Liver transplantation is a complex, supra major, life saving surgery in which diseased liver is replaced with healthy liver.
Most common indication for liver transplant is chronic liver disease or cirrhosis of liver. Other indications are acute liver failure, liver cancer and metabolic liver diseases. If liver transplant surgery is performed in time, the success rate of liver transplant surgery is approximately 95%.
There are many factors responsible for a successful liver transplantation and each of them are equally important. Depending upon indications of liver transplant, there are many patients who need liver transplant, are stable and their transplant is performed electively. There are many patients who need liver transplant, are admitted in ICU, very sick and liver transplant is required as earliest as possible as a life saving surgery. In any case, preoperative optimization is very important. Result of such a high-end surgery is good only when patient is optimized before the surgery.
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Because of cadaveric donor shortage, we have to be dependent upon living donor liver transplantation. For living donor liver transplant, blood group matching is important. With time liver transplant science has evolved and now blood group non-matching or ABO incompatible liver transplant can be performed safely. ABO incompatible transplant is one of the options when recipient needs early transplant and there is no blood group matching donor in the family. Recently we performed ABO incompatible pediatric liver transplant at Dr L H Hiranandani Hospital. Patient was suffering from Wilson’s disease related Chronic liver disease. Wilson’s disease is a genetic condition in which copper is deposited in vital organs like liver, eye, brain, kidney. Patient did very well after surgery and was discharged on postoperative day 12.
Dr Swapnil Sharma Consultant and Chief Liver Transplant & HPB Surgeon
There are many challenges during liver transplant surgery. Most of the liver transplant recipients have coagulopathy and their platelets are low so they have bleeding tendency.
When bad liver or cirrhotic liver is removed from the body, there is risk of bleeding. Surgical technique as well as role of anesthetist is crucial when there is bleeding during surgery. We have modality like ROTEM and TEG which can help to understand coagulopathy status during surgery. Small blood vessels of graft are joined to the recipient blood vessels which are sometimes 1.5mm – 2mm size. Surgeon has to use surgical loupe or microscope to join such a small blood vessel. Live related liver donor surgery is also a major surgery in which part of liver is removed from donor’s body and is implanted into recipient body. Liver is the only organ in our body which has regeneration capacity. Liver donor can donate up to 70% of their liver without any consequences in life expectancy. Because of modern liver parenchyma cutting techniques like CUSA, water jet, liver donor surgery is safe and can be performed with minimal blood loss.
In postoperative period, patient is kept into special ICU and are cared by nurses who are specially trained to manage liver patients. Most of liver transplant recipients are discharged within 2 weeks after liver transplant and most of the donors are discharged within a week after liver transplant. After successful liver transplant surgery, patient lives normal life. They can resume their work in next 2 to 3 months and all other activity within next 6 months.
Although liver transplant surgery is supra major surgery with many associated challenges, liver transplant results are good and patient can live absolutely normal life after liver transplantation.
For more details contact :-
Dr L H Hiranandani Hospital Hill Side Avenue, Hiranandani Gardens, Powai, Mumbai - 400 076.
Call: 022 25763300 / 3333
Email id: wecare@hiranandanihospital.org
Website: www.hiranandanihospital.org
Instagram: @drlhhiranandanihospital
Facebook: Dr L H Hiranandani Hospital
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