When the liver no longer functions properly (liver failure), either due to infection or complications from certain drugs and illnesses, a liver transplant is considered. Prior to any procedure, a possible transplant patient must be assessed. A liver can be received from a living or deceased donor.
In this article, Dr. Gaurav Gupta who is known for many successful liver transplant in Mumbai will discuss everything you should know about the liver transplant surgery process & possible complications after the surgery.
Where does a transplanted liver come from?
Living donor and cadaveric liver transplants are the two types of liver transplants available.
Some patients with end-stage liver disease may be candidates for a living donor liver transplant. A piece of liver is taken from a healthy living donor and placed into a recipient in this surgery. In a few weeks, both the donor and recipient liver segments will be of sufficient size.
The donor, who could be a blood family, spouse, friend, or even a wholly anonymous altruistic individual, will undergo comprehensive medical and psychological testing to ensure that there is minimal risk. Most of the liver transplant hospitals in India consider blood type and body size when it comes to deciding if someone is a suitable donor.
Living donor transplant recipients must be currently on the transplant waiting list. They must also be in good enough health to undergo transplantation with a high possibility of success.
The donor in cadaveric liver transplantation may have had a cerebral vascular accident or other type of head injury, such as spontaneous bleeding into the brain. There are two categories of cadaveric donors, both of whom have experienced permanent brain injury:
- The brain injury in a donation after cardiac death is severe, but the patient does not meet the brain dead threshold. The family has decided to stop paying child support, and it will be done in a controlled environment. When the donor’s heart stops beating, he or she is deemed dead, and organs can be removed.
- Although there is no longer any cerebral activity in brain dead donors, the heart continues to beat.
The name of a cadaveric donor and the circumstances of his or her death are kept private. It’s seen as a “gift” given anonymously.
All possible donors will be screened for liver illness, alcohol or drug misuse, malignancy, or infection by hospitals. Donors will also be subjected to serology and infection testing. If the liver screening reveals no issues, donors and recipients are matched based on blood type and body size. Age, race, and gender are not taken into account.
Your transplantation alternatives will be discussed with you during your pre-transplant evaluation, or you can contact the transplant team for further information.
What happens during the procedure for a liver transplant?
Transplanting the liver normally takes six to twelve hours. During the procedure, your liver will be removed and replaced with a donor liver.
Surgeons will need to insert multiple tubes in your body because a transplant is a significant procedure. During the operation and for a few days later, these tubes will assist your body in performing specific duties.
A tube will be inserted into your trachea (windpipe) through your mouth to assist you in breathing throughout the procedure and for the first day or two afterward. The tube is connected to a ventilator, which mechanically expands your lungs.
To drain secretions from your stomach, a nasogastric tube will be put through your nose into your stomach. It will stay in place for a few days until your bowel function improves.
A catheter will be inserted into your bladder to drain urine. This will be taken out a few days following the surgery.
Blood and fluid will be drained from around the liver using tubes inserted into your abdomen. For roughly a week, these will be in place.
What are the risks associated with liver transplantation?
Rejection and infection are two of the most prevalent problems following a liver transplant:
Rejection: When foreign chemicals penetrate your body, your immune system strives to destroy them. The immune system, on the other hand, can’t tell the difference between your new liver and undesirable intruders like viruses and bacteria, so it attacks and destroys it. This is referred to as a “rejection episode.” In the first year after a liver transplant, about 30% of patients have some form of organ rejection. Patients take anti-rejection drugs to protect themselves from the immune system’s attack.
Infections: Anti-rejection medicines decrease the immune system, therefore liver transplant recipients are more susceptible to infections. With time, this issue becomes less of an issue. Infections do not affect all people, and most infections may be treated successfully on the spot.
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