A liver Transplant is basically a surgical procedure, also called Hepatic Surgery which can replaces someone’s diseased liver part or all of the liver with a healthy liver from another person. Liver Transplant is prescribed when someone’s liver is not able to continuous work with leading Liver Failure. Liver Transplant is a life saving surgery that can improve someone’s health and life with the help of another one’s healthy Liver.
During the liver transplant surgery doctors removes a part or all of the liver from patient, another side doctors removes a healthy liver from the living-donor, then it can replaced in the body of the Patient.
Procedure Type: Surgical Procedures
Function: To remove diseased liver from the body and implants a healthy liver from a living-donor
Pain Intensity level: Less Invasive
Liver Transplant Cost in India
Starting from INR 12,00,000
Procedures Duration: 1-2 Hours
Hospitals Stay: 5-10 days
Types of Anesthesia: General
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The first and primary assessment is to determine whether you actually need a transplant. If you have been recommended for a liver transplant by your doctor, you are free to select a transplant center of your own choice or may visit the one referred by your doctor. While choosing a transplant center consider the following criteria:-
Look up to the number and types of transplant that has been performed by the center.
Compare the cost statistics with several other centers that will be incurred during, before, after the transplant and whether the center is upgraded with modern and updated equipment for choosing the best available at an affordable range.
Do not forget to check up on the additional services available such as local stay housing, traveling facilities, medicine availabilities, and so on.
The very next step that would be recommended by your doctor is to undergo a few specific tests and procedures such as
Laboratory tests including blood, urine, stool in order to assess the health of your organs along with the liver.
Cardiology tests to examine your heart condition.
Ultrasound of your liver better known as imaging tests.
A general whole body checkup to determine whether any other illness can have an adverse impact on the transplant.
Nutritional recommendations to guide you with a healthy diet chart before and after the transplant along with a friendly family surrounding to take care of you and help you recover after the transplant.
Psychological and addiction exhort to help you get rid of any depression or anxiety as well as tobacco or alcohol consumption.
Last but not the least, a financial check in order to make sure that you are eligible enough to meet up the cost criteria offered.
The Waiting List Process
After the tests and procedures, doctors use them to analyze the extremity of your ailment and accordingly decide whether you require an immediate transplant and your position on the liver transplant waiting list which is determined by two scoring systems MELD( MODEL FOR END-STAGE LIVER DISEASE) FOR ADULTS AND PELD (PEDIATRIC END-STAGE LIVER DISEASE) FOR CHILDREN WITHIN AGE 12. A high MELD score specifies that you need an immediate transplant. The MELD scores are actually important as it sums up the risk of death within 90 days of your transplant.
Donors
Living donors are usually from a bloodline or a friend because finding one is pretty difficult. Living donor liver transplants are usually common or seen in cases that involve children and their success rates have enabled adults to undergo this new technique as well especially those who are suffering from end-stage liver illness. A living liver donor can donate a section of the liver and can still maintain a healthy form of life as both the person- the donor and the recipient have a full-grown sized liver after the transplant whereas a person who is dead, i.e. a deceased donor’s liver can be ruptured and used by two people as a healthy liver has two lobes – one is about 60 percent and the other 40. Above all, the safety of the donor, as well as the recipient, is the major concern as both the individual should be of adaptable blood group type, age, as well as organ size, is also a point of critical consideration and the donor is willing to donate without hesitation or selfish motive. If after all these courses of action results out to be positive then a surgery date is stated and arranged. The risk factor for the donor is equally fetched as a transplant patient.
It is often noticed suitable deceased donor organs are scarce for children.
The very first step post-surgery is that you will be shifted to the intensive care unit (ICU) until you regain consciousness and able to breathe on your own. While throughout the ICU stay you are kept under constant observation as the blood level, internal fluids and electrolytes can be notably deviating. You will also be injected with immunosuppressive agents or drugs that make your body less likely to reject a transplanted organ as it reduces the power of the immune system and the amount of the drugs will be adjusted accordingly.
After you regain consciousness you will be transferred to the inpatient unit where you will be kept under regular observation and the tubes placed in your body will remain intact for the upcoming days. At the time of discharge, your family member will be handed a list of instructions of do’s and don’ts, prescribed medications that are to be taken, followed-up with an overall checkup appointment. It usually takes a period of six months to fully recover but you can get back to your normal activities or work within a few months depending upon your complicacy.
As long as the diet and nutrition after the transplant is concerned it is very important to maintain a balanced diet to keep your liver vigorous and recover speedily. Usually, your diet should comprise of food low in sugar, fat, cholesterol, salt, and items that will be easily digestible. Alcohol consumption should be strictly stopped. It is always recommendable to visit a dietitian for an elaborated diet chart. For reference a short diet instruction is provided below:
Having plenty of fruits and vegetables and fiber-rich food.
Avoiding fried and richly cooked items, red meat instead tries having poultry and fish.
Staying hydrated by drinking enough water.
Avoiding grapefruit items can have adverse effects on the immunosuppressive agents and quitting alcohol.
Consuming low-fat dairy products in order to balance the calcium percent in your body.
Exercising
Mild physical activity is always recommendable even after the surgery (within a few months) as it would help you to have a physically and mentally fit body. Then depending on your betterment, you can start including more activities after consulting with your doctor.
Possible risks and complications of the procedure:
The transplant surgery procedure and the medicines or drugs given incorporate considerable risks as it all prevents rejection of the donor’s liver after the transplant.Risks linked to the transplant process include:
Biliary tract issues i.e., bile duct leakage and shrinking of bile ducts.
Hemorrhage
Coagulum
Infection
Rejection and failure of the donated liver.
Nausea
Though these are the short-term complications the long-term ones involve reoccurrence of liver ailments.
Anti-rejection antidote aftereffect
After the surgery, you will have to be under medications for the rest of your life as it would prevent your body from rejecting the donated liver. Your doctor might prescribe you some medicines linked to infections as the anti-rejection antidotes subdue the immune system that surges the probability of infection. Possible side effects include: –
Bone resorption
Arthritis
Vomiting
Anemia
High blood pressure
High cholesterol
Diabetes
Diarrhea
Transplant surgery is a complex procedure that indulges feeling tense and anxious but it can be solved by gaining moral support from your family and friends. Seeking help from your close ones can help you cope up with the situation. Considering a surgeon who is best at his job and a hospital that would provide quality services, care, and a positive environment would help in your recovery and betterment.
The conclusion of any surgical treatment depends on the aftercare and precautions adopted for the patient to recover. The postoperative care is to be strictly followed as advised by the doctor because the treatment remains incomplete if the period of recovery is omitted especially for a transplant surgery that entails complex surgical interventions.
Precautions at the hospital
Once the surgery is over the effect of anesthesia will dwindle within in a few a hour and that is when you start experiencing pain for which you will be provided with medications and pain killers. You will be kept under observation by the hospital stuffs and as far as your diet is concerned, you will be kept under liquid diet. During discharge you will handed with a list of recommendations, food-habits, do’s and don’ts, the nest appointment date by your doctor. It is also made sure that there is someone to take you back home.
Recovery at home
First concern for the patient while at home should be the hygiene. Cleansing with water and dressing up the operated area is very important while keeping in mind that the patient should be kept in a well-ventilated aery room and it should be cleaned regularly. The medicines provided should be strictly according to the prescription that is to be consumed on time without delay. Visiting the doctor for overall checkup at regular intervals without fail is also a priority.
Do not expose yourself to elements that can cause or increase the risk of infection. Your diet and nutrition should be well balanced and nutritious that would help you to recover speedily and is discussed within the article in details. You can get back to your daily activities once you recover completely. You may exercise in order to keep your mind fresh by consulting your doctor as he advises. Avoid lifting heavy elements, weight training, swimming. Meditate as it would not only boost your mood but also keep your mind fresh.
The surgery procedure includes removal of the unhealthy liver and nidation of the new organ. As the organs are interconnected, therefore, it is important to re-establish the connections so as to enable the new liver to function properly and healthily. The technique of connecting the veins and structures varies from person to person as it depends on the recipient’s disease or structural issues but the basic blood flow and the bile drainage from the liver remains the same. The surgery procedure is quite crucial and involves placing several tubes in your body. A windpipe will be attached to your mouth which would help you to breathe during the process and for the initial days as the ventilator attached to it would help to expand your lungs, a nasogastric tube will be pushed through your nose that will pass down your stomach to drain out the fluid secretion until your bowel functions return to normal. Moreover, a catheter tube will be inserted into your bladder to drain out urine along with a tube that will be placed around your liver for the blood and fluids to drain out. The tubes inserted might remain for a period after your surgery.
Deceased Liver Donor
A liver transplant is usually done by general anesthesia so you will be tranquilized during the process. A long incision (the cut size and location depends on your doctor’s proposition) is made across your abdomen in order to ingress your liver. Then, the diseased liver is replaced by the donor’s liver. The doctor further establishes connections within the veins, blood vessels, and biliary tract. Further proceeding to the end, the incision is secured by staples and stitches and you will be carried to the intensive care unit for better recovery.
Living Liver Donor
Usually, in the case of a living liver donor transplant, the date of surgery is planned in advance. There is no such difference in the living liver donor procedure to that of the deceased liver donor transplant procedure. In this process, the donor himself is operated on first in order to remove a part of the liver for transplant. Then the surgeon removes the diseased liver from the patient’s body replacing it with the donated portion along with re-establishing the internal connections of veins, blood vessels, the biliary tract.
It usually takes several weeks for the liver to grow and regenerate that is left in the donor’s body as well in the patient’s body. The surgery process consumes about 6-12 hours to complete.
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Top 10 Best Hospitals in India for Liver Surgery Treatment
Surgery is the most critical part of medicine that not only requires superlative accuracy but also adequate homely post operative care and therefore, choosing the best out of all has no other alternative. Here being the following top 10 hospitals pioneering surgery recommendations provided to the patients to recover illness and lead a healthy lifestyle.
Top 10 Best Liver Surgery Treatment Hospitals In Kolkata
Choosing the best hospitals would not only provide quality services but also the positive, clean and polished environment would help in the betterment of the patient’s health.
Top 10 Best Surgeons in India for Liver Surgery Treatment
Well , undergoing a cholecystectomy you should always rely and opt for a highly qualified surgeon. Above all, when it concerns the welfare of the patients the following top 10 verified gallbladder stone laparoscopic surgeons ensure a speedy and comfortable recovery along with the best medically prescribed recommendations.
Dr. Vivek Vij
Director – Liver Transplant, Hepatobiliary Surgeon Fortis Hospital, Noida | Fortis Memorial Research Institute, Gurugram
The liver is the solid and largest organ in our body (Filmann et al. 2019). Liver surgery refers to the surgical procedure of removing different parts of the liver. It is also called ‘Hepatectomy’. In this whole process, a complete liver is transplanted in a place of diseased liver. Liver surgery is a very serious and major operation that can be only done by experienced and skilled surgeons (Saito et al. 2020).
The function of a Liver:
The work of the liver is to regulate blood chemicals and emit a product known as ‘Bile’. Bile generally takes away waste products from the liver. The liver processes blood and helps to break down, generate and balance nutrient levels in our body. It also helps to metabolize medicine faster. There are other vital functions of the liver which are given below (Molnar et al. 2019)-
To convert glycogen from excess glucose for future energy storage.
To regulate amino acids in blood level which helps to build protein blocks in our body.
To produce particular proteins for plasma.
To produce cholesterol and carry out fats.
To convert toxic ammonia into urea.
To remove bacteria from the bloodstream.
To clear ‘Bilirubin’ and generate red blood cells.
To process hemoglobin to store iron in our bodies.
To clear toxic drugs and other lethal substances from the blood.
To regulate blood clotting.
Liver’s Importance in Our Body:
Our liver helps to process blood and break down all the important chemicals and nutrients in our blood cells. The liver changes all those nutrients into a specific form that our body can easily use. In addition, it also regulates our blood chemical levels. That is why the liver is a very important part of our body.
Liver Disease Symptoms:
Symptoms of liver disease may vary from person to person depending on the cardinal cause. However, there are some common symptoms like yellow eyes and skin, pale or black and bloody stool, dark urine, swollen legs or abdomen, nausea, no appetite, vomiting, itchy skin, persistent fatigue and so more (Northup et al. 2021). Apart from these symptoms, there are some specific liver diseases with some specific symptoms which are mentioned below-
Viral Hepatitis:
This specific disease is caused due to inflammation of the liver because of the virus. This is a contagious disease (Dirks et al. 2019).
Symptoms:
Aching joints and muscles
Abdominal pain
Nausea
Losing appetite
Fatigue
Decreased energy
Pale stool
Jaundice
Treatment:
Proper vaccination can help to mitigate the risk of Viral Hepatitis.
Fatty Liver:
Fatty liver happens when our liver contains an excess amount of fat. This causes swollen and inflamed liver which can lead to cirrhosis. Cirrhosis can permanently damage our liver. There are two kinds of fatty liver diseases which are 1) Alcoholic fatty liver, and 2) Non-alcoholic fatty liver (Chalasani et al. 2018). Generally, Alcoholic fatty liver disease does not show any symptom on early stage but with time both types can show the following symptoms-
Symptoms for Alcoholic fatty liver:
Jaundice
Fever
Nausea
Vomiting
Symptoms for Alcoholic fatty liver:
Normal weakness
Fatigue
Abnormal weight loss
Losing appetite
Itchy skin
Swollen abdomen and legs
Liver Failure:
This can be acute or chronic. It happens in the final stage of any liver disease when the liver is too damaged for functioning. It is a slow process in maximum cases.
Symptoms of chronic liver failure:
Fatigue
Appetite loss
Nausea
Diarrhea
The last stage of Liver Failure may show the following symptoms:
Confusion
Fatigue
Coma
Symptoms of Acute Liver Failure:
Acetaminophen overdoses can be the reason for acute liver failure. If you have any of the following signs seek medical help immediately.
Pain in abdomen
Vomiting
Confusing
Nausea
Jaundice
Always feeling sleepy
Always unwell
Liver Cancer:
It refers to any cancer that begins from the liver. The two most common type of liver cancer is HCC (Hepatocellular Cancer), and Hepatocellular Carcinoma (Nahar and Ara, 2018). Liver cancer develops slowly in your body and does not show any specific symptoms. However, it has some basic symptoms like-
Symptoms:
Vomiting
Jaundice
Itchy skin
Abdominal pain
Losing weight
Easy brushing
Nausea
These symptoms can easily overlap with other less serious conditions. So, try to take early action if you have any of these symptoms.
Genetic condition:
Common genetic conditions that can cause liver diseases in the future are Hereditary Hemochromatosis, Alpha-1 antitrypsin deficiency, and Wilson’s disease (Northup et al. 2021). In this kind of liver disease, symptoms may vary but it can include:
Symptoms:
Joint pain
Abdominal pain
Decreased appetite
Low energy
Fatigue
Jaundice
Autoimmune Symptoms:
In this condition, your weak immune system can attack your liver badly. This condition may include PBC (Primary Biliary Cholangitis), PSC (Primary Sclerosing Cholangitis), and Autoimmune Hepatitis (Peng et al. 2019).
Symptoms of PBC and PSC:
Jaundice
Pain in the right abdomen
Enlarged liver
Spleen
Abdomen or leg swelling
Losing weight
Fever
Night sweats
Chills
Symptoms of Autoimmune Hepatitis:
Sudden flu
Decreased Energy
Fatigue
Yellow eye and skin
Joint pain
Dark urine and pale stool
Itchy skin
Testing of Liver Related Problems:
Identifying the general cause of liver damage is highly important in case of offering a proper and guiding treatment. At first, the doctor may start with your past medical history and go through some physical tests. After all of these, the doctor may recommend:
Blood Test: The doctor may prescribe some blood tests to ensure liver function and diagnose the disease. This can also help in identifying genetic conditions.
Imaging Tests: CT scan, Ultrasound, and MRI can give an idea about liver damage.
Examining Tissue Samples: Biopsy or removing tissue from the liver can help in identifying any kind of liver disease. This can also help in diagnosing any liver damage. It is done with a long needle inserted through your skin and removes liver tissue for sample testing.
Surgery Types Related to Liver:
There are mainly two types of surgery related to liver cirrhosis or liver tumor. Both are mentioned below:
Lobectomy and Liver resection:
The procedure of removing surrounding tissues and cancer from your liver is called a Liver Resection. This is only consulted by your surgeon when:
Your liver is healthy and in the early stage of cancer
Cancer has not spread into your blood vessels
A Liver Transplant:
A liver transplant is only possible in the case of some patients with HCC (Hepatocellular Liver Cancer). You can have a liver transplant when:
There are less than 3 tumors in your liver
Each tumor has to be 3cm or less
Your tumor is not grown in the last three months
Liver transplantation is an abscission/surgical method that restores a malfunctioned or injured liver with a healthy liver from an expired benefactor(donor) or a part of the healthy liver from a living donor. The liver being the most essential and crucial organ of our body as it is responsible for:-
Decontaminating of matter carried from the intestines, and the concoction of many proteins.
The main function carried out by the liver is the metabolic process: to mechanize nutrients, medicines, hormones, produces bile in order to absorb fats, cholesterol, fat-soluble vitamins, and break fats in the small intestine during digestion.
Production of certain proteins for blood plasma and even removes many unwanted chemicals from the body.
Liver diseases are a common matter, but chronic and acute liver illness can lead to liver cirrhosis(a situation where the liver does not function properly and worsens due to chronic injury). There are diversified reasons why liver failure is triggered. People develop cirrhosis of the liver when scar tissues replace normal healthy liver tissues by partially blocking the blood flow eventually resulting in liver malfunction. The main reasons why liver cirrhosis occur so as to why liver transplantation takes place:
Hepatitis B, C, and D.
Too much alcohol consumption causes alcoholic liver illness.
Fatty liver(fat accumulating in the liver) is a cause of liver cirrhosis.
Cystic fibrosis.
Biliary atresia(diseases affecting the bile duct).
Genetic disorders affecting the liver which leads to excessive buildup of iron and copper.
In many cases, a person suffering from liver cancer also requires liver transplantation.
Frequently Ask Questions (FAQs):
Question: What are the types of liver transplants?
Answer: The liver is procured from a deceased donor or a living donor that is explained above in details but another type of liver transplant is:
Domino Liver Transplant: This rare process involves transplanting liver in the body of a patient suffering from end-stage liver disease, the donor being the patient suffering from metabolic disease better known as familial amyloidosis. The donor (having amyloidosis) himself receives a liver from a deceased donor. It is generally expected that the recipient does not develop symptoms of amyloidosis and even if he does it would take decades before the end of natural life expectancy. Doctors usually choose recipients of older age around 55 or more for this type of transplant.
Question: What are the survival rates of the transplant?
Studies have disclosed that survival rates depend on your situation and complicacies but it is noticed that 70%-75% of people who have undergone transplant surgery have a life expectancy of about 5 years which means out of 100 people 75 stays alive for 5 years and the remaining die within 5 years.
Question: Is it possible to live longer for more than 5 years after a liver transplant?
Answer: As estimated by many people about 72% of the candidates are alive even after 5 years of the transplant surgery so there remains a considerable point as to what reasons are responsible that predict the survival chances of a patient. Well, a variety of complicated factors and the patient’s health complications are linked to the surgery because it is almost impossible to forecast an individual’s chances of having a successful transplant surgery and life afterward.
Question: Is transplantation the only treatment after, when everything else has failed?
Answer: The main reason for transplantation is that to remove a malfunctioned liver and replacing it with a healthy liver. In some cases, transplantation is the only treatment to cure a diseased liver as no other machine or medication can reliably perform or function as a liver does.
Question: How to prevent chronic liver disease?
Answer: Following the below guidelines can help you to prevent liver disease to some extent:
Avoid alcohol and never mix medicines with alcohol
Vaccinate yourself to fight against hepatitis A and B
Never consume multiple enzymes or digestive medicines and once you start having digestion issues do visit a doctor
Try avoiding intravenous drugs unless you need them for other complicated ailments in your body and never share your needles or syringes
If you are working with some hazardous substance or in some hazardous environment never fail to wash your hands or change your clothes as the intake of those chemicals mistakenly can harm you internally
Try using your personal care products very carefully and from a recognized brand because if somehow it is consumed the chemicals can be seriously harmful. Never share your personal care cosmetic products.
Question: What are the complications of advanced liver disease?
Answer: The complications are listed below:
Jaundice
Stomach infection
Pleurorrhea
Bleeding in the gastrointestinal tract
Hepatic Encephalopathy (HE)
Swelling of your hands and legs due to an imbalance of fluids in your cells
Hepatocellular Carcinoma (HCC)
Hepatorenal Syndrome(HRS)
Itching due to irritation of sensory nerve ending
Spontaneous Bacterial Peritonitis (SBP)
Hydroperitoneum
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