Liver Transplant Surgery
A liver transplant surgery is a procedure where a diseased liver is replaced with a healthy liver from another individual. In many cases, the healthy liver comes from an organ donor who has recently passed on. In some cases, a healthy, living individual may also opt to donate a part of their liver.
This is possible because the liver is the only organ in the human body that is designed to regenerate and increase its size. When a part of a liver is transplanted to another body, it has the capacity to rebuild itself into its normal size within a few weeks.
The choice of whether a patient requires an entire liver or can get a part of a liver transplanted into their body depends on the indications of the transplant and the judgement of our experts at India Health Help.
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Liver transplantation procedures are typically recommended when the patient is critically ill due to failure of the liver. The most common indications include the Hepatitis C virus and Idiopathic/autoimmune liver disease. In addition to this, other indications that may result in the recommendation of a transplant are –
- Primary Biliary Cirrhosis
- Primary Sclerosis Cholangitis
- Acute Liver Failure
- Hepatitis B
- Metabolic Liver Disease such as inborn errors of metabolism.
Other causes include –
- Loss of healthy liver cells that are replaced by scar tissue
- Abnormal bile ducts or the absence of them
- Hemochromatosis, a hereditary condition that causes damage of the liver due to iron and salt deposits in its tissues
- Portal Hypertensive Gastropathy that leads to liver cirrhosis.
That said, there are a few scenarios under which a liver transplant may not be recommended by our experts at India Health Help. These include –
- Infections that cannot be controlled
- Active or advanced cancer that is outside the liver
- In case of brain death
- If the patient has known heart diseases
- If the patient is too old
- Portal vein
- HIV infections/ AIDS
- The existence of a Psychiatric illness
To assess whether you or a loved one is a suitable candidate for a liver transplant, contact our experts at India Health Help today!
As soon as a patient is given the go-ahead for a liver transplant, a surgeon typically requests for a list of tests. This includes –
- Blood and urine tests
- Ultrasound of the liver
- A cancer screening
- Tests that help assess the condition of the heart
Once these tests are conducted, the surgeon provides the patient with a letter that enables him/her to be placed on a waiting list to get a liver from a matching deceased donor. You may also be able to discuss the option of getting a part of the liver from a blood-relative. Finding a compatible donor is among the most challenging and important steps in the liver transplant process.
What Happens once the Liver is Available for transplant?
As soon as a donor is made available to the patient, the surgeon sits down with him/her along with the family to explain the entire process. The patient and/or a trusted family member must give consent by signing the necessary paper-work that offers all the information regarding the procedure along with the risks involved. Signing the paperwork essentially means that the patient has given written permission for the surgery.
A few hours before the surgery, the patient will be expected to be on a “Nil-by-Mouth” diet where he/she will only be given fluids via an IV drip.
What does the team that will perform the transplant include?
A typical liver transplant procedure involves two or more surgeons along with a hepatologist, an anaesthesiologist and a group of paramedical support staff that includes transplant nurses.
How long does the procedure last?
A quintessential liver transplant procedure is rather complex and lasts anywhere between 6 and 12 hours. The procedure will be performed under general anaesthesia.
What can I expect during the procedure?
The surgeons and all the other experts involved do their best to make sure that the patient is comfortable and calm. The patient will be asked to wear the surgical gown after which the necessary IV lines and monitoring devices will be placed. Anaesthesia is given through an intravenous catheter. Along with this a tube is inserted into the lungs and connected to the ventilator. This helps the patient in the respiration process.
Upon making the necessary checks and making sure that the anaesthesia has taken full effect, the incision is made across the abdomen for accessing the liver. At this point, the blood supply to the liver is disconnected and the procedure to remove the bile ducts begins.
Next, the damaged liver is replaced with a new liver after which the blood vessels and the bile ducts are reattached. In case the transplant involves a living donor, the first portion of the liver is taken out from the donor and then transplanted in place of the damaged one.
Upon completion of the procedure, the incision is sutured and the patient is shifted into recovery and ICU for observation.
Post procedure, the patient is transferred to the ICU where his/her vitals such as blood pressure levels, pulse, respiratory rate, oxygen saturation and temperature is kept a watch on. It is common for patients that have undergone the transplant to undergo the following –
- Swelling of the body
- Pain in the abdomen
- Bleeding from the site of incision
The patient may have to undergo a few more blood tests to make sure that the post-surgery recovery is on track. A few hours after surgery, the tube in the lungs is removed. The tubes in the throat and the urinary bladder is removed after a few days.
Once the surgeon and the other medical experts involved are confident about the patient’s condition, he or she will be allowed to start clear fluids. A soft and a normal diet follow after a few days. For quicker recovery, it is recommended that the patient walks around and moves as much as possible.
Typically, a patient is discharged and allowed to go home after 10 to 15 days post-surgery. That said, it is important to discuss with the surgeon on when you will be permitted to take a flight to travel back to your home country post-surgery.
As a liver transplant patient, you will be asked to take immuno-suppressants and blood-thinning medications for the rest of your life.
RISK AND COMPLICATIONS
It is important to understand that a liver transplant procedure isn’t a simple one and comes with its fair share of risks and complications. As a patient who is investing so much time and money towards this procedure, keeping realistic expectations from the end-results is a must.
Here are a few risks and complications that some liver transplant patients face –
- Rejection of the new liver by your body
- The new liver may not function perfectly for a while right after the transplant
- Bleeding and/or infections
- Blockage or leakage of the bile ducts
- Blockage of the blood vessels
Furthermore, the immune-suppressants and the blood thinning medications may also result in some of the following side effects –
- High blood pressure or rise in cholesterol levels
- In extremely rare cases, cancer
The approx. cost of liver transplant in India would be $34,000 - $ 46,000 and approx. duration will be 21 days in Hospital. Make sure you discuss with the team at India Health Help all the options you have before you undergo the procedure.
You may also have to consider your living and travel expenses as well as miscellaneous medical expenses such as diagnostics, doctor fees. etc, for a liver transplant in India.