Liver Transplant

Liver transplant is a complex surgical procedure to replace non-functional liver from the body by a healthy liver. Healthy liver can be obtained from a living donor or a deceased person.

Liver is the largest organ inside the body and does multiple complex functions:

• Processing nutrients, medications and hormones
• Producing bile, to help in absorption of fats, cholesterol and fat-soluble vitamins
• Making proteins
• Removing toxins, chemicals and bacteria from the blood
• Regulating body immunity to prevent and fight infection

Liver transplant is done in cases of people with end-stage liver disease or in cases of sudden complete liver failure.

Living donor liver transplant doesn’t have any detrimental effect on donor as only a part of liver is transplanted. Liver has the capacity to grow back to its normal size.

Sudden onset liver failure is a rare condition usually due to complications of medications or toxins. Most liver failure are chronic and its most common cause is cirrhosis. Cirrhosis takes months to years to develop and is the most common reason for liver failure.

Common reason of cirrhosis is:

• Hepatitis B and C.
• Alcoholic damages the liver when consumed in excess amount.
• Fatty liver disease, a condition in which liver tissue is gradually replaced by fat.
• Genetic diseases like hemochromatosis causing excessive iron deposit and Wilson’s disease, which causes excessive copper deposit in the liver.
• Bile ducts which channels the bile is affected in many conditions’ primary biliary cirrhosis, primary sclerosing cholangitis.
• Biliary atresia is non formation of the bile duct. It is the commonest reason for liver transplant in children.
• Liver cancers.

Risks and complications:

• Bile duct leaks or stenosis of the bile ducts
• Bleeding
• Infection
• Blood clotting
• Rejection of donated liver
• Failure of donated liver
• Liver disease can recur in the transplanted liver.

Anti-rejection or immune-suppressant medication side effects

• Bone thinning
• Diarrhoea
• Diabetes
• Headaches
• Blood pressure changes
• High cholesterol
• Infection

Living donor liver transplants uses a small part of liver from a healthy, living person. This allows the organ recipient to avoid delay, prolonged medical treatment and complications while waiting for a transplant.

Most living liver donors who match are usually close family members.

After a liver transplant:

• Recipient may need to stay in ICU for few days.
• Spend about a week to 10 days in the hospital.
• Have regular check-ups.
• And need to take medications for the rest of your life.

Usually it takes few months before one can head to office and about 6 months for full recovery.

Results

Liver transplant survival is up to 75% at 5 years i.e about 75% of recipients 5 years or more. Survival after liver transplants depends on pre-transplant health and presence of other disease like diabetes, high blood pressure or other chronic illness.

Patients receiving liver from living donor have higher success rates and better survival.

Diet and nutrition after a liver transplant is important for recovery and keeping new liver healthy. Diet must be low in salt, cholesterol, fat and sugar. Recipient must refarain from alcohol consumption.

Dietary recommendations are:

• Eating fruits and vegetables every day at least 5 times
• Grapes and its juice interact with anti-rejection medication, and must be avoided
• High fibre diet
• Whole-grain foods
• Low-fat or fat-free dairy products

• Lean meat, poultry and fish
• Drinking adequate water and other fluids to stay hydrated

Exercise

Exercise and physical activity can be started few months after liver transplant with doctor’s approval. It can include initially with walking and later on like bicycling, swimming, low-impact strength training and other physical activities.