Procedures For Successfully Carrying Out A Liver Transplant

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What Exactly is A Liver Transplant?
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Liver Transplantation is a type of surgery which
is carried out to remove an infected or
dysfunctional liver and replacing it with a
functional and healthy liver. The surgery has
been carried out by surgeons all over the world
since 40 years and have carried out the majority
of surgeries in a successful manner. During a
transplant a patient's entire liver is removed
and is replaced with either a full grown liver or
a part of a it which grows after some time to
full form.
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Under What CircumstancesA Person Has To Get A
Liver Transplant?
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People whose liver becomes dysfunctional are
likely to die if they do not get a transplant.
Various types of liver diseases can cause liver
failure out of which the most common disease is
Cirrhosis in which the liver cells suffer from
cuts or scars which results in the liver cells
becoming dead. Cirrhosis is a disease which is
caused by prolonged symptoms of Hepatitis C.
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There are other conditions like Bile Duct
diseases, primary biliary Cirrhosis, Atresia and
primary sclorosing which cause the liver to fail
because of excess bile juice secretion. Also,
Disease like Wilson Disease and Hemochromatosis
which are hereditary diseases cause the Copper
and Iron levels in the liver to rise to dangerous
levels respectively. Also, Alcoholism and Liver
Cancer are the reason for a person to get a liver
transplant.
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What is Cirrhosis?Cirrhosis is a disease which
affects most of the patients who their livers
transplanted. Most of the the adults suffer from
Cirrhosis which requires them to get a liver
transplant.
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How Cirrhosis Affects The Liver In
Adults?Cirrhosis is a transformation disease
which over the time replaces the liver tissues
with the scar tissues which disables proper
functioning of the liver. The scar tissues
inhibits the blood flow into the liver which
prevents it from processing the drugs, hormones
and various nutrients. This inhibition reduces
the ability of the liver to produce proteins and
other chemicals which are necessary for the body.
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What Is The Most Common Reason For A Child To Get
A Liver Transplant?
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The most common liver disease among children is
Biliary Atresia which is the cause for getting a
transplant. The disease is related to the bile
ducts which carry out the bile enzyme out of the
liver. When these duct are not present or are
damaged there is high possibility of having liver
Cancer or Cirrhosis.
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What Is A Liver Donor Operation?
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The donor of the liver is operated by making a
incision in the upper abdomen area of the body.
If a child has to be transplanted with a liver
then only 25 of the portion of the donor's liver
is taken out.
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But if The patient is an adult then about 60 of
the liver is taken out from the donors body.
Usually, surgeons take out the right portion of
the liver for transplanting it to the patient.
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The Blood Vessels in the liver are separated from
the body and the portion of the liver to be used
is cut out and taken to another operating room
where it is fitted in the recipient's body. The
operation of the donor usually takes 6-8 hours
for completion.
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What Are The Symptoms Indicating You To GetA
Liver Transplant?
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The Prolong or worsening of the following
symptoms is the indication for a person to get
their liver transplanted - Itching- Increased
tendency To Bleed- Forgetfulness And Confusion-
Abnormal storage of fluid known as Ascites in the
abdomen area.- Blood in Vomit- Gray colored
Stools- Dark Colored Urine (tea colored)
-Jaundice
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How Can A Liver Be Procured For A Transplant?

• There are 2 choices for a patient for a Liver
  transplant
• 1. Cadaveric Transplant
• 2. Donor Transplant

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Cadaveric Transplantation

• In this type of transplant the donor of the liver
  may be a victim who has suffered serious injuries
  in an accident which has caused his/her brain to
  stop working but his/her heart beats. In this
  situation the donor is declared legally dead
  because of the dysfunctioning brain. The person
  is put on to a life support system in the
  Intensive-care Unit (ICU). The reasons for the
  death of the person are kept confidential and are
  only known to the doctors. The liver of the
  patient is used for transplanting it in to the
  person in need of it.

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Living Donor Transplant

• patient who are at the last stage of the disease
  require a live donor liver transplant. A segment
  of the donor's liver is removed and is planted in
  to the body of the recipient. Mostly family
  members who are blood related donate their liver
  to the patient. The liver grows back to the
  normal size with in weeks after the operation.
  It is important for the patient and the donor to
  be stable in their health which may cause serious
  concerns over their lives as the operation
  involves a lot of blood loss chances and other
  complication which can be controlled only if a
  person's health is at the required level.

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What Tests are neededBefore a Liver Transplant?
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- Your medical history would be examined by
the specialists and various tests would be
performed to ensure the safety during the
operation. - Doppler Ultrasound test is carried
out to find out if the blood vessels coming from
and going to the liver are working properly.-
Pulmonary Function Study is done to determine
whether the lungs are able to exchange carbon
dioxide and oxygen or not. - Computer
Tomography test uses the X-rays and computer
generated images of the liver which would help
the doctors determine the condition of the liver
so that they can carry out further procedures.-
Echo-cardiogram test is also done to get a
detailed evaluation of the condition of the
Heart. - Apart from all these specific tests
which require specialized machinery, the doctors
carry out blood tests to determine various
symptoms and ability of blood like clotting
ability, blood type, AIDS and Hepatitis detection
and biochemical status of the blood is done.
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What Is Done After The DoctorsFind A Matching
Donor?

• When the doctors find a matching liver for you,
  the transplant coordinator would contact you.
  After you have been informed about the matching
  liver you should not eat or drink anything until
  you reach the hospital for the transplant. You
  would be informed about any further instructions.
  An Electrocardiogram test and a chest X-ray would
  be performed before your transplant operation
  begins. The surgical resident and the
  anesthesiologist would meet you in the operation
  theater. If the test done approve the transplant
  to be carried out then you would be operated
  otherwise you would be sent back and would not be
  called again until a matching liver is found.

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What Are The Procedures During The Time Of The
Surgery?

• During the time of surgery your diseased liver is
  removed from your body by the surgeons who
  disconnect the bile ducts and blood vessels from
  it and replace it with the new liver. The blood
  which was present in the liver which was taken
  out would be sent in to the body with the help of
  a machine. After the liver is connected to the
  bile ducts and the blood vessels the blood in the
  body would automatically start flowing through
  your liver. This operation would last for around
  6 to 12 hours during which you would be made
  unconscious by injecting a dose of anesthesia in
  your body.

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What Are The ProceduresAfter The Surgery?

• After you undergo the surgery you will have to
  stay at the hospital for one to three weeks until
  you become strong enough to be discharged and to
  make sure that your liver is functioning
  properly. You would have to consume medication
  for the prevention of any kind of infections in
  the liver. The doctor would perform regular
  checkups during your stay at the hospital.
• During the time your Liver Transplant Surgeon
  will tell you about the procedures and routines
  which you have to follow so that you keep
  yourself healthy and away from any kind of
  infections. After few days or a week you will be
  provided liquid meals for sometime and eventually
  would be switched on to solid food.
• The patients have to take the immunosuppresive
  medications for their entire life to prevent any
  kind of immune rejection in the liver which can
  have harmful effects on rest of the body.

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What Complications Can Occur In A Liver
Transplant Surgery?

• There are basically two common type of
  complications which occur after a surgery, i.e.
  Infection and Rejection.

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Infections

• A patient is more prone to get infected rather
  than suffering from rejection. This is because of
  the anti-rejection medicines which are prescribed
  to you. These medications increase the risk of
  getting liver infections. Thought this problem
  does not persists for a longer period of time but
  is very much likely to occur if proper care is
  not done.

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Rejections

• Our immune system works to prevent any alien
  substances or elements from entering our body or
  fights the harmful substances which can cause
  harm to our health. Sometimes it is not possible
  for our immune system to distinguish between our
  newly transplanted liver and the unwanted
  invading elements. This makes the immune system
  to attack the liver and destroy it by ceasing its
  functions. This is known as rejection. Some or
  the other kind of rejection occurs among 70 of
  the patients which is treated with the help of
  anti-rejection medicines in most of the cases.

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What Side Effects Can A PatientSuffer After The
Liver Transplant?

• The rejection Preventing drugs are the main
  reason for any kind of side effects among the
  patients who have got a liver transplanted in
  them.
• Most Of The Side Effects Include
• - Nausea
• - Diarrhea
• - Fluid Retention
• - Incresed Blood Pressure
• - Headaches
• To Check whether your new liver is functioning
  properly or not they conduct blood test for
  testing various conditions in the blood quality.
  Your are recommended to eat a healthy diet
  containing fresh vegetables and less fats and
  oils.

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Important Info

• It should be noted that liver transplant can be
  some times dangerous for a person's health if
  they have other diseases outside the liver or
  have active alcoholic and smoking habits. Any
  kind of septic infections may also result in the
  prevention of a liver transplant in a person.
  Therefore, most of the transplants are performed
  on people who have Chronic Liver Cancer Disease.

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• Dr. Arvinder Singh Soin is one of the Pioneers of
  Liver Transplantation in India and the world. He
  has conducted more than 1500 Liver transplants
  and over 12000 Bil Duct, Gall Bladder and other
  complex liver surgeries all over the world.

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Contact Us Liver Transplant IndiaDr. A.S.
SoinHepatobiliary and Liver Transplant
Surgeon,Chief Hepatobiliary and Liver Transplant
Surgeon Chairman,Medanta Institute of Liver
Transplantation and Regenerative Medicine.Sector
38, Gurgaon, Haryana 122001, IndiaTel
NumbersMedanta-The Medicity (Gurgaon, Delhi
NCR)(91) - 124-4855-222, 0124-4855-444Fax 91
-124 4834111Website http//www.livertransplanti
ndia.com/
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