Search - Liver Transplant

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Description

A liver transplant is a surgical procedure by which a surgeon replaces a dysfunctional or damaged liver with a healthy one. Either a part of liver or whole liver is transplanted, according to the indication of the transplant. In most cases, liver is taken from a deceased donor. It is also possible to take a part of liver from living donor. Since liver is the only organ in the body which can regenerate to increase its size, a part of liver when transplanted in the body rebuilds to the normal size liver within few weeks.

Symptoms

Liver transplantation is done only when the patient is critically ill becasue of liver failure. Main causes of liver failure include Liver transplantation is done only when the patient is critically ill becasue of liver failure. Main causes of liver failure include Liver Cirrhosis – loss of healthy liver cells, replaced by scar tissue Biliary Duct Atresia – Abnormal/absence of bile ducts Alcoholic Fatty Liver or Non - Alcoholic Fatty Liver diseaseHemochromatosis - a hereditary disease that may cause liver damage due to iron salt deposits in the tissuesPrimary Sclerosing Cholangitis (PSC) - inflammation, swelling and scarring of bile ducts inside and outside the liverWilson's disease - a genetic disorder that causes copper deposits in the tissues leading to copper poisioning in liverEarly stage Liver cancer Portal Hypertensive Gastropathy leading to liver cirrhosis Liver Cirrhosis – loss of healthy liver cells, replaced by scar tissue Liver Cirrhosis – loss of healthy liver cells, replaced by scar tissue Biliary Duct Atresia – Abnormal/absence of bile ducts Alcoholic Fatty Liver or Non - Alcoholic Fatty Liver disease Alcoholic Fatty Liver or Non - Alcoholic Fatty Liver disease Hemochromatosis - a hereditary disease that may cause liver damage due to iron salt deposits in the tissues - a hereditary disease that may cause liver damage due to iron salt deposits in the tissues Primary Sclerosing Cholangitis (PSC) - inflammation, swelling and scarring of bile ducts inside and outside the liver Wilson's disease - a genetic disorder that causes copper deposits in the tissues leading to copper poisioning in liver Early stage Liver cancer Portal Hypertensive Gastropathy leading to liver cirrhosis In the following cases liver transplant may not pe performed: In the following cases liver transplant may not pe performed: Active or Advanced cancer outside the liver Uncontrolled infection If the patient is an alcoholic Heart Diseases Brain death Advanced age Portal Vein Thrombosis HIV infection or AIDS Psychiatric illnesses Active or Advanced cancer outside the liver Active or Advanced cancer outside the liver Uncontrolled infection If the patient is an alcoholic Heart Diseases Brain death Advanced age Portal Vein Thrombosis HIV infection or AIDS Psychiatric illnesses

Pre Procedure

After the patient is declared as the candidate for liver transplant, the surgeon will recommend the following tests Blood and Urine testUltrasound of the liverCancer screeningTests for checking the condition of heart Blood and Urine test Ultrasound of the liver Cancer screening Tests for checking the condition of heart After the tests, the surgeon will discuss issue a letter that will allow you to be on the waiting list to get liver from deceased donor. The surgeon will also discuss the possibility of getting a part of the liver from family or friend. Finding a compatible donor is the most important thing to do before liver transplant. Once the liver is available for the transplant: Surgeon will explain the procedure and give a consent form (which contains information about the procedure). Signing this consent form means a written permission for the surgery. The patient is not given anything by mouth a few hours prior to the surgery. Fluids will be given with the help of IV drip. Surgeon will explain the procedure and give a consent form (which contains information about the procedure). Signing this consent form means a written permission for the surgery. The patient is not given anything by mouth a few hours prior to the surgery. Fluids will be given with the help of IV drip.

During Procedure

The team that performs a liver transplant comprises two or more surgeons, hepatologist, anesthesiologists, trained paramedical staff (transplant nurses & support staff). Liver transplant procedure is a complex procedure of approximately 6 to 12 hours performed under general anesthesia. During the procedure: The patient will be asked to wear the gown and IV lines are placed.Before the surgery starts, the patient is made comfortable by engaging in a conversation by the surgeon & the anaesthesiologist. The anaesthesia is given via intravenous (IV) catheter. A tube is inserted into the lungs & connected to the ventilator to assist respiration. After cleaning the area, an incision is made across the abdomen to access the liver.Blood supply to the liver is disconnected and bile ducts are carefully removed. The damaged liver is replaced with the new liver. Blood vessles and bile ducts are re-attached. If it is living donor, then first a portion of liver is taken from the donor and it is transplanted in place of damaged liver. After the procedure, the incision is sutured and the patient is shifted to ICU for further observation. The patient will be asked to wear the gown and IV lines are placed. Before the surgery starts, the patient is made comfortable by engaging in a conversation by the surgeon & the anaesthesiologist. The anaesthesia is given via intravenous (IV) catheter. A tube is inserted into the lungs & connected to the ventilator to assist respiration. After cleaning the area, an incision is made across the abdomen to access the liver. Blood supply to the liver is disconnected and bile ducts are carefully removed. The damaged liver is replaced with the new liver. Blood vessles and bile ducts are re-attached. If it is living donor, then first a portion of liver is taken from the donor and it is transplanted in place of damaged liver. After the procedure, the incision is sutured and the patient is shifted to ICU for further observation.

Post Procedure

After the procedure, the patient is closely observed in the ICU – Pulse, blood pressure, respiratory rate, temperature, oxygen saturation, etc are monitored at regular intervals. After the surgery, the patient can expect FeverSwelling in the bodyNausea/vomitingTirednessBleeding from incision sitePain in abdomen Fever Swelling in the body Nausea/vomiting Tiredness Bleeding from incision site Pain in abdomen Blood tests are done to ensure the post surgery recovery of the patient. The tube in the lungs is removed after few hours or few days. The other tubes in the throat, urinary bladder are also removed after few days. The patient will be allowed to take clear fluids after the condition stabilizes, followed by soft diet and normal diet. The patients are advised to move and walk around as much as possible. The patient can go home in 10 to 15 days after the surgery. Immunosuppressants and blood thinning medications will have to be taken for the rest of the life.

Risk And Complications

Liver translant is a complex surgery, and has significant risks and complications: Rejection of new liver by the body Blockage or Leakage bile ducts Bleeding Infection Blood vessel blockageNew liver may not function properly for some time after the transplant Rejection of new liver by the body Blockage or Leakage bile ducts Bleeding Bleeding Infection Blood vessel blockage New liver may not function properly for some time after the transplant Immunosuppressants and blood thinning medications may have the following side effects High BP and cholestrolDiarrheaDiabetesIn rare cases, cancer High BP and cholestrol Diarrhea Diabetes In rare cases, cancer

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