How does liver transplantation work

How Liver Transplantation Works

Liver transplantation is a surgical procedure that replaces a diseased or failing liver with a healthy liver from a donor. It is a life-saving option for patients with end-stage liver disease, acute liver failure, or liver cancer that cannot be treated otherwise.

1. Indications for Liver Transplant

Liver transplantation is considered for patients with:

• End-stage liver disease (Cirrhosis) – Due to hepatitis B/C, alcohol-related liver disease, or fatty liver disease (NAFLD/NASH).
• Acute liver failure – Often caused by infections, drug toxicity (e.g., acetaminophen overdose), or autoimmune hepatitis.
• Liver cancer (Hepatocellular Carcinoma, HCC) – If confined to the liver and within transplant criteria.
• Genetic or metabolic liver disorders – Such as Wilson’s disease or primary sclerosing cholangitis.

2. Types of Liver Transplants

1. Deceased Donor Liver Transplant (DDLT): The liver is taken from a brain-dead donor.
2. Living Donor Liver Transplant (LDLT): A portion of a healthy liver is taken from a living donor (since the liver can regenerate).
3. Split Liver Transplant: A deceased donor liver is divided and used for two recipients, usually a child and an adult.

3. Liver Transplant Process

a. Evaluation and Waiting List

• Patients undergo medical tests to assess their suitability for transplant.
• They are placed on a transplant waiting list, prioritized based on the MELD (Model for End-Stage Liver Disease) score – the higher the score, the more urgent the need.

b. Surgery and Transplantation

• The diseased liver is removed, and the healthy donor liver (or part of it) is implanted.
• Blood vessels and bile ducts are reconnected.
• Surgery takes 6-12 hours, with a hospital stay of 1-2 weeks post-surgery.

c. Post-Transplant Care

• Patients require lifelong immunosuppressive medications to prevent organ rejection.
• Regular follow-ups and liver function tests are needed.

4. Risks and Complications

• Rejection: The immune system may attack the new liver.
• Infections: Due to immunosuppressants weakening the immune system.
• Bile duct complications: Blockages or leaks may occur.
• Recurrence of Liver Disease: In cases of viral hepatitis or fatty liver disease.

5. Outcomes and Survival Rates

• One-year survival rate: ~85-90%.
• Five-year survival rate: ~75-80%.
• Many recipients lead long, healthy lives with proper care.

Liver transplantation offers a second chance at life for patients with irreversible liver failure, making post-transplant care and lifestyle changes essential for long-term success.