Liver Transplant Procedure

Liver Transplant Surgery

What Is A Liver Transplant?

What is a liver transplant

A liver transplant is a surgical procedure that replaces a patient’s diseased liver with a new healthy liver either partially (live donor) or whole (cadaveric donor).

A liver transplant is usually reserved as a treatment option for patients who have the end-stage liver disease which include:

  • Poor liver function leading to liver failure
  • Liver cancer that is not treatable by other options
  • Metabolic disease

Following a liver transplant, patients will require long-term medication (immunosuppression) to prevent the body from rejecting the new organ.

With advancements in immunosuppression, medical management, and surgical techniques, the patient’s survival rate has been improved greatly over the years.

 

Who Needs a Liver Transplant?

A liver transplant may be offered to patients with the end-stage liver disease after other treatment options have been exhausted. These patients usually will have one of the following conditions:
 

Chronic Liver Failure
This occurs after repeated injury to the liver over many years or decades. Some of the common causes of chronic liver injury include:

 

Acute Liver Failure
This occurs after the liver suffers massive injury, resulting in rapid liver failing. Unlike patients with chronic liver disease – who can survive up to weeks, months or years while waiting for liver transplantation – patients with acute liver failure may die within days if not transplanted. Some of the common causes of acute liver injury include:

  • Acetaminophen (Panadol) overdose
  • Viruses including Hepatitis A, B and C (especially in children)
  • Adverse reactions to certain prescription and herbal medications

 

Types of Liver Transplant

There are two types of liver transplant – Living Donor Liver Transplantation and Cadaveric Liver Transplantation.
 

Living Donor Liver Transplantation (LDLT)
In LDLT, part of the donor’s healthy liver will be removed and transplanted to the patient. This can be done because the liver has a remarkable ability to regenerate itself. Both the donor and recipient’s liver will grow back to its normal size in a few months.

Due to the shortage of deceased donors in Asia, LDLT has become a feasible option for patients who require liver transplantation.

LDLT
 

Cadaveric Liver Transplantation
This is also known as deceased donor liver transplantation. The majority of livers that are transplanted come from brain-dead organ donors where consent is available. The donor’s whole liver will be transplanted to the patient.

In Asia, many people do not come forward to be an organ donor (possibly due to personal or religious reasons, or lack of awareness) which has led to a shortage of cadaver livers.

Liver Transplant
 

Advantages of Living Donor Liver Transplantation (LDLT)

The current waiting period for a cadaveric donor liver is often too long to benefit patients with these rapidly progressive diseases. Without LDLT, it is highly unlikely that these patients will be transplanted before they develop fatal complications.

Besides being an alternative source of donor’s livers, the other advantage of LDLT over cadaveric liver transplantation is that it allows scheduling of the procedure. As such, the patient with decompensated liver function can be optimised prior to the transplant surgery. In addition, the quality of the liver graft is better as it is retrieved from a healthy donor and the cold ischemic time (the time the donated liver has no blood supply) is much shorter.
 

 

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