How do liver transplantations work? Here’s what you need to know

Liver transplantation is a serious procedure, resorted to only when no other means of treatment would help the patient. The liver is a fantastic organ that metabolizes drugs, and toxins, clears ammonia and bilirubin and synthesizes many vital proteins and enzymes, and one cannot live without the organ. No artificial device is fully capable of performing the liver’s functions. Hence, when an individual’s liver suffers extensive damage and becomes diseased, transplanting the liver from another human being is the only means for the individual to survive.

Here’s what you need to know:

The severity of liver damage influences donor urgency

Remarkably, the liver can repair itself when met with scarring in its tissue. But repeated injury and repair can lead to permanent loss of liver functions and result in chronic liver failure. These individuals are checked and declared eligible for aliver transplant surgery.  Subsequently, they are placed on the waitlist to get a donor match.

However, patients with acute liver failure caused due to virus infection, drug overdose, toxin exposure, and ingestion are given priority. This is because liver insufficiency in such individuals can lead to toxin accumulation and eventually death if not treated immediately.

If the necessary criteria are met, and the patients get a matching donor, the surgery is performed at the earliest.

Not all are eligible for a liver transplant.

Soon after liver cirrhosis or decompensated liver disease diagnosis, the patient is first checked on specific parameters before determining if they are eligible to be put on the donor waitlist. Some individuals will not qualify if they have the following:

Shorter life expectancy due to other irreversible illnesses, cancer in other organs, pulmonary hypertension, and severe uncontrollable infection

A risk due to active substance abuse practice, historical non-compliance to medical regimens, or psychiatrically disabled

Liver donors can be living or dead.

While predominantly liver donations are from individuals who were brain dead or had a sudden cardiac arrest, living individuals can donate livers too. Friends, family, and close relatives are typically the living donors. This is possible if the recipient and donor’s blood and body type match and both are declared fit for undergoing the procedure.

When a Liver transplant donor becomes available, the liver is usually transferred from a dead person. The patient might be suddenly called for the procedure after months of waiting, as the liver should be removed and transferred within 8 to 9 hours of death. On the other hand, the process involving living liver donors is scheduled in advance and performed after a detailed analysis of the individuals.

Liver transplantation surgery is complicated.

Though the success rate of liver transplantation surgery is between 85 and 90%, it involves the complete removal of an organ, replacing it, and reinitiating the blood flow. There is a lot of bleeding, and there is a possibility of vein or bile duct blockage after the surgery.

Also, the patient’s immune system can reject the new liver within the first few weeks of the procedure. Immunosuppressants are prescribed to suppress the recipient’s immune system, and the individual has to take the medication throughout their life. Due to the compromise in immunity, they are more prone to viral infections or cancer (although the probability is less).

Several medicines are available to treat liver rejection, and it is prescribed depending on the individual’s situation and anatomy. Liver diseases can recur with the new liver. Hepatitis B is one infection that can deteriorate the liver rapidly. Other infections are more gradual and may again lead to cirrhosis after ten years of transplant.

The liver transplantation procedure is crucial for saving an individual during dire situations. The number of liver transplants done per year is increasing globally, and there have been good success rates. Following medical professionals’ recommendations and taking care of health post-transplantation is the most critical to the survival rates after the procedure.

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