly admitted to the hospital to be prepared for the surgery. If the new liver is from a living donor, both you and the donor will have surgery at the same time. If the new liver is from a deceased donor, your surgery will start when the new liver arrives at the hospital.
The transplant surgery can take up to 12 hours. The surgeon will remove your diseased liver and then replace it with the donated liver.
After the transplant of the new liver, you will stay in the hospital about 1 to 2 weeks to be sure the new liver is functioning. Medicines are administered to prevent infections and rejection of your new liver. Doctors will check for bleeding, infections, and liver rejection. During this time of recovery learn how to take care of yourself. There will be a lifelong in-take of medicines to protect your new liver. Learn about these medicines, dosages and
What is organ rejection?
The new liver is often seen as a foreign substance and then there might be chances of rejection. Rejection occurs when your immune system attacks the new liver. After a transplant, it is common for your immune system to try to destroy the new liver.
How is organ rejection prevented?
To keep your body from rejecting the new liver, you will take anti-rejection medicines. The immunosuppressive medicines need to be taken for the rest of your life to fight off your immune system form rejecting the new liver.
Do anti-rejection medicines have any side effects?
Anti-rejection medicines can have many serious side-effects. As the immunosuppressive medicines weaken your immune system, there may be increased chances of other infections. Other possible side effects include
- weight gain
- high blood pressure
- high blood cholesterol
- brittle bones
- kidney damage
- skin cancer
What are the signs of organ rejection?
If your body rejects the new liver, you might feel tired, lose your appetite, or feel sick to your stomach. Other symptoms include having
- a fever
- pain around the liver
- dark-colored urine
- light-colored stools
Rejection will not always make you feel ill, therefore Doctors will check your blood for signs of rejection. A liver biopsy is usually needed to tell whether your body is rejecting the new liver. For a biopsy, the doctor takes a small piece of the liver to view with a microscope.
What other problems can damage my new liver?
If the liver is functional and not rejected by the body, the problem is not yet over. Relapse of the liver disease that caused the need for a transplant can also damage a new liver.
Other possible problems include
- blockage of the blood vessels going into or out of the liver
- damage to the bile duct
What if the liver transplant doesn’t work?
Liver transplants usually work. About 80 to 85 percent of transplanted livers keep functioning after one year. If the new liver does not work or if your body rejects it, your doctor and the transplant team will decide whether another transplant is possible.
How do I take care of my liver after I leave the hospital?
After discharge from 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.
To help care for your liver, you will need to
- Avoid people who are sick as you may fall ill to your suppress immune system.
- Report any illnesses you have to your doctor.
- Eat a healthy diet, exercise, not smoke cigarettes, and not drink alcohol.
- Take the prescribed immunosuppressive medicines as directed.
- Ask your doctor before taking any other medicines, including ones you can buy without a prescription.
- Follow your doctor’s instructions about how to take care of your new liver.
- Have blood tests and other tests as directed by your doctor.
- Use sunblock to prevent skin cancer and have cancer screening tests recommended by your doctor.
- Eating a healthy diet and taking medicines are part of taking care of your new liver.
Can I go back to my daily activities?
After a successful liver transplant, you can go back to their normal daily activities, and may even return to work. Getting your strength back may take months, especially if you were very sick before the transplant. Your doctor will guide you about how long your recovery period will be. Families, friends and support groups help you adjust to life with a new liver.
- Most people can go back to eating as they did before the transplant. Some medicines prescribed after your transplant may cause you to gain weight, and others may cause diabetes or raise your cholesterol. Eating a balanced, low-fat diet can help you stay healthy.
- Most people can be physically active after a liver transplant.
Most people can have a normal sex life after a liver transplant. For women, avoiding pregnancy in the first year after a transplant is recommended. Talk with your transplant team about when it is okay to have sex again or get pregnant after your transplant.