Liver transplant

Definition

Liver transplant is surgery to replace a diseased liver with a healthy liver from a donor.

Description

Liver transplants have become common operations worldwide.

A healthy liver is usually obtained from a donor who has recently died, but has not suffered liver injury. The donor liver is transported in a cooled saline solution that preserves the organ for up to 8 hours, thus permitting the necessary tests for donor-recipient matching.

The diseased liver is removed through an incision in the upper abdomen. The donor liver is put in place and attached to the patient's blood vessels and bile ducts. The operation may take up to 12 hours and requires a large amount of transfused blood.

In some cases, a living donor may donate a section of liver for transplant to someone else, often a family member or friend. This poses some risk to the donor because of the nature of the operation, but since the liver can regenerate itself to some extent, both parties usually end up with fully functioning livers after a successful transplant.

Indications

A liver transplant may be recommended for:

• Liver damage (cirrhosis or primary biliary cirrhosis)
• Long-term active infection (hepatitis)
• Hepatic vein clot (thrombosis)
• Birth defects of the liver or bile ducts (biliary atresia)
• Metabolic disorders associated with liver failure (Wilson's disease)

• Heart, lung, or kidney disease
• Insulin-dependent diabetes mellitus (IDDM)
• Other life-threatening diseases

Risks

Risks for any anesthesia are:

• Reactions to medications
• Problems breathing

• Bleeding
• Infection

Liver transplants carry major risks. There is an increased risk of infection because of the immunosuppressive medications that must be taken to prevent transplant rejection. Call your doctor if there are signs of infection (redness, drainage, fever, swelling, tenderness, jaundice, diarrhea) or if the condition worsens.

Expectations after surgery

Liver transplants can save the lives of people who might otherwise die. Approximately 75% of patients survive 3 years or more after the transplant. Major problems with any transplant include:

• Finding a healthy organ
• Transplant rejection
• Life-long need for immunosuppressive drugs, which weaken the body's ability to fight infections
• Cost

Convalescence

The recovery period averages 12 weeks. Move legs often to reduce the risk of deep vein thrombosis. Resume normal activity as soon as possible after consulting with your physician.

Illustrations

Donor liver attachment

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