What is liver transplant?

A liver transplant surgery is a procedure where a diseased liver is replaced with a healthy liver from another individual. In many cases, the healthy liver comes from an organ donor who has recently passed on. In some cases, a healthy, living individual may also opt to donate a part of their liver.

This is possible because the liver is the only organ in the human body that is designed to regenerate and increase its size. When a part of a liver is transplanted to another body, it has the capacity to rebuild itself into its normal size within a few weeks.

The choice of whether a patient requires an entire liver or can get a part of a liver transplanted into their body depends on the indications of the transplant and the judgement of our Experts at Med Treatment Hospital.

Risks

Liver transplant surgery carries a risk of significant complications, including:

Side effects of anti-rejection medications

After a liver transplant, you'll take medications for the rest of your life to help prevent your body from rejecting the donated liver. These medications can cause a variety of side effects, including:

Being placed on the waiting list

If you have chronic liver failure, your doctor may refer you to a transplant center to undergo evaluation for liver transplant. The transplant center team conducts a wide variety of tests and procedures to determine whether to place your name on the waiting list for a new liver.

Tests, procedures and consultations you may undergo include:

Once these tests and consultations are completed, the transplant center's selection committee meets to discuss your case. It determines whether a liver transplant is the best treatment for you and whether you're healthy enough to undergo a transplant. If the answer to both questions is yes, then you're placed on the transplant waiting list.

Determining your position on the waiting list

Doctors use results of liver function tests and other factors to determine your prognosis and your place on the transplant waiting list. Your prognosis is sometimes called your Model for End-Stage Liver Disease (MELD) score. The higher your MELD score, the more dire your situation. Organs are allocated based on MELD scores. People with higher MELD scores generally are offered donated livers first. MELD scores range from 6 to 40.

Some liver conditions, such as liver cancer, may not result in a person getting a high MELD score. The transplant center can request additional MELD points for people with specific diseases if they meet defined criteria.

Waiting for a new liver

Your wait for a donor liver could be days, or it could be months. Or a donor liver that's a good match for you might not become available.

As you wait for a new liver, your doctor will treat the complications of your liver failure to make you as comfortable as possible. Complications of end-stage liver failure are serious, and you may be frequently hospitalized. If your liver deteriorates, your MELD score is updated.

Living liver donors

A small percentage of liver transplants are completed each year using a portion of a liver from a living donor. If you have a family member or friend who is willing to donate part of his or her liver to you, talk to your transplant team about this option.

Living-donor transplants have good results, just like transplants using livers from deceased donors. But fewer living transplants are performed because of restrictions on the donor's age, size and health that make finding a good match difficult. The surgery carries significant risks for the donor. Your transplant team can discuss the risks with you and the potential donor.

What can you expect?

During a liver transplant

If you're notified that a liver from a deceased donor is available, you'll be asked to come to the hospital immediately. Your health care team will admit you to the hospital, and you'll undergo an exam to make sure you're healthy enough for the surgery.

Liver transplant surgery is done using general anesthesia, so you'll be unaware during the procedure.

The transplant surgeon makes a long incision across your abdomen to access your liver. The location and size of your incision varies according to your surgeon's approach and your own anatomy.

The surgeon disconnects your liver's blood supply and the bile ducts and then removes the diseased liver. The donor liver is then placed in your body, and blood vessels and bile ducts are reattached. Surgery can take up to 12 hours, depending on your situation.

Once your new liver is in place, the surgeon uses stitches and staples to close the surgical incision. You're then taken to the intensive care unit to begin recovery.

Liver transplant using a living donor

If you're receiving a liver transplant from a living donor, such as a friend or family member, surgeons will transplant a portion of the donor's liver in your body. Surgeons first operate on the donor, removing the portion of the liver for transplant. Then surgeons remove your diseased liver and place the donated liver portion in your body. They then connect your blood vessels and bile ducts to the new liver.

The transplanted liver portion in your body and the portion left behind in the donor's body regenerate rapidly.

After a liver transplant

After your liver transplant, you can expect to:

Results

Expect six months to a year of recovery before you'll feel fully healed after your liver transplant surgery. You may be able to resume normal activities or go back to work a few months after surgery. How long it takes you to recover may depend on how ill you were before your liver transplant.

Survival rates after liver transplant

Your chances of a successful liver transplant and long-term survival depend on your particular situation. In general, about 72 percent of people who undergo liver transplant live for at least five years. That means that for every 100 people who receive a liver transplant for any reason, about 72 will live for five years and 28 will die within five years.

People who receive a liver from a living donor have higher survival rates because having a living donor usually means a shorter wait for a liver. For liver transplants using living donors, the five-year survival rate is about 78 percent. That means that for every 100 people who receive a liver transplant using a living donor, 78 will live for five years and 22 will die within five years.