Cadaveric Liver Transplant

By Author: Dr manoj Dongare
Total Articles: 18
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What is Liver Transplant?
Liver transplantation is a treatment option for end-stage liver disease and acute liver failure. Liver transplantation is the replacement of a diseased liver with a healthy liver from another person. The donor liver can be from a brain dead person where usually the whole liver is transplanted (cadaveric liver donation) or more commonly it is from a family member who donates part of his or her liver (living donor liver donation)

Who requires a Liver Transplant?
A liver transplant is a treatment option for people with liver failure whose condition can’t be controlled with other treatments and for some people with liver cancer. The Following are the disease/condition that leads to liver transplant surgery.

Liver Cirrhosis
Liver Cancer
Acute liver failure
Chronic Liver Failure
Alcoholic liver disease
NASH
Viral Hepatitis
Metabolic Disease
Biliary atresia
What are the risks of liver transplants?
The long-term outlook for a liver transplant is generally good. The biggest risks associated with liver transplants are rejection ...
... and infection. Rejection occurs when the body’s immune system attacks the new liver as an unwanted foreign substance; just as it would attack a virus.

To prevent rejection, transplant patients must take drugs to suppress the immune system. However, because the immune system is weakened, it is harder for liver transplant patients to fight other kinds of infections. Fortunately, most infections can be treated with other medicines.

How to evaluate patient for a liver transplant:
Evaluation:
The evaluation for liver transplantation begins with an initial consult with the transplant team. The main goals of the initial consultation are to determine

Are healthy enough to have surgery and tolerate lifelong post-transplant medications , history
Have any medical conditions that would interfere with transplant
Heart or lung disease (or other life-threatening diseases)
History of cancer
Liver Infections
Smoking, alcohol or drug abuse, or other risky lifestyle habits
Are willing and able to take medications as directed and follow the suggestions of the transplant team
Your evaluation may also include:

Nutrition counseling with dieticians: He will assess your nutritional status, dietary knowledge, and provide education and recommendations for your diet.
Psychological evaluation to assess and treat any underlying issues, such as depression or anxiety, and determine whether you fully understand the risks of a liver transplant
Social workers will discuss your support team at home, your prescription insurance coverage, and other social parts of the transplant process. You will also learn about fundraising options.
Addiction counseling to help people who are struggling with how to quit alcohol, drug, or tobacco
Financial counseling: They will review your insurance coverage and benefits information. He or she will help you to understand your insurance policy and will be your point of contact for insurance changes. They will also explain any parts of the liver transplant process that insurance does not cover and suggest options to assist with those costs.
Pre Liver Transplant Test:
Before the liver transplant, you may need a specific test to find out whether a liver transplant procedure is best for you

Laboratory tests: such as blood tests (liver function test, blood group test) and urine tests to assess the health of your organs, including your liver
CT Scan/MRI: MRI of the liver and CT scan of the abdomen to look at the veins and arteries
Heart tests: to determine the health of your cardiovascular system
A general health exam: including routine cancer screening tests, to evaluate your overall health and to check for any other illnesses that may impact the success of your transplant.
Mammogram for women, pelvic ultrasound Test and Pap Smear (Pap Test)
Tumor Marker Tests: These tests look for tumor markers, sometimes called cancer markers, in the blood, urine, or body tissues
These tests will provide comprehensive data for the transplant team to assess the function of your liver and other body systems to determine if you are a candidate for transplant.

After the evaluation is complete, the liver transplant committee meets to discuss your results and determines whether a liver transplant should be your next step. The committee can make a decision whether you are a candidate for a Liver transplant or not. If you are a suitable candidate, your financial coordinator will work with your health insurance to seek approval for the liver transplant surgery. Once the surgery is approved, you will have blood work done to determine your MELD (Model for End-Stage Liver Disease) score. This ranks your degree of sickness and how quickly you need a liver transplant. Also, your name is placed on the national waiting list.

Waiting List:
Because of the lack of available livers, it’s rarely possible to have a liver transplant as soon as it’s needed, so you’ll usually be placed on a waiting list. Your transplant waiting list priority is determined by two scoring systems called Model for End-Stage Liver Disease (MELD) for adults and Pediatric End-Stage Liver Disease (PELD) for children younger than age 12. MELD scores range from 6 to 40; the higher the score, the greater your need for a liver and the higher your place on the waitlist.

Many people are well enough to stay at home until a liver becomes available. You’ll be contacted by the hospital team at the liver transplant center as soon as a suitable liver becomes available. The call could be at any time during the day or night, so you may be given a beeper to alert you.

Lifestyle changes:
As a candidate for a liver transplant, you have a responsibility to stay as healthy as possible before and after surgery. This means eating properly, exercising regularly, and quitting smoking, abstaining from alcohol, taking your medications as prescribed and keeping appointments with your transplant team. We have a zero-tolerance policy for alcohol, nicotine, and drug use and may randomly screen you for these substances. Establishing healthy habits before surgery will also help you as you recover and in your life after transplantation.

Liver Transplant Procedure:
After the procedure

Possibly stay in the intensive care unit for a few days. Doctors and nurses will monitor your condition to watch for signs of complications. They’ll also test your liver function frequently for signs that your new liver is working.
Spend 5 to 10 days in the hospital. Once you’re stable, you’re taken to a transplant recovery area to continue recuperating.
Have frequent checkups: You’ll have regular follow-up appointments to monitor your progress after a liver transplant. These will be frequent at first – usually once a week for the first 4 to 6 weeks – but may eventually only be necessary once every few months, or even once a year.
Take medications for the rest of your life. You’ll take several medications after your liver transplant, many for the rest of your life. Drugs called immune suppressants to help keep your immune system from attacking your new liver. Other drugs help reduce the risk of other complications after your transplant.
Liver Transplant Success Rate:
Liver Transplant is a very successful treatment and the in-hospital survival or success rate is more than 75% at advanced and well-equipped liver transplant centers. This means that out of 100 liver transplants performed, 75 patients recover and are discharged in healthy conditions.

Life after Liver Transplant:
Your recovery will depend on your health before liver transplant and how dedicated you remain to your care plan. To make the most of your new liver, it is important to follow your treatment plan and maintain a healthy lifestyle. Follow these tips to help you heal and stay healthy:

Stick with the healthy lifestyle changes:
Follow the personalized meal and diet plan: Diet and Nutrition play an important role in helping the body heal after transplant. For the first few weeks after transplant surgery, it is important to eat enough calories and protein to help your body heal, fight infection, and provide the energy you need.
Eat healthy and avoid alcohol: to achieve the fullest life with your new liver. In general, limit salty or sugary foods and eat lean sources of protein.
Exercise: Although exercise may be difficult or even impossible for a period after the operation, it is a good idea to increase your physical activity level after you recover. For the first few weeks, stick to Walking, bicycling, swimming, low-impact strength training, and other physical activities you enjoy can all be a part of a healthy, and avoid any sport that could result in injury.
For more information about our comprehensive treatment options, or to request an appointment with one of the best Surgical Liver Transplant and HPB surgeons in Pune call 09881379573 or Click on Book Appointment for online booking.

I m a one of the best Liver Transplant and HPB surgeons in PCMC and Pune. I have more than 16 years of experience in the field of Liver transplants, HPB Surgeries, and surgical oncology. I m currently working as a senior consultant in the Department of HPB and Liver Transplant at D.Y. Patil Medical College, Hospital & Research Centre, Pimpri, Pune. In his clinical experience, he performs adult and Paediatric Liver transplants (Living donor Liver transplants, Cadaveric Liver transplants), and liver & HPB Pancreatic cancer surgeries.