The liver is one of the silent workers in our body. We couldn’t live without this amazing organ that detoxifies the things we eat, creates energy, and produces proteins. But sometimes, what if the liver stops functioning completely due to a medical condition or cancer? Then a liver transplant may be the only option to save your life. Although this is a big topic, let’s talk about it simply, in a way that you can understand.
What is this liver transplant?
Simply put, a liver transplant is the surgical removal of a diseased, dysfunctional liver and the replacement with a healthy liver. This is a treatment for both children and adults. This healthy liver is usually obtained in two ways. 1.
Deceased Donor: A complete liver transplant from a brain-dead donor. This is the method used for most transplants. 2.
Living Donor: A healthy person donates part of their liver and transplants it into the patient. The amazing thing about our liver is that a healthy part of the liver can grow back over time and become a complete liver.
Why is a liver transplant necessary?
The liver is an essential organ in our body. It performs many essential functions, such as removing toxins from the blood, metabolizing nutrients, and making proteins. In other words, we cannot live without a functioning liver. If someone has severe liver failure or liver cancer, the liver can completely fail. In such cases, the only and best solution to save life is a liver transplant.
Is it easy to find a liver?
To be honest, it's not that easy. Usually, the number of patients who need a liver far exceeds the number of donor livers available. As a result, patients have to stay on a waiting list.
Sadly, some patients become too ill to undergo surgery or die while waiting in this manner.
Your place on this waiting list is determined by the severity of your condition. Doctors use a score system called
MELD (Model for End-Stage Liver Disease) based on your blood test results and the severity of your condition. The higher the score, the more likely you are to receive a liver sooner.
Who is not eligible for a liver transplant?
Not everyone with liver failure can undergo this surgery. If there are other serious medical conditions, it may be an obstacle to the surgery. The table below lists some such conditions.
Conditions that may make a liver transplant unsuitable
| Cancer status | Cancer that has spread to other parts of the body outside the liver. |
| Heart disease | Severe heart failure (Congestive Heart Failure). |
| Uncontrolled infections | Severe infections that cannot be controlled with medication and cannot be cured with a transplant. |
| Lung diseases | Severe lung disease or severe pulmonary hypertension. |
| Mental health problems | Uncontrolled, severe mental illness. |
What happens when you receive a matching liver?
Imagine, after waiting for months, maybe years, you suddenly get a call from the hospital... "You've found a suitable liver, come quickly." From that moment on, everything happens very quickly.
- They will call you and tell you to come to the hospital immediately.
- You will be advised not to eat or drink anything from that time on. This is to prepare you for anesthesia.
- When you arrive at the hospital, several tests (e.g., EKG, blood tests ) will be done to make sure your body is in a good condition for surgery.
- Then you will meet with your surgeon and anesthesiologist to prepare for the surgery.
This is a major surgery that takes about 12 hours. You will be fully anesthetized (put to sleep) during the surgery. Several tubes will be inserted to help your body function during and after the surgery.
These may sound a little scary, but they are all done to keep you safe during and after the surgery.
The surgeon makes a long incision in your abdomen and carefully removes the diseased liver. Then, a healthy liver from a donor is transplanted into the area, connected to the blood vessels and bile ducts. Finally, the incision is closed.
What happens after the surgery?
After the surgery, you will need to stay in the intensive care unit (ICU) for a few days. The medical team will do regular blood tests to check that your new liver is working properly. Once your condition is stable, you will be transferred to a regular ward. You will stay there for about one to three weeks. Before you go home, the medical team will tell you about:
- How to care for a surgical wound.
- How to take medications, especially immunosuppressants , correctly.
- How to check blood pressure and pulse .
- How to recognize the symptoms of an infection.
- Situations when you should inform your doctor immediately.
What are the risks and complications of the surgery?
Like any major surgery, a liver transplant carries risks. Some are minor, while others can be life-threatening.
| Risk/Complication | Simple explanation |
|---|
| Organ Rejection | Your body's immune system recognizes the new liver as "foreign" and attacks it. To prevent this, you will have to take immunosuppressants for the rest of your life. |
| Infection | Immunosuppressant medications reduce the body's immunity, which can lead to infections ranging from minor colds to more serious bacterial and fungal infections. |
| Bile Leak | Bile leakage from newly connected bile ducts into the abdominal cavity. |
| Blood Clots | Blood clots in the blood vessels of the new liver. This is rare but requires immediate treatment. |
| Other diseases | Immunosuppressants may increase the risk of high blood pressure, diabetes, kidney disease, and some types of cancer (especially skin cancer). |
How to care for a new liver?
It is your responsibility to take good care of this liver, which is like a new life.
- Follow your doctor's instructions: Follow all the instructions your doctor gives you. Don't skip clinic appointments.
- Take your medicine exactly as prescribed: Take your medicine at the right time, in the right dosage. Don't skip a single dose. Always check with your doctor before taking any other medication (even vitamins ).
- Protect yourself from infection: Stay away from crowded places. Wear a mask if necessary. Stay away from people who are sick . Wash your hands often.
- Good diet: Eat nutritious foods.
- Lifestyle changes : If you smoke , try to quit. Alcohol should be avoided completely. Alcohol is very harmful to a new liver.
Regardless of these statistics, your doctor is the best person to tell you about your own situation, so don't be afraid to talk to him or her.
Take-Home Message
- Liver transplantation is a major life-saving surgery performed in cases of severe liver disease or cancer.
- Finding a suitable liver is a time-consuming process, and you have to be patient and wait on the waiting list.
- After surgery, immunosuppressants must be taken for the rest of your life to prevent the body from rejecting the new liver.
- Completely stopping alcohol and adopting a healthy lifestyle are essential for the healthy survival of the new liver.
- Talk to your medical team immediately if you have any problems or notice any unusual changes in your body.
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