What you need to know about:

Liver transplantation [Recipient]

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Overview of

Liver transplantation [Recipient]

in Thailand

Liver transplantation is the replacement of a diseased liver with a new, healthy one. This is a treatment option for patients with end-stage chronic liver disease that cannot be treated with any other method and restores adequate function of the liver to meet the body’s needs. Liver transplantation also improves quality of life and extends lifespan.

Goals of

Liver transplantation [Recipient]

Liver translplants can be used to treat acute and chronic failure, the latter of which is more common. Chronic liver failure may be caused by a variety of conditions. The most common cause of chronic liver failure is scarring of the liver (cirrhosis). When cirrhosis occurs, scar tissue replaces normal liver tissue and causes the liver to not function properly. Cirrhosis is the most frequently reason for a liver transplant.  

Major etiological causes of cirrhosis leading to liver failure and liver transplant include:  -Hepatitis B and C. -Alcoholic liver disease, which causes damage to the liver due to excessive alcohol consumption. -Nonalcoholic fatty liver disease, a condition in which fat builds up in the liver, causing inflammation or liver cell damage. -Genetic diseases affecting the liver, including hemochromatosis, which causes excessive iron buildup in the liver, and Wilson's disease, which causes excessive copper buildup in the liver. -Diseases that affect the bile ducts (the tubes that carry bile away from the liver), such as primary biliary cirrhosis, primary sclerosing cholangitis and biliary atresia. Biliary atresia is the most common reason for liver transplant among children.

Price of

Liver transplantation [Recipient]

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Pros and cons of

Liver transplantation [Recipient]

Pros

-The main pro of having a transplant is to live longer. Transplants typically extend the lift of recipients by approximately 5 years.  -You will enjoy a better quality of life and have reduced chances of dying from your current liver diseases. -Transplant recipients will no longer have to be on liver dialysis which can take long hours for each session.  

Cons

-After a liver transplant, you will need to be on medications for the rest of your life to help prevent your body from rejecting the donated liver. These anti-rejection medications can cause a variety of side effects, including:  Bone thinning Diabetes Diarrhea Headaches High blood pressure High cholesterol Because anti-rejection drugs work by suppressing the immune system, they also increase your risk of infection. Your doctor may give you medications to help you fight infections.

How it works:

Liver transplantation [Recipient]

There are two possibilites in which you will receive your new liver; If you're notified that a liver from a deceased donor is available, you'll be asked to come to the hospital immediately. Your health care team will admit you to the hospital, and you'll undergo an exam to make sure you're healthy enough for the surgery.Liver transplant surgery is done using general anesthesia, so you'll be sedated during the procedure.The transplant surgeon makes a long incision across your abdomen to access your liver. The location and size of your incision varies according to your surgeon's approach and your own anatomy.The surgeon removes the diseased liver and places the donor liver in your body. Then the surgeon connects your blood vessels and bile ducts to the donor liver. Surgery can take up to 12 hours, depending on your situation.Once your new liver is in place, the surgeon uses stitches and staples to close the surgical incision. You're then taken to the intensive care unit to begin recovery. If you're receiving a liver transplant from a living donor, your surgery will be scheduled in advance. Surgeons first operate on the donor, removing the portion of the liver for transplant. Then surgeons remove your diseased liver and place the donated liver portion in your body. They then connect your blood vessels and bile ducts to the new liver.The transplanted liver portion in your body and the portion left behind in the donor's body regenerate rapidly, reaching normal volume within a several weeks.

Preparation before

Liver transplantation [Recipient]

Pre - treatment

You will need an evaluation to determine whether you meet the hospital's eligibility requirements.The goals of the evaluation process are to determine whether you: -Are healthy enough to have surgery and tolerate lifelong post-transplant medications -Have any medical conditions that would interfere with transplant success -Are willing and able to take medications as directed and follow the suggestions of the transplant team You will also undergo specific procedures and consultations which include; Laboratory tests, imagine tests, heart tests, and counselling.

Recovery after

Liver transplantation [Recipient]

Post - treatment

After the liver liver transplant you can expect to:  -Possibly stay in the intensive care unit for a few days. Doctors and nurses will monitor your condition to watch for signs of complications. They'll also test your liver function frequently for signs that your new liver is working. -Spend 5 to 10 days in the hospital. Once you're stable, you're taken to a transplant recovery area to continue recuperating. -Have frequent checkups as you continue recovering at home. Your transplant team designs a checkup schedule for you. You may undergo blood tests a few times each week at first and then less often over time. -Take medications for the rest of your life. You'll take a number of medications after your liver transplant, many for the rest of your life. Drugs called immunosuppressants help keep your immune system from attacking your new liver. Other drugs help reduce the risk of other complications after your transplant. Side of effects from your medications may include;  Bone thinning Diabetes Diarrhea Headaches High blood pressure High cholesterol Because anti-rejection drugs work by suppressing the immune system, they also increase your risk of infection. Your doctor may give you medications to help you fight infections.  Expect six months or more recovery time before you'll feel fully healed after your liver transplant surgery. You may be able to resume normal activities or go back to work a few months after surgery. How long it takes you to recover may depend on how ill you were before your liver transplant.

Risks & side effects

Liver transplant surgery carries a risk of significant complications. There are risks associated with the procedure itself as well as with the drugs necessary to prevent rejection of the donor liver after the transplant.  

Risks associated with the procedure include:  -Bile duct complications, including bile duct leaks or shrinking of the bile ducts -Bleeding -Blood clots -Failure of donated liver -Infection -Rejection of donated liver -Mental confusion or seizures -Long-term complications may also include recurrence of liver disease in the transplanted liver.

FAQs:

Liver transplantation [Recipient]

How long do patients who receive liver transplants live for?

According to a study, people who have a liver transplant have an 89% percent chance of living after one year. The five-year survival rate is 75 percent. Sometimes the transplanted liver can fail, or the original disease may return.  Although liver transplants have high success and survival rates, an individual’s chances of surviving and thriving after the surgery depend on a mix of critical factors.  

Factors include:  -Age -Body mass index (BMI) and major fluctuations in body weight. -Health of the patient before surgery -Severity of their liver failure and how many other organs are involved, especially the kidneys -Cause of the liver failure -Medical history and additional health conditions  

What is the likelihood of success of this procedure?

The success rate of liver transplantation at Bumrungrad Hospital is comparable to that in the United States, Canada, and Western Europe. Statistical data of Bumrungrad Hospital in the past 10 years showed the one-year survival rate of liver transplant patients is 97%, the five-year survival rate is 82%, and the ten-year survival rate is 67%. The success and survival rates of patients depend on a number of factors, including: The age, health, and condition of both the donor and recipient. The health of the donor liver. Rejection of the donor liver. Other post-surgical complications. Side effects of the medications prescribed. How the recipient takes care of themselves.

What if the procedure is not performed?

The liver is the largest organ in the body and is located in the abdomen, under the right ribs, extending under the xiphoid process towards the left ribs. The liver’s functions are important and cannot be replaced by any other organs. No matter the liver disease is caused by hepatitis, fatty liver, cancer, or cirrhosis, when the disease reaches the end-stage, if the patient does not receive liver transplantation he/she will have a shorter life span.

Will my liver disease come back after a transplant?

Certain liver diseases can reappear in the new liver. One such example is hepatitis C. Your transplant team can advise you on the incidence of recurrence of specific liver ailments. In cases where there is a risk of recurrence the transplant team will monitor you very closely to help prevent recurrence.

What kinds of medications will I need to be on after my liver transplant?

You will be on immunosuppressant medications after a liver transplant: to prevent organ rejection. Other medications that you will take will help fight infections, and others to treat the side effects of the immunosuppressants.   Patients returning home after transplantation will be taking approximately 7 to 10 different type of medicines. During the recovery process with your new liver, the dosage and number of medications are reduced over time.  By six months, it is common to be down to 1 or 2 medications. However, most patients will end up taking immunosuppressive medications for the rest of their lives in virtually all cases. It is vital that these medications are taken as prescribed, in the proper amounts and at the specified times. Missing medication doses or discontinuing them on one's own can lead to rejection and organ failure.

What are the side effects from the medications prescribed after transplant?  

Many medications have side effects. Side effects typical with post-transplant medications include: elevated blood pressure, changes in mood, hair loss or hair growth, elevated blood sugar, bone and muscle weakness, kidney dysfunction, nausea, vomiting, diarrhea, and headache. Most patients will experience side effects initially, but these often diminish over time as dosages are reduced.  Although side effects can be troublesome, medications should never be discontinued without the knowledge and agreement of the transplant team. When side effects are severe, the array of medicines can often be adjusted to improve their tolerance.

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Boonlert Imraporn
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