Category Archive Multispeciality Treatment

Heart Transplant – Procedure, Risk and Treatments

What is a Heart Transplant?

Heart transplant is a major operation of replacing a diseased heart from a person with a healthy heart from an organ donor. A person can only donate their heart once they have been declared brain-dead. And their family has agreed to donate the organs of their loved one’s. 

Heart transplant is done only when the patient’s health does not get better after trying multiple other treatment methods or medication. However, once you get a heart transplant, you can live a good and healthy life, if you follow the doctor’s instructions and take your medication on time. 

What are the reasons for getting a Heart Transplant?

A heart transplant is major surgery. It is not the first treatment option for a patient suffering from heart diseases. However, if your heart is failing and all the other treatments have failed, then your doctor might recommend you to get a heart transplant. Various reasons can cause heart failure, such as-

  • Heart attack (myocardial infarction)
  • High blood pressure 
  • Heart valve disease 
  • Heart muscle infection 
  • Heart defects since birth (congenital heart)
  • Irregular rhythms or heartbeats (arrhythmias)
  • Substance abuse 
  • Lung disease 
  • Low red blood cell count
  • Heart muscle infection 
  • Thick, stiff and enlarged heart muscle (cardiomyopathy)
  • Low red blood cell count (anemia)

Who cannot have a Heart Transplant?

Sometimes, getting a heart transplant is not the right option for you. Since it is major surgery, your body bears a lot of strain, which may risk your life and thus outweigh transplant’s potential benefits. 

You may not be able to get a heart transplant if you are-

  • Old, above the age of 65
  • Excessive substance abuse 
  • Blood vessels damaged due to diabetes
  • Have an active infection
  • Have other diseases related to liver, kidney, lungs or nerves
  • Have cancer or have overcome it recently 

Heart Transplant Procedure

Before the procedure

Before you are selected as an appropriate candidate for heart transplant, your doctor will ask you to get a couple of tests done and will also review your medical history to determine your condition. The tests include psychological tests, blood tests, and diagnostic tests. The blood tests will make it easier to find a donor heart that matches your blood type to avoid the risk of your body rejecting the new heart. Through diagnostic tests including X-rays, ultrasounds, CT scans, etc, your overall health will be checked.      

Waiting for a Donor Heart

Once your doctor has approved you as an eligible candidate for heart transplant, you will be put on a waiting list. Sadly, the number of patients for heart transplant exceeds the number of donor hearts available so the waiting time for getting a heart transplant might be long. It also depends upon the size of your heart, your blood type, and the severity of the heart disease.

During the transplant 

  • Once you are ready for the surgery, you will be given general anesthesia, which will put you in a deep sleep till the transplant is over.
  • Your body will be connected with a heart lung bypass machine. This machine will maintain the flow of oxygen rich blood in the body, even when the heart is being operated. 
  • Using a sharp tool, the surgeon will make an incision in your chest. The surgeon will then cut the chest bone to reach your diseased heart.
  • The heart will be removed except for its upper 2 chambers, and the back walls of the atria.
  • The new heart will be then placed at the newly vacated spot and will be connected with the blood vessels, and the blood will be able to flow through the heart and lungs.
  • Once the heart starts beating, the bypass machine will be removed. 
  • The chest bone will be closed and the sin and tissues will be closed with the help of tissues.
  • Heart transplant surgery is an open heart surgery and takes a lot of time, around 4 to 10 hours.

After the transplant 

  • After the surgery, you will be put in an Intensive Care Unit for continuous monitoring to see that your heart is working properly. 
  • The nurse will keep a check on your blood pressure, breathing rate, oxygen level, and other vitals via machines connected to you. 
  • You will be put on a ventilator for a few days. This ventilator will help you to breathe. Gradually, as you start breathing yourself, the machine will be adjusted accordingly to allow you to breathe on your own. 
  • Initially, a tube will be inserted into your mouth to give fluids and other nutrients to the body.
  • After getting a heart transplant, you might have to daty in the hospital for one to two weeks depending upon your recovery rate and other factors. 
  • When the doctor thinks that you are recovered enough, you will be sent back home with clear instructions regarding the medication and follow-up visits.

What are the risks associated with a Heart Transplant?  

Since heart transplant surgery is a major operation, there are risks of certain complications that could occur at any time. Some of these complications might take place a few days after the transplant while others might take months or even years. 

These risks are-

  • Donor heart rejection 

Rejection of the donor heart is one of the most common and significant risks associated with a heart transplants. Your immune system might see the donor heart as a foreign body and fight against it like it does with any other virus or bacteria that enters the body. This can damage the heart. To prevent the immune system from doing so, you have to take immunosuppressants for the rest of your life. They can reduce the risk of rejection by weakening your immune system but cannot always prevent it from happening.

To ensure that your heart is working properly, you will have to visit your doctor frequently to get biopsies done (till at least the first year of transplant).

During Biopsy, a tube is inserted inside a vein through the neck or groin and directed to the heart. And a biopsy device, which runs through the tube takes a small sample of heart tissue for examination in a lab.

  • Graft Failure 

There are certain cases in which, soon after the transplant the donor heart fails and stops working properly. This condition is what causes the most frequent deaths during the first few months of transplant.

  • Problems in arteries 

After the heart transplant, there is a possibility of thickening and hardening of the blood vessels connected to the new heart, leading to cardiac allograft vasculopathy (CAV). This is a long-term condition, which might make it difficult for the blood to reach your heart and could lead to a heart attack, heart arrhythmias, or sometimes even a sudden cardiac death. 

  • Side effects of medication 

There are certain risks you may face due to the immunosuppressants you’ll have to take for the rest of your life to prevent rejection of the donor heart. There is a risk of – kidney damage, increased risk of infections and cancer, diabetes, osteoporosis, weight gain and high blood pressure. 

If you notice any of the following symptoms, you should immediately contact your doctor- 

  • Fever, chills
  • Low blood pressure
  • Chest pain
  • Extreme tiredness
  • Pain, redness, swelling or bleeding at the incision site
  • Difficulty in breathing

These could be signs of rejection or infection and should be treated as soon as possible to avoid further damage.

After care

To increase the possibility of healthy life after getting a heart transplant surgery, there are certain lifestyle changes you will have to make. Such as-

  • Proper medication

Make sure that you take all the medicines as per your doctor’s instructions. These immunosuppressants will prevent the body from rejecting your new heart. However, they cause other problems in the body like creating a risk of – high BP, kidney damage, weakening of bones, increased risk of infections and cancer and much more. Additional medication is prescribed to combat these. 

  • Follow up appointments 

Never miss a follow up appointment with your doctor, as they will check the functioning of the transplanted heart and see to it that no complications have risen. You might have frequent follow-up appointments in the beginning after the transplant, however as the time passes the frequency of visits will decrease. 

  • Exercise 

If you have gotten a heart transplant, you are recommended to exercise regularly to keep the transplanted heart healthy and to avoid weight gain. However, since a transplant heart beats faster (100-110 beats per minute) than a normal heart (approximately 70 beats per minute), you should consult your doctor or a physiotherapist regarding the type of exercise most beneficial for you. Exercising will also help you increase your strength and mobility to a great extent. 

  • Diet 

A balanced diet is very beneficial after getting a heart transplant surgery as it will make the body heal faster and keep you healthy. It might also help reduce the side effects of immunosuppressants like- weight gain, high blood pressure, diabetes and osteoporosis. 

FAQs 

Q-1. What is the heart transplant cost?

Ans. The cost of a heart transplant can vary anywhere between 20 – 25 lakhs. This includes pre-transplant evaluation, the surgery itself, and the post-transplant recovery period.

Q-2. How long can you live after a heart transplant?

Survival rates after heart transplantation vary based on several factors. Survival rates remain to improve despite an increase in older and higher-risk heart transplant recipients. Worldwide, the overall survival rate is more than 85% after one year and about 69% after five years for adults. 

Q-3. What is the success rate of heart transplant?

Ans. Around 85-90% of heart transplant patients live up to one year after their surgery. The yearly death rate after one year is 4%. The one-year survival rate in people with congenital heart disease is 79%.

Skin Treatment – Procedure and Risks

Skin is the largest organ in the human body, and like all other organs it has an important role. It’s your skin’s job to protect you by preventing any harmful infections from entering the body and not letting you get sick. Hence, it is imperative to keep it in good health. Taking good care of your skin will ensure low chances of future problems, like wrinkles, scars and many more. Apart from that, good skin has mental and social benefits. Having good skin boosts your self-confidence and when you look good, others might have a great first impression of you. Thus, proper skin care is very important.

Nowadays, people do not wish to have any skin problems and want to look good all the time. Skin problems might include- scars (from acne, injury or surgery), wrinkles, discoloration and age spots. These skin problems can be treated with the help of cosmetic skin treatments. These treatments are performed by highly trained and experienced dermatologists/cosmetic surgeons.

Who is a Dermatologist?

Dermatologist is a doctor who specialises in the treatment of conditions related to skin, hair and nails. A dermatologist can identify internal problems in your body by looking at your skin. They diagnose and treat skin medical issues like acne, rosacea and other skin problems. Many dermatologists also perform surgeries like doing skin biopsies or removing warts. They also do skin cosmetic treatments which make your skin look rejuvenated, younger and smooth. This may include treating scars, smoothing wrinkles, plumping up saggy skin, removing age spots and much more.

What are Cosmetic Skin Treatments and why do you need them?

Cosmetic skin treatments are various surgical and nonsurgical procedures that are done to treat your skin, to enhance your appearance. These skin treatments help to restore a more rejuvenated, youthful complexion by eliminating the outer damaged skin layers to reveal a new and healthy skin from beneath and also encourages the growth of new healthy skin cells. 

Various types of skin treatments are used by Cosmetic surgeons to address a myriad  of skin concerns. They include- Chemical Peel, Laser Skin Resurfacing, Dermabrasion, Microdermabrasion, Botox, etc. Some of these treatments encourage the growth of new cells and collagen production, while others use the techniques of removing scar or filling in wrinkles to make your skin look smooth and clean. The level of invasion, recovery time and how long the treatment will last differs from treatment to treatment. 

Cosmetic Skin Treatments

  • Chemical Peels

Chemical Peeling is a type of skin treatment, in which a chemical solution is applied on the surface of the skin which results in the peeling away of the damaged outer skin layer. Chemical Peeling is used to treat skin problems by removing scars caused from acne, injury or a surgery, smoothing out wrinkles, removing age spots, discoloration and freckles. It also helps in tightening and toning of the skin.

Chemical peel should be done by an experienced cosmetic surgeon. In this, a chemical solution is brushed on your skin and then it will be left there for a certain period of time. Over time, this chemical solution causes the damaged skin to peel apart, revealing a cleaner, smoother and younger looking skin.

Depending upon the severity of your skin problems, chemical peel can be classified into a range of 3- light, mild and deep. This classification is based upon the number of skin layers that need to be peeled. Light peels use Alpha Hydroxy acid (AHA), mild peels use trichloroacetic acid (TCA) and deep peels use Phenol. Light chemical peels reach the outermost layers of skin which is called the epidermis. Deeper peels on the other hand go further down, they will pass the epidermis and go to the next layer- dermis. This is recommended for more severe skin issues and must be performed by a trained and experienced cosmetic surgeon.

By evaluating your skin problem, your cosmetic surgeon will recommend the types of peel you require to get a healthy and rejuvenated skin. After the chemical peel heals, you will be able to see a brighter and smoother skin.

  • Laser Skin Resurfacing

As the name suggests, Laser-skin treatment uses pulsating laser beams to treat the damaged skin by improving its tone, texture and removing deep lines and wrinkles on the face and neck. In this, the outer layer of the skin is removed and the deeper layers are heated up. This triggers the growth of collagen and new skin cells in the skin layers. It is also used to remove unwanted facial or body hair and scars caused from acne, injury or surgery. There are 2 types of lasers- Ablative Lasers and Non-Ablative Lasers.

Ablative Lasers

Ablative Lasers remove the outer skin layer, it is used to treat deep wrinkles and scars. This laser shows results faster but takes longer time for recovery. 

Non-Ablative Lasers

Unlike Ablative lasers, Non-Ablative lasers do not penetrate the skin. Their work is to heat up the skin below the surface to push the growth of collagen and help to treat early signs of aging by making the skin firm and toned. Non-ablative lasers work just like Ablative lasers, the only difference is the time of discomfort and recovery is very less. And they also have long lasting results.

Laser Skin Treatment is a long-lasting treatment but sometimes, it may take several months for the results to show (effects of collagen and new skin cell) depending upon your skin type. Side effects such as redness might take several weeks to go away, you also might have to stay away from sunlight for several months. Your cosmetic surgeon will make you understand the expected results which vary from patient to patient, depending upon their skin type and problems.

  • Botox Injections

In Botox skin treatment, a small amount of liquid which includes a substance called Botulinum toxin is injected in the face muscles. It is a very common type of skin treatment these days and is used for both cosmetic as well as problems. Cosmetic problems include- frown lines, crow’s feet, furrow lines, lines at the corner of the mouth and much more. A temporary paralysis is caused in the muscle in which the Botox is injected. The muscle is unable to contract as all the nerve signals to it get blocked.

This procedure does not take more than 15 minutes depending upon the amount and area in which the Botox needs to be injected. You can start seeing the results between 24-72 hours after the treatment. This treatment may last for 3 to 12 months depending on the type and area of treatment.

Some patients may face side-effects like- Bruising around the injection site, eyelids drooping, swelling in the eyes area, headache, weakness, numbness, dry eyes or allergic reactions like rash or itching, but they all go away in a few weeks time. In case that does not happen, immediately contact your doctor. People who are breastfeeding, pregnant, have a neurosurgical disease or are allergic to any of the ingredients used in Botox should not get Botox done.

  • Dermabrasion

Dermabrasion, often used for facial procedures, is a surgical procedure in which your doctor uses a wire brush or a rapidly rotating device to remove the damaged skin layer by layer. The number of layers to be removed/ depth of the procedure depends upon how severe the skin problems are. Once the skin is removed, the treated area heals which allows the growth of new skin in its place by encouraging new cell growth. This treatment is used to remove acne and pimple scars, wrinkles, skin whitening and smoothening. 

This treatment is performed only by trained dermatologists and cosmetic surgeons. Before the procedure begins, to numb the skin, you are injected with an anesthetic so that you don’t feel any discomfort during or after the treatment . Dermabrasion is not recommended for all, as it goes deeper into the skin and can affect skin pigmentation. There might be some side effects including redness, pain, burning or swelling. Since the treated skin is delicate, it is very important to protect it from the sun and infection.

  • Microdermabrasion

As the name suggests, microdermabrasion is a mild version of dermabrasion, which is used on the face, hands, neck, or body. It is done to remove light acne scars, discolored skin, enlarged pores and age spots and also helps in skin brightening. In microdermabrasion treatment, the area is exfoliated with the application of fine abrasive crystals or with the help of a fine tipped instrument. This exfoliated skin is then vacuumed away. Unlike Dermabrasion in which there is a high risk of side-effects, it requires no recovery time. Also, microdermabrasion carries a low risk of side-effects and can be used on all skin types. It might take a long time, sometimes a few months to get visible results and how long the results will last depends upon how severely the skin was damaged.

It is one of the most common wrinkle treatments as the procedure is quick and does not take a long time. In some cases, more than one session of microdermabrasion might be required to get the desired skin results. After getting the treatment, it is necessary to keep the skin away from the sun as it is very sensitive and can get damaged easily.

Kidney Transplant – Procedure, Risk and Treatment

What is Kidney transplant?

Kidney transplant, also known as a renal transplant is a major surgical procedure, in which a healthy kidney from a deceased or living donor is placed in a human who has kidney failure at end-stage renal disease (ESRD). This happens when both of your kidneys stop working, which results in the accumulation of waste and other toxic substances in your body which can further raise your blood pressure and ultimately lead to kidney or renal failure.

Kidney Anatomy and Functions-

The kidneys are the internal organs of a human, which are essential for life. They are two bean-shaped organs placed on each side of the spine below your rib cage in the lower abdominal activity on the back wall. Kidneys are roughly the size of your fist about 4 to 5 inches long. Their main function is to filter out waste and other toxins from the blood by producing urine, which is then excreted from the body.

To ensure the proper functioning of the body, these kidneys perform several major functions. They include-

  • Maintain body fluid balance by filtering out the waste and other toxins from your blood. This waste is then turned into urine and stored in the bladder. And once you feel that the bladder is full, the urine is passed out from the body through the urethra.
  • Regulate blood pressure by releasing hormones.
  • Produce erythropoietin for regulating the production of red blood cells in the bone marrow. 
  • Control the acid-base balance 
  • Regulate the concentration of electrolyte (salt) in the body.

Kidney Transplant

When a kidney failure or End Stage Renal DIsease (ESRD) occurs, both the kidneys stop functioning, which results in the accumulation of waste in the body, making you sick. There are two ways to treat this- Dialysis and Kidney Transplant. Dialysis is a mechanical process used to clean the blood by filtering out the waste products.

Kidney transplant is considered over a lifetime of dialysis and only one kidney is needed to replace the functioning of the two previous kidneys which stopped functioning. Kidney from a living person is also an option as an individual can live a healthy life with just a single kidney functioning properly. This new donor kidney is transplanted in your lower abdomen. The artery and the vein of the new kidney are connected with your artery and vein. Once the connection is done, the blood will start flowing through the new kidney and resume the work of filtering out the waste from the blood and excreting it out of your body in the form of urine. Sometimes, it may take weeks for the new kidney to start functioning. Kidney transplant will treat ESRD and allow you to live a normal and healthy life once again.

Why is Kidney Transplant done? What are the reasons of Kidney Transplant?

Kidney transplant is done when both the kidneys have stopped working by more than 90%, leading to the endangerment of your life. Multiple reasons for kidney failure include-

  • Diabetes
  • Chronic high blood pressure
  • Glomerulonephritis, a situation in which glomeruli, tiny filters within your kidneys get damaged by inflammation and eventual scarring.
  • Polycystic kidney disease

Who cannot get a kidney transplant done?

Sometimes, there are certain reasons, due to which getting a kidney transplant is not possible. They are-

  • Severe cardiovascular disease
  • Cancer (active or recently treated)
  • Alcohol or drug abuse
  • Uncontrolled mental illness or dementia
  • Infections like- tuberculosis, hepatitis, or bone infections
  • Problem in liver

Kidney Transplant Procedure-

Kidney transplant Evaluation Process

To find an identical kidney, from a living donor or deceased donor, there are certain tests that need to be conducted to find out your blood type and tissue. These results are then used to match with a donor kidney for transplant. They are-

Blood Type Testing – To prevent the risk of your body rejecting the new kidney, your blood is tested to find its type, out of- A, B, AB, or O. For transplant, the donor blood type should either be the same or at least compatible unless special treatment is being done which can allow any blood type. Compatible blood types-

    • For recipient with blood type A, donor type – A, O 
    • For recipient with blood type B, donor type – B, O
    • For recipient with blood type AB, donor type – A, B, AB, O
    • For recipient with blood type O, donor type – O

Tissue Typing – Once a donor with a compatible blood type has been found, the next test conducted is a tissue typing test known as human leukocyte antigen typing (HLA). This test is done to compare antigens. Inherited from parents,  antigens are genetic markers found in everyone that distinguish every individual. Although not necessary, compatible tissue typing plays a very important role in a long-lasting kidney transplant.

Crossmatch – A human body forms antibodies, who destroy any foreign material present in the body. And since the donor kidney is also a foreign object, crossmatch is done to see if your body forms antibodies against the donor kidney. Cross Matching is done by mixing a sample of donor’s blood and your (recipient) blood in the lab. If the test results are negative, your body will most likely not reject the donor kidney. However, if the test results are positive, special treatment needs to be done to reduce the antibodies in the recipient’s body before the kidney transplant.

Additional tests might be done to ensure that the donor is healthy and no medical problem is transferred from the donor’s body to the recipient’s body.

Kidney Donation from a Living Person-

Instead of waiting for a kidney from a deceased person, a donor kidney from a willing living person is also an option. Generally, for a proper match, family members are the best option. But unrelated people like- friends, co-workers can also donate a kidney (willingly).

Kidney Donation from a Deceased Person-

If you are unable to find a living donor, you will be put on a waiting list for a deceased donor kidney. You might have to wait for years to get a kidney transplant from a deceased donor.

While you are waiting for a kidney transplant, you need to maintain a healthy lifestyle as you will be more prepared for the kidney transplant. Do regular exercising, and don’t do any sort of substance abuse. And take your prescribed medication.

Kidney transplant Surgery Procedure

  • Once you have been called for kidney transplant from a living or a deceased donor to the hospital, you will be prepared for the surgery.
  • You will be administered anesthesia before the surgeon begins with the transplant. And your heart rate, blood pressure, and blood oxygen level will be measured during the roughout of the procedure.
  • The original two kidneys are not removed, instead a third kidney added. The original kidneys will only be removed if you have pain, kidney stones, high blood pressure, or infection.
  • An incision is made in the lower part of the abdomen at either of the sides. 
  • The new kidney is placed there and the artery and vein carrying blood from the new kidney are surgically connected to the artery and vein present in your pelvis.
  • The ureter of the new kidney is also connected with the bladder for the flow of urine.
  • The incision is then closed with stitches.
  • To help you pee, the surgeon might also insert a tiny tube called a stent into your ureter.
  • This surgery takes about 3 to 5 hours to complete.

Post Procedure After Care

  • Once the surgery is complete, you will be taken to another room for recovery, where your vitals will be continuously monitored.
  • You might have to stay in the hospital for more than a week depending upon the speed of recovery. During this time, you will feel pain at the incision site, which will heal gradually.
  • The transplanted kidney might start making urine immediately or might take some while. Kidneys donated from a family member generally start working faster than a kidney from a deceased or an unrelated donor.
  • Before leaving the hospital, you will be given instructions by the doctor regarding the medication you will have to take for the rest of your life, so that your body doesn’t reject the new kidney. The medication (immunosuppressants) prevent our immune system from attacking the donor kidney.
  • You will be called to the hospital for regular checkups.
  • You will be able to return to normal activities in about six weeks or it may take longer depending upon certain conditions.

What are the risks of a Kidney Transplant?

A kidney transplant carries some risks. They are-

  • Bleeding
  • Blood Clots
  • Infection
  • Leakage at the incision site
  • Stroke
  • Heart attack
  • Transplanted kidney fails and gets rejected
  • Blockage in the urethra

The immunosuppressants which you have to take for the rest of your life also carry some risks. They include-

  • Bone thinning
  • Weight gain
  • High risk of cancer
  • Acne
  • High blood pressure
  • Hair growth or hair fall in excess

Care At Home-

At home, there are certain things you need to keep in mind to ensure the proper functioning of the donor kidney. They are-

  • Take medication regularly
  • Eat a healthy and proper diet
  • Exercise daily, after the wound has healed
  • Don’t lift heavy objects for a short while

FAQ

Q-1. What is the kidney transplant cost in India?

Kidney transplants in India cost Rs. 5-6 lakhs (Purely indicative). After the surgery, it could cost Rs. 15,000 a month for the aftercare and another Rs.

Q-2. Is kidney transplant a major surgery?

Kidney transplants in India cost Rs. 5-6 lakhs (Purely indicative). After the surgery, it could cost Rs. 15,000 a month for the aftercare and another Rs.

Yes, kidney transplant is a major surgery and thus involves a higher rate of risk.

Q-3. What is the Kidney Transplant success rate?

According to the national Organ Procurement and Transplantation Network, the success rate after a kidney transplant with a living-donor kidney was reported as 97% at 1 year and 86% at 5 years.

Q-4.Why is kidney transplant better than dialysis?

There are many reasons why getting a kidney transplant is better than dialysis. They are-

  • Kidney transplant patients live longer than people who get dialysis.
  • A person who is on dialysis has to follow a strict diet, whereas people who opt for kidney transplant can eat more freely.
  • Dialysis patients have low energy levels as compared to kidney transplant patients and can thus return back to their normal work life much quicker.     

Liver Transplant – Procedure, Risk and Treatment

What is Liver transplant?

A liver transplant is a surgical operation in which a damaged liver that is no longer in a working condition is replaced with a healthy liver. The healthy liver can be taken from a deceased person or a portion of a healthy liver taken from a volunteer who is either known to the patient or is a third-party reference.

Liver Anatomy and Functions

Located in the upper right part of the abdominal cavity, the liver is the largest internal organ in the human body. It is underneath the diaphragm and above the stomach, intestines, and right kidney. The gallbladder and parts of the pancreas and intestines sit under the liver. The liver along with these organs work together for digestion, absorption, and processing of food.

Functions of the Liver

The liver plays a vital role in the human body. It performs various important functions, without which, life is not possible. Some of its most important functions include –

  • During digestion, it produces bile, which helps in carrying away the waste and breaking down fats (metabolism) in the small intestine to help the human body in making energy.
  • Produces protein needed by the body.
  • To prevent the shortage of nutrients, the liver stores vitamins, minerals, and sugar. It converts and stores the extra glucose in the form of glycogen to balance the amount of glucose in the body.
  • Also responsible for regulating blood-clotting.
  • Removes the drugs and toxic substances from the blood.
  • Helps our body in fighting against infections by eliminating the bacteria from the blood.
  • Regulates the blood cells of amino acids and also processes the hemoglobin to use the iron present in it.

Liver Transplant

In humans, the liver is the only organ which can regenerate i.e., it can replace lost or injured tissue and grow back to the normal size in a span of a few months. This means the donor who donates a portion of his liver will have his liver grown back to its normal size after surgery. Similarly, the liver part which you have received will also grow to normal size in a short while.

Generally, livers are taken from registered donors who have expired/passed away. a family member or someone whose blood type matches yours. And their part of the liver and your new liver will grow back to its normal size in a few weeks time.

Why is Liver Transplant done? What are the reasons for liver failure?

Liver Transplant is done if your liver is damaged and is not in working condition any longer (liver failure). Causes of liver failure could be acute as well as chronic problems.

Acute Liver Failure- Also known as Fulminant Hepatic Failure, acute liver failure occurs quickly, in a few week’s time. It could be a result of an infection or health disorder due to certain medication.

Chronic Liver Failure- More than Acute liver failure, liver replacement is used to treat chronic liver failure. Chronic liver failure happens slowly, and it might take months and years to scarring or liver, known as Cirrhosis. It is the main cause of chronic liver failure.

In Cirrhosis, the liver stops working as all the normal and healthy liver tissue gets replaced with scar tissue. After this, the liver can no longer heal itself.

Major reasons for Cirrhosis are –

  • Chronic Hepatitis
  • Liver damage due to excessive consumption of Alcohol
  • Fatty liver disease, a condition in which fat builds upon the liver and leads to inflammation or damaging of liver cells.
  • Genetic diseases like Hemochromatosis (excessive iron build in the liver),  Wilson’s disease (excessive copper build up in the liver).
  • Scarring, narrowing, or damaging of bile ducts.
  • Biliary atresia, a liver disease that affects babies.

How are people selected for Liver Transplant?

If none of the treatments work, your doctor may recommend you to get a liver transplant. After evaluating your health condition to check whether you are fit for the surgery, tests are conducted to see if you can get a transplant. There are some medical conditions that reduce the chances of liver transplant success. In these cases, a liver transplant is not possible. They are-

  • Untreatable infection
  • Overuse of drugs and alcohol
  • Cancer outside of the liver
  • Severe heart or lung conditions 

The doctor will explain all the post-surgery care instructions and the medication that you need to take for the rest of your life.

Before it is confirmed that you need a liver transplant, there are certain tests and procedures which you have to go through. They are-

  • Laboratory tests, like blood and urine tests, are done to evaluate your health along with your liver. Blood tests help to find a liver donor match and your place on the waiting list for liver replacement.
  • Diagnostic tests include liver biopsy, ultrasounds, X-rays, heart and lungs tests, dental exams, and colonoscopy. These tests are done to check your liver and evaluate your general health. It is also done to check for any other health conditions that may hamper the liver transplant success rate.

Psychological and social evaluation might also be done to check stress, financial conditions. It is also checked if post-surgery you will have someone to support you or not. They could be family, friends, or relatives.

Once all these tests are done, and it has been decided that you can undergo a liver transplant surgery, you are placed on the waiting list based on how urgently you need a liver transplant.

Your position on the waiting list depends upon your score on two scoring systems-

  • MELD – Model for End-Stage Liver Diseases, for adults.
  • PELD – Pediatric End-Stage Liver Disease, for children under the age of 12.

The score ranges between 6 to 40. People with a high MELD score and acute liver failure are placed on the top of the waiting list. If someone’s condition worsens and their MELD score rises, their place goes up. As soon as a donor liver is available, it is allocated in accordance with the MELD score and blood type. There is no fixed time for which you might have to wait for the donor liver. Some people might wait for only a few days, whereas others might have to wait for months or may never get a donor liver from a deceased person. Meanwhile, the doctor will try to ease your liver complications to make the wait as comfortable as possible.

There is also an option of liver from living donors. In this, a small portion of the liver from a healthy and living person is transplanted into your body. As time goes by, the donor and your new liver grows back to their natural size. This is an alternative to waiting for a liver from a deceased person. Factors that determine the possibility of a liver transplant from a living donor are- age, blood type, health, and others. Usually, these people are close family members or friends. The percentage of living donor liver is very less, as the donor has to go through an extensive evaluation to make sure/ensure that their liver matches yours. Liver transplant surgery is also risky for the donor.

Liver Transplant Procedure

If the doctor has received a liver from a deceased donor, they will notify you. Or, in the case of a living donor, once they have taken a small portion of their liver they will transplant the liver into your body. 

  • After examining your health, to check if you are fit for the surgery, you will be taken for surgery.
  • You will be given general anesthesia, which will put you in a temporary sleep until the transplant surgery is complete.
  • The surgeon will now make an incision across your abdomen to reach your liver.
  • During the procedure, several tubes will be placed in your body to help it perform certain functions. These tubes are not removed for a few days, post surgery.
  • The diseased liver will then be replaced with the donor liver, and the surgeon will connect the blood vessels and the bile duct to the new donor liver. 
  • After the incision will be closed, you will be put in the Intensive Care Unit for recovery.
  • This surgery takes from 6 to 12 hours, depending on your situation.

Post Procedure 

  • You might have to stay in the ICU for 1-2 weeks or more, depending upon your condition. Where, you will be hooked to monitors to keep a continuous check on your heart rate, blood pressure, oxygen level, and more. 
  • Once the doctors are satisfied with the functioning of your new liver, you will be sent home.
  • Though, you will have to come for regular check-ups.
  • And you will be prescribed a medication, known as immunosuppressants, which you need to take for the rest of your life.
  • The minimum time of recovery from a liver transplant is 6 months.

Results

Survival rate after the liver transplant varies from patient to patient. 

Self care at home

  • Eat a healthy and balanced diet with enough fibre and limit the intake of salt, sugar, cholesterol and fat.
  • Stay hydrated.
  • Exercise regularly.
  • Don’t drink or smoke.
  • Don’t consume grapefruit in any form, as it affects the work of immunosuppressants.
  • Don’t eat raw eggs, fish, fish, or unpasteurized milk products.

What are the risks of getting a Liver Transplant?

A procedure as complex as a liver transplant carries a lot of complications and risks. They could come soon after the transplant or after many years. They are-

Rejection

There are cases, in which your body might reject the liver transplant in your body. Your immune system sees that liver as a foreign object and tries to fight against it. Rejecting a foreign object is a normal task of your immune system. To prevent your immune system from attacking the new liver, you have to take anti-rejection medication (immunosuppressants). This medication weakens your immune system’s attack. You have to take this medication for your entire life ahead.

Surgery Risks

Even after the liver transplant surgery is completed, there are some risks that might arise. They could be-

  • Blockage in the vessels carrying blood to your new liver. 
  • Leakage of bile from the bile ducts into your belly or blockage or shrinking of bile ducts.
  • Infection at the surgery site.
  • Bleeding   

Infection

A liver transplant can result in a higher risk of infection. The medication which you have to take to stop your body from rejecting the liver transplant makes your immune system weak, which can lead to infection. 

Recurrence of Liver disease

There are cases, in which after getting a liver transplant, the problem (s) that caused your liver failure in the first place might come back. The problems could be-

  • Fatty Liver Disease
  • Hepatitis C
  • Primary sclerosing cholangitis 

Cancer

People who have an organ transplant are at a higher risk of getting cancer than the rest of the world. Anti-rejection medication (immunosuppressants) can make you prone to other cancers, and also a rare condition known as Post- Transplant Lymphoproliferative Disorder (PTLD).

FAQs

What is the liver transplant cost in India?

The cost of a liver transplant can vary anywhere between 20 – 30 lakhs. This cost is significantly very less when compared to the cost of the same treatment and care in clinics in developed countries

What is the liver transplant success rate?

In general, about 75% of people who undergo liver transplants live for at least five years. That means that for every 100 people who get a liver transplant for any purpose, about 75 will live for five years and 25 will die within five years.

    APPLY FERTILITY LOAN