Liver transplant involves surgical removal of your diseased liver and implanting a new liver. The liver can come from a cadaver (cadaveric liver transplant) or a living person can donate part of his liver (Living donor liver Transplant).
Cadaver Liver Transplant
Organs for liver transplant are obtained from deceased donors, after they or their families have given consent to be an organ donor. A liver transplant is a big step to take, but it can save your life. You will be able to take better care of your new transplant if you understand your illness and your treatment. You will need to reach certain goals in your recovery. It is very important that you understand what you must do to make your transplant work. You must take your medicines as told, keep your appointments, and stay in close touch with your doctors.
The liver does several things:
- It helps digest your food.
- It clears wastes from your blood.
- It makes proteins that help your blood to clot.
- It stores the sugars (glycogen) that are used for energy.
- It makes proteins that the body must have.
- It helps use and store vitamins.
- It makes chemicals that protect the body.
- It breaks down many toxins.
This happens when the liver cannot do what it is supposed to do.2. Portal hypertension
This happens when scarring in the liver stops blood from flowing through it. This causes pressure to build up in the vein that feeds the liver (portal vein). The liver can take a lot of damage, but when most of it is damaged, it will start to fail. Once a person has signs of liver failure, it means there is not much of the liver left for the body to use during sickness and times of need. Signs of liver failure may include:
- Yellow skin and eyes (jaundice)
- Forgetfulness, confusion, or coma (encephalopathy)
- Feeling very tired
- Muscle loss (muscle wasting)
- Blood does not clot
Your General practitioner or a gastroenterologist will refer you for liver transplantation when and if your liver disease begins to get worse, and you show signs of liver failure or portal hypertension. This is a specialized operation, so you will need to go to a hospital where liver transplant is done.
We call this evaluation the pretransplant evaluation. It is how we
decide if a liver transplant is right for you. During this time, you and your
family will learn what you need to know about having a liver transplant.
You will have many tests done. This process can take a few days or a few
weeks. It depends on how many tests you need to have.
Some things that will happen during this evaluation:
- You will meet with the liver specialist, the transplant surgeon, and other doctors.
- The transplant coordinator will schedule you for lab tests (blood work) and x-rays. Most patients do not need a liver biopsy.
- You will receive the usual vaccines.
- Other tests to expect:
You will have regular x-rays taken, such as a chest x-ray. You will also have more specialized imaging tests, like a CT or MRI scan. These tests will give your doctors a detailed view of your liver, its blood supply, and other organs. The tests are also used to look for tumors in the liver. All these images will show the surgeon what he needs to know in order to do your operation.Endoscopy and colonoscopy
You may have an endoscopy test done. During this test, the doctor will run a flexible tube with a tiny television camera on the end of it down your throat and into your stomach. With a colonoscopy, the doctor will run a tube through your rectum and into your large intestine. Both of these tests look for enlarged veins called varices. They are a sign of liver disease or problems with the lower intestine. If you have large varices, the doctor may tie them off with rubber bands. This prevents them from bleeding. You will be given medicine to make you sleepy during your colonoscopy and endoscopy. Heart and stress tests
Since a liver transplant is major surgery, it is important to know that your heart and lungs are healthy. We will do a detailed evaluation of your heart. They may do an electrocardiogram (ECG), echocardiogram, and a stress test. If you have been a smoker, your may undergo lung function tests and a blood gas test. If you smoke, you need to quit before you have the transplant. Your emotional health will also be evaluated.
Your emotional health is as important to your transplant team as your physical health. For this reason, you will also be seen by a team of health professionals like a social worker, psychologist, addiction specialist. We will schedule a family meeting so everyone can meet the transplant team. At this meeting, will explain what a liver transplant involves and answer any questions. This team can also help you with financial concerns, connect you to hospital services, and give you information on support groups.
Finally, your nutritional needs will be evaluated.
A dietician will talk to you about your nutritional needs and design an eating plan for you to follow. They will also support you in eating well to you help your body heal after your transplant.
If you are for cadaver transplant then you will be listed on a waiting list. You will be informed when your turn comes and there is a suitable liver for you.
Be sure to notify your transplant center of any change in your medical condition. When a liver is found for you, the transplant team must be able to contact you quickly. Your coordinators will need a current list of names and phone numbers of people who will know where to reach you.