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.
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.
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 –
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.
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 –
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-
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-
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-
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.
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.
Survival rate after the liver transplant varies from patient to patient.
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-
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.
Even after the liver transplant surgery is completed, there are some risks that might arise. They could be-
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.
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-
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).
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.