Liver transplantation is the surgical removal of a diseased liver and its replacement with a healthy one.
Anyone with a long standing (chronic) or sudden (acute) liver failure (encephalopathy or coma) due to severe liver diseases needs to be considered as a candidate for a liver transplantation. The common diseases requiring transplant are advanced liver disease (Cirrhosis) due to Hepatitis C, Hepatitis B, Alcoholic liver disease ,Non alcoholic fatty liver disease ( NASH),Primary sclerosing cholangitis, Primary Biliary cirrhosis, Biliary atresia in children and Metabolic diseases. Acute hepatic failure due to acute viral, drug induced or alcohol-induced hepatitis may also need transplantation. Liver transplant is also done for primary liver cancers with fulfillment of certain criterias.
Donor liver comes from two sources:
a) Deceased Donor Liver Transplant (DDLT): This liver is taken from a brain dead person (where there is no chance of survival after withdrawal of life support).
b) Living Donor Liver Transplant (LDLT): A living person donates a part of his/her liver (right or left lobe) to one of his/her relative dying from liver failure.
The donated part of the liver regrows (regenerates) from the remaining part of donor liver, which completes after 6-12 weeks of donation. The donated liver (graft) also grows quickly in the recipient’s body and performs the functions as new liver (central organ) according to the metabolic demand of the body.
Cirrhotic liver Whole liver transplant
|Partial Liver transplant|
Successful living donor liver transplant recipient survive 01 year 85%, 05 years 69% and 10 years 61%. The success rate is better in children than adult population.
Immunosuppressive drugs are started immediately after liver transplant to prevent rejection. It must be maintained for the rest of the life. Liver functions and drug level also needs to be evaluated repeatedly. It is mandatory to maintain a healthy life style after the transplant.