Because the liver is the only organ in the body that regenerates or grows back, a transplanted segment of the liver can grow to normal size within a few months. Liver transplantation is a surgical procedure performed to remove a diseased or injured liver from one person and replace it with a whole or portion of a healthy liver from another person called a donor. Liver transplant is not an option for people
- Aged 65 years or older with other serious illness.
- With severe organ disease due to diabetes.
- With severe obesity.
- With severe and active liver disease such as hepatitis B.
- Who are currently on alcohol and drugs.
- Who have severe or uncontrollable infection (human immunodeficiency virus [HIV]).
- Who are diagnosed with aggressive cancers such as bile duct cancer, lymphomas, bone cancer, and myeloma type cancer.
- With failure of other organs apart from the liver.
- With irreversible brain damage or disease.
- With severe untreatable lung, liver, and heart diseases.
- Who are diagnosed with portal vein thrombosis (PVT). It is a vascular disease of the liver that occurs when a blood clot occurs in the hepatic portal vein, which can lead to increased pressure in the portal vein system and reduced blood supply to the liver.
- With hepatorenal syndrome (HRS). HRS is a type of progressive kidney failure seen in people with severe liver damage, most often caused by cirrhosis. As the kidneys stop functioning, toxins begin to build up in the body. Eventually, this leads to liver failure.
- With pulmonary hypertension. It is a condition of increased blood pressure within the arteries of the lungs. Symptoms include shortness of breath, syncope, tiredness, chest pain, swelling of the legs, and a fast heartbeat. The condition may make it difficult to exercise.
- With autoimmune diseases (rheumatoid arthritis, multiple sclerosis, etc.).
Who may qualify for a liver transplant?
Never will a race, ethnicity, religion, national origin, gender, or sexual orientation have any part in deciding if a patient is a transplant candidate. Liver transplant is major surgery; hence, a patient should meet certain criteria that include:
- A patient’s quality of life may be improved with a liver transplant.
- The patient should not have other diseases that cannot be treated or are not too sick to likely survive the transplant surgery.
- All other medical or surgical treatment options either have not worked or are not a good choice for the patient.
- The patient and support systems (family and friends) understand and accept the risks of having a liver transplant.
- The patient’s support systems are fully committed to and compliant with what is needed before and after the transplant to make the transplant a success. This would include access to funding for the transplant procedure, post-transplant medicines, and other healthcare costs. The social worker and patient financial liaison may be able to help find other ways to pay for their care.
Indications for liver transplantation are as follows:
- The patient has an acute (sudden) onset of liver failure.
- The patient has had cirrhosis (liver disease) for a long time.
- The patient has a liver disease that will lead to death or hurt their quality of life.
- The patient had treatments that did not work (and others are not expected to work).
- The patient has diseases that affect the bile ducts (the tubes that carry the bile away from the liver), such as primary biliary cirrhosis, primary sclerosing cholangitis, and biliary atresia. Biliary atresia is the most common reason for a liver transplant among children.
What are the potential complications of liver transplantation?
Complications of liver transplantation may occur early (in the first 30 days) or later (after 30 days):
- Primary non-function (the liver never works)
- Delayed liver function (the liver does not work right away)
- Bleeding (that requires surgery)
- Clotting of the major blood vessels to the liver
- Rejection (usually in first 3 months)
- Recurrent disease
- High blood pressure
- Kidney failure and other side effects of anti-rejection medications
- Multiorgan failure
- Anesthesia reactions
- Leakage in the bile
- Excessive bleeding
- Damage to other organs during the procedure
- Less immunity due to immunosuppressants