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| Who needs
a Liver Transplant - All about liver transplant operation, liver transplantation,
liver transplant in India. |
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The liver is the largest organ in the body.
It is located on the right side of the abdomen (to the right
of the stomach) behind the lower ribs and below the lungs.
The liver performs more than 400 functions each day to keep
the body healthy. Some of its major jobs include :
› Converting food into nutrients the body can use (for
example, the liver produces bile to help break down fats)
› Storing fats, sugars, iron, and vitamins for later
use by the body
› Making the proteins needed for normal blood clotting
› Removing or chemically changing drugs, alcohol, and
other substances that may be harmful or toxic to the body
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Who
needs a liver transplant?
Persons with one or more of the following problems should
seek expert advice regarding liver transplant. The transplant
doctor can then suggest if liver transplant is appropriate.
Those with end-stage chronic liver disease complicated by
tiredness, fatigue, weight loss, repeated attacks of blood
in the vomit or stool, low serum albumin or prolonged prothrombin
time, hospitalization for intractable (which keeps accumulating
inspite of medicines) ascites, infection in the ascites (spontaneous
bacterial peritonitis or SBP), attacks of excessive drowsiness,
mental confusion or coma or excessive jaundice.
Those with severe acute liver failure which is not improving
with medicines. Acute liver failure is said to be present
when the duration of illness is a few days or weeks. It may
be caused by Viral Hepatitis, Wilson’s disease, drug
overdose, Budd-Chiari syndrome(obstruction to the hepatic
veins or IVC draining the blood from the liver) or some unknown
causes.The illness is characterized by worsening coma, jaundice,
prothrombin time (PT), liver tests (SGOT / SGPT / Alk phos,
GGT) and kidney function, and falling blood glucose levels.
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What are the signs of liver problems?
 Some
signs of liver problems are:
feeling tired or weak
losing your appetite
feeling sick to your stomach
losing weight
bruising or bleeding easily, such as nosebleeds
bloating due to fluid buildup in the abdomen
declining mental functions
Also, liver problems often make the skin and the whites of
the eyes turn yellow, a condition called jaundice, and may
cause swelling in the legs and the abdomen.
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What is liver transplantation?
Liver transplantation is surgery to remove a diseased liver
and replace it with a healthy one. This kind of surgery has
been done for more than 38 years. Many people have had liver
transplants and now lead normal lives.
Can
anyone with liver problems get a transplant?
You cannot have a transplant if you have:
- cancer in another part of your body
- serious heart, lung, or nerve disease
- active alcohol or illegal drug abuse
- an active, severe infection
- inability to follow your doctor's instructions
Where
do the livers for transplants come from?
Whole livers come from people
who have just died. This type of donor is called a cadaveric
donor. Sometimes a healthy person will donate part of his or
her liver for a particular patient. This kind of donor is called
a living donor.
All living donors and donated livers are tested before transplant
surgery. The testing makes sure the liver is healthy, matches
your blood type, and is the right size so it has the best chance
of working in your body.
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What happens in the hospital?
When a liver is available, you will be prepared for
the surgery. If your new liver is from a living donor, both
you and the donor will be in surgery at the same time. If your
new liver is from a person who has recently died, your surgery
starts when the new liver arrives at the hospital.
During Surgery
 The
surgery can take from 4 to 14 hours. While the surgeon removes
your diseased liver, other doctors prepare the new liver.
The surgeon will disconnect your diseased
liver from your bile ducts and blood vessels before removing
it. The blood that flows into your liver will be blocked or
sent through a machine to return to the rest of your body. The
surgeon will put the healthy liver in place and reconnect it
to your bile ducts and blood vessels. Your blood will then flow
into your new liver.
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After Surgery
You will stay in the hospital for an average of 1 to 3 weeks
to be sure your new liver is working. You will take medicines
to prevent rejection of your new liver and to prevent infections.
Your doctor will check for bleeding, infections, and rejection.
During this time you will start to learn how to take care of
yourself and use your medicines to protect your new liver after
you go home.
In the hospital, you will slowly start eating again. You will
start with clear liquids, then switch to solid food as your
new liver starts to work.
What
is rejection?
Rejection occurs when your body's natural defenses, called the
immune system, damage the new liver. Your immune system keeps
you healthy by fighting against things that don't belong in
your body, such as bacteria and viruses. After a transplant,
it is common for your immune system to fight against the liver
and try to destroy it.
To keep your body from rejecting the new liver, you will take
medicines. These drugs, such as steroids, cyclosporine, tacrolimus,
sirolimus, and mycophenolate mofetil, are called immunosuppressants.
Immunosuppressants weaken your immune system's ability to reject
your new liver.
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What
are the other problems that can damage the liver transplant?
Return of the problem that made the transplant necessary in
the first place is the most common problem for patients with
liver transplants. Also, hepatitis C virus may damage a transplant
if the patient was infected before the operation took place.
Other problems include
blockage of the blood vessels going into or out of the liver
damage to the tubes that carry bile into the intestine
How
do I take care of my liver after I leave the hospital?
 After
you leave the transplant center at the hospital, you will see
your doctor often to be sure your new liver is working well.
You will have regular blood tests to check that your new liver
is not being damaged by rejection, infections, or problems with
blood vessels or bile ducts. You will need to avoid sick people
and report any illnesses to your doctor. You will need to eat
a healthy diet, exercise, and not drink alcohol, especially
if alcohol was the cause of damage to your own liver. You should
use medicines, including ones you can buy without a prescription,
only if your doctor says they are safe for you. It is important
to do what your doctor says to take care of your new liver.
Can
I go back to my daily activities?
Yes. After a successful liver
transplant, most people can go back to their normal daily activities.
Getting your strength back will take some time, though, depending
on how sick you were before the transplant. You will need to
check with your doctor on how long your recovery period should
be. Social workers and support groups will help you adjust to
life with a new liver.
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Work. After recovery, most people are able to go back
to work.
Diet. Most people can go back to eating as
they did before. Some medicines may cause you to gain weight,
and others may cause diabetes or a rise in your cholesterol.
Meal planning and a balanced low-fat diet can help you remain
healthy.
Exercise. Most people can engage in physical
activity after a successful liver transplant.
Sex. Most people return to a normal sex life
after liver transplantation. It is important for women to avoid
becoming pregnant in the first year after transplantation. You
should talk to your transplant team about sex and reproduction
after transplantation.
If you have any questions, you may want to check with your doctor
before starting any activity.
Window For Patients
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