Liver transplant (LT) simply means replacing a diseased liver with a healthy one. The new liver may be taken from a brain-dead person (cadaver) or given by a living relative.
The life expectancy post the LT depends on many variables. These include the initial reason for the transplant, age, co-morbidities, and response to the drugs the person is put on post-transplant.
On average, most people who receive LT live for more than 10 years. Many may live for up to 20 years or more after the transplant.
A study says 90% of people with transplant survive for at least 1 year, and 70% of people may live for at least 5 years after transplant. This is often accompanied by a good quality of life, resumption of schooling and jobs, and reduced hospitalization episodes as compared to those who do not undergo the procedure.
Why does one require a liver transplant?
The wonderful thing about the liver is it can recover by itself from a lot of damage. However, when the damage is too much, the liver will fail. Once a person has signs of liver failure, they may experience the following:
- Jaundice (yellow skin and eyes)
- Vomiting
- Hand tremors
- Confusion
- Encephalopathy (comatose state)
- Fatigue
- Muscle loss
- Itching all over the body
- Poor blood clotting
- Swelling over the legs
- Ascites (abnormal fluid buildup in the tummy)
- Bleeding from the esophagus (gullet), stomach, or rectum
At one point, there will be a stage when no treatment can help the liver function properly. When the liver disease reaches a certain stage, there is no option but to get a replacement. This is called liver transplant (LT), and it is the only way to save a person’s life.
When will the doctor suggest a liver transplant?
When the liver gets severely damaged with scarring, it cannot heal itself. This stage is called cirrhosis. When liver disease begins to get worse, a person may show signs such as:
- Liver failure: Liver fails when it is not able to do the normal functions that are needed to keep a person alive.
- High blood pressure in the portal vein: Scarring in the liver stops blood from flowing through it normally. It leads to pressure buildup in the blood of the portal vein (the vein that feeds the liver). It manifests as blood-filled vomit and blood in stools.
- Hepatocellular carcinoma (liver cancer): It can develop within a scarred liver.
A primary care doctor or a specialist who treats stomach problems (gastroenterologists) will refer the patient for a transplant evaluation to a major medical center.
What are the complications?
The doctors will monitor the patient closely to help prevent and treat these conditions that may occur after liver transplant (LT) such as:
- Transplant rejection
- Recurrence of your liver disease
- Cancer (especially skin cancer) due to drugs you are put on after the transplant
- Other complications include:
- Infections (hepatitis B, C, and E; Ebstein–Barr virus)
- High blood pressure
- Diabetes
- High cholesterol
- Bones thinning
- Excessive weight gain
The patient will need to follow-up with their medical team for the rest of their life. However, they might require less frequent visits after a couple of years.
QUESTION
What percentage of the human body is water? See AnswerTrotter JF. Liver transplantation around the world. Curr Opin Organ Transplant 2017;22(2):123e7. https://doi.org/10.1097/MOT.0000000000000392. PMID: 28151809.
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