Procedures For Successfully Carrying Out A Liver Transplant


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Liver Transplant is a procedure which requires planning and preparations in the form of precautions so that everything goes on smoothly and safely. The surgeons who carry out these procedures are dependent on various types of machinery and tests for determining the success rate of the operation.

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Procedures For Successfully Carrying Out A Liver Transplant

  1. 1. What Exactly is A Liver Transplant?
  2. 2. Liver Transplantation is a type of surgery which is carried out to remove an infected or dysfunctional liver and replacing it with a functional and healthy liver. The surgery has been carried out by surgeons all over the world since 40 years and have carried out the majority of surgeries in a successful manner. During a transplant a patient's entire liver is removed and is replaced with either a full grown liver or a part of a it which grows after some time to full form.
  3. 3. Under What Circumstances A Person Has To Get A Liver Transplant?
  4. 4. People whose liver becomes dysfunctional are likely to die if they do not get a transplant. Various types of liver diseases can cause liver failure out of which the most common disease is Cirrhosis in which the liver cells suffer from cuts or scars which results in the liver cells becoming dead. Cirrhosis is a disease which is caused by prolonged symptoms of Hepatitis C.
  5. 5. There are other conditions like Bile Duct diseases, primary biliary Cirrhosis, Atresia and primary sclorosing which cause the liver to fail because of excess bile juice secretion. Also, Disease like Wilson Disease and Hemochromatosis which are hereditary diseases cause the Copper and Iron levels in the liver to rise to dangerous levels respectively. Also, Alcoholism and Liver Cancer are the reason for a person to get a liver transplant.
  6. 6. What is Cirrhosis? Cirrhosis is a disease which affects most of the patients who their livers transplanted. Most of the the adults suffer from Cirrhosis which requires them to get a liver transplant.
  7. 7. How Cirrhosis Affects The Liver In Adults? Cirrhosis is a transformation disease which over the time replaces the liver tissues with the scar tissues which disables proper functioning of the liver. The scar tissues inhibits the blood flow into the liver which prevents it from processing the drugs, hormones and various nutrients. This inhibition reduces the ability of the liver to produce proteins and other chemicals which are necessary for the body.
  8. 8. What Is The Most Common Reason For A Child To Get A Liver Transplant?
  9. 9. The most common liver disease among children is Biliary Atresia which is the cause for getting a transplant. The disease is related to the bile ducts which carry out the bile enzyme out of the liver. When these duct are not present or are damaged there is high possibility of having liver Cancer or Cirrhosis.
  10. 10. What Is A Liver Donor Operation?
  11. 11. The donor of the liver is operated by making a incision in the upper abdomen area of the body. If a child has to be transplanted with a liver then only 25% of the portion of the donor's liver is taken out.
  12. 12. But if The patient is an adult then about 60% of the liver is taken out from the donors body. Usually, surgeons take out the right portion of the liver for transplanting it to the patient.
  13. 13. The Blood Vessels in the liver are separated from the body and the portion of the liver to be used is cut out and taken to another operating room where it is fitted in the recipient's body. The operation of the donor usually takes 6-8 hours for completion.
  14. 14. What Are The Symptoms Indicating You To Get A Liver Transplant?
  15. 15. The Prolong or worsening of the following symptoms is the indication for a person to get their liver transplanted: - Itching - Increased tendency To Bleed - Forgetfulness And Confusion - Abnormal storage of fluid known as Ascites in the abdomen area. - Blood in Vomit - Gray colored Stools - Dark Colored Urine (tea colored) -Jaundice
  16. 16. How Can A Liver Be Procured For A Transplant? There are 2 choices for a patient for a Liver transplant : 1. Cadaveric Transplant 2. Donor Transplant
  17. 17. Cadaveric Transplantation In this type of transplant the donor of the liver may be a victim who has suffered serious injuries in an accident which has caused his/her brain to stop working but his/her heart beats. In this situation the donor is declared legally dead because of the dysfunctioning brain. The person is put on to a life support system in the Intensive-care Unit (ICU). The reasons for the death of the person are kept confidential and are only known to the doctors. The liver of the patient is used for transplanting it in to the person in need of it.
  18. 18. Living Donor Transplant patient who are at the last stage of the disease require a live donor liver transplant. A segment of the donor's liver is removed and is planted in to the body of the recipient. Mostly family members who are blood related donate their liver to the patient. The liver grows back to the normal size with in weeks after the operation. It is important for the patient and the donor to be stable in their health which may cause serious concerns over their lives as the operation involves a lot of blood loss chances and other complication which can be controlled only if a person's health is at the required level.
  19. 19. What Tests are needed Before a Liver Transplant?
  20. 20. - Your medical history would be examined by the specialists and various tests would be performed to ensure the safety during the operation. - Doppler Ultrasound test is carried out to find out if the blood vessels coming from and going to the liver are working properly. - Pulmonary Function Study is done to determine whether the lungs are able to exchange carbon dioxide and oxygen or not. - Computer Tomography test uses the X-rays and computer generated images of the liver which would help the doctors determine the condition of the liver so that they can carry out further procedures. - Echo-cardiogram test is also done to get a detailed evaluation of the condition of the Heart. - Apart from all these specific tests which require specialized machinery, the doctors carry out blood tests to determine various symptoms and ability of blood like clotting ability, blood type, AIDS and Hepatitis detection and biochemical status of the blood is done.
  21. 21. What Is Done After The Doctors Find A Matching Donor? When the doctors find a matching liver for you, the transplant coordinator would contact you. After you have been informed about the matching liver you should not eat or drink anything until you reach the hospital for the transplant. You would be informed about any further instructions. An Electrocardiogram test and a chest X-ray would be performed before your transplant operation begins. The surgical resident and the anesthesiologist would meet you in the operation theater. If the test done approve the transplant to be carried out then you would be operated otherwise you would be sent back and would not be called again until a matching liver is found.
  22. 22. What Are The Procedures During The Time Of The Surgery? During the time of surgery your diseased liver is removed from your body by the surgeons who disconnect the bile ducts and blood vessels from it and replace it with the new liver. The blood which was present in the liver which was taken out would be sent in to the body with the help of a machine. After the liver is connected to the bile ducts and the blood vessels the blood in the body would automatically start flowing through your liver. This operation would last for around 6 to 12 hours during which you would be made unconscious by injecting a dose of anesthesia in your body.
  23. 23. What Are The Procedures After The Surgery? After you undergo the surgery you will have to stay at the hospital for one to three weeks until you become strong enough to be discharged and to make sure that your liver is functioning properly. You would have to consume medication for the prevention of any kind of infections in the liver. The doctor would perform regular checkups during your stay at the hospital. During the time your Liver Transplant Surgeon will tell you about the procedures and routines which you have to follow so that you keep yourself healthy and away from any kind of infections. After few days or a week you will be provided liquid meals for sometime and eventually would be switched on to solid food. The patients have to take the immunosuppresive medications for their entire life to prevent any kind of immune rejection in the liver which can have harmful effects on rest of the body.
  24. 24. What Complications Can Occur In A Liver Transplant Surgery? There are basically two common type of complications which occur after a surgery, i.e. Infection and Rejection.
  25. 25. Infections A patient is more prone to get infected rather than suffering from rejection. This is because of the anti-rejection medicines which are prescribed to you. These medications increase the risk of getting liver infections. Thought this problem does not persists for a longer period of time but is very much likely to occur if proper care is not done.
  26. 26. Rejections Our immune system works to prevent any alien substances or elements from entering our body or fights the harmful substances which can cause harm to our health. Sometimes it is not possible for our immune system to distinguish between our newly transplanted liver and the unwanted invading elements. This makes the immune system to attack the liver and destroy it by ceasing its functions. This is known as rejection. Some or the other kind of rejection occurs among 70% of the patients which is treated with the help of anti-rejection medicines in most of the cases.
  27. 27. What Side Effects Can A Patient Suffer After The Liver Transplant? The rejection Preventing drugs are the main reason for any kind of side effects among the patients who have got a liver transplanted in them. Most Of The Side Effects Include: - Nausea - Diarrhea - Fluid Retention - Incresed Blood Pressure - Headaches To Check whether your new liver is functioning properly or not they conduct blood test for testing various conditions in the blood quality. Your are recommended to eat a healthy diet containing fresh vegetables and less fats and oils.
  28. 28. Important Info It should be noted that liver transplant can be some times dangerous for a person's health if they have other diseases outside the liver or have active alcoholic and smoking habits. Any kind of septic infections may also result in the prevention of a liver transplant in a person. Therefore, most of the transplants are performed on people who have Chronic Liver Cancer Disease.
  29. 29. Dr. Arvinder Singh Soin is one of the Pioneers of Liver Transplantation in India and the world. He has conducted more than 1500 Liver transplants and over 12000 Bil Duct, Gall Bladder and other complex liver surgeries all over the world.
  30. 30. Contact Us : Liver Transplant India Dr. A.S. Soin Hepatobiliary and Liver Transplant Surgeon, Chief Hepatobiliary and Liver Transplant Surgeon Chairman, Medanta Institute of Liver Transplantation and Regenerative Medicine. Sector 38, Gurgaon, Haryana – 122001, India Tel Numbers: Medanta-The Medicity (Gurgaon, Delhi NCR) (+91) - 124-4855-222, 0124-4855-444 Fax: +91 -124 4834111 Website :