Liver transplantation is an advanced technique through which an unhealthy or non-functioning liver is replaced by a healthy one. Unlike other organs, it only requires a part of the liver to be replaced in the recipient, and then it grows on its own as liver cells are regenerative. Liver transplantation allows the patient to lead a normal and healthy lifespan without compromising the quality of life. Transplantation is a surgical procedure where the recipient receives a donor organ from a healthy individual.
The major goal of liver transplantation is to improve quality of life and maximize life expectancy. Usually, it happens when there is an acute or chronic liver disease and the body is unable to function properly. The most prevalent of all causes is cirrhosis (scarring of the liver) which leads to end-stage hepatic failure. It occurs when the normal tissues of the liver are replaced by scar tissues.
Other common causes of liver cirrhosis that may lead to liver transplant are the following:
Lifetime anti-rejection medications are prescribed as transplanted organs are likely to be rejected by the body. The side effects of those medications include:
Besides this, there is an increased risk of developing infections as these medications suppress the normal immune response. However, the doctor might suggest drugs to overcome these infections.
There are two possibilities in which you will receive your new liver;
Liver transplantation largely depends upon the donor. The recipient is likely to receive a liver in two ways:
A detailed evaluation including physical examination, blood tests, urine tests, ECG, CXR, etc. is carried out before proceeding to the surgery to rule out:
Other medical conditions that may affect transplant results
After the transplant surgery, the patient is shifted to ICU and is likely to stay there for several days.
Continuous hemodynamic monitoring and liver function test are done by the medical team. Any imbalance or complication is immediately reported and treated.
Usually, the hospital stay lasts around 5 to 10 days depending upon the stability and liver functioning.
After the normal liver regeneration is assured, the patient is transferred to the transplant recovery room.
Strict doctor’s follow-ups must be followed once the patient is discharged. Several blood and liver functioning tests are performed during the whole recovery phase.
The anti-rejection and other medications prescribed by the surgeon should not be missed for the rest of the life.
Due to immunosuppressant drugs, the recipient is recommended to be in isolation even after discharge to avoid the risk of infections. The doctor may recommend precautionary drugs to fight infections.
However, these anti-rejection medications may show some side effects including:
Overall recovery may take as long as six months. The patient can get back to normal daily living activities once they’re stable and their doctor approves. However, the complete healing process majorly depends upon the health of the recipient.
Unlike other surgical procedures, a liver transplant is major surgery and hence carries a significant risk of complications and adverse effects. Some of the commonly encountered risks are as follows:
How long do patients who receive liver transplants live for?
A study suggests, that 89% of liver transplant recipients survive one year after surgery whereas 75% of recipients survive 5 years.
Even though the success rates and survival percentage is satisfactory yet the chances of reoccurrence of liver failure in the transplanted liver are never zero. The risk of failure and rejection of donated liver depends upon several factors including age, BMI, overall health condition, the severity of previous disease, cause of failure, and other medical histories of the patient.
What is the likelihood of success of this procedure?
According to a study conducted in Bumrungrad Hospital in the last 10 years, the one-year survival rate of liver transplant recipients is 97%, five years is 82% and ten years is 67%. The figure, however, differs from that of Canada, the US, and Western Europe.
The likelihood of success highly depends on several factors including age, the overall health status of both the donor and the recipient, lifestyle, post-surgical complications or rejection, infection, and adverse effects.
What if the procedure is not performed?
The liver is one of the five vital organs of the human body. The liver function is essential for the body to function and lead a healthy life. In the case of end-stage chronic liver failure due to any cause, if the person doesn’t get a liver transplant, the likelihood of illness, shorter life expectancy, and compromised quality of life are high.
Will my liver disease come back after a transplant?
The incidence of reoccurrence of liver disease after a transplant is noticeable in a few cases. Some liver disorders may reoccur even in the donated liver such as hepatitis C. However, the medical team will monitor any signs of reoccurrence of the disease in follow-up appointments to prevent them.
Will kinds of medications will I need to be on after my liver transplant?
Post-surgery, during the recovery phase, the recipient will take as many as 7 to 10 different medications. The dose and medications reduce gradually over time. Although this number will drop down to 1 or 2 medicines after 6 months of the procedure, some medications are to be taken lifelong.
Immunosuppressants: drugs that suppress the immune system. When a donated liver is placed in the body, the immune system assumes it as a foreign agent and may attack it. Therefore, immunosuppressants are prescribed to the liver transplant recipient so that the donated liver may regenerate without being attacked by the body’s defense mechanism. This also increases the risk of other infections hence other medications are given to fight them as well.
Irrespective of any health conditions, these medications must be taken by the patient at the proper time with the prescribed dosage. Missing or discontinuing any of them may lead to liver rejection or reoccurrence of liver disease.
What are the side effects of the medications prescribed after transplant?
Medications involved in post-liver transplants have several noticeable side effects that may include:
These side effects are often experienced during the initial days and later subside on their own. However, even if the side effects persist, no medication should be discontinued or missed without a doctor’s consultation.