The liver is one of the essential organs of the body. It is responsible for several functions, including the detoxification of blood from harmful substances,
the production of hormones and enzymes, the conversion of pharmaceutical drugs to metabolites that can be excreted, and the synthesis/storage of glucose.
Unfortunately, this marvelous organ is susceptible to damage inflicted because of the same properties it offers. This article will discuss all basic concepts of liver failure, liver transplant, and who needs this surgery.
Who needs a liver transplant?
If you search the medical literature, you will find several scores (e.g., Model of End-Stage Liver Disease (MELD) and indications for liver transplantation, which can be confusing.
In general, two subsets of patients need liver transplantation. Those are patients who suffer from the following:
- End-stage liver disease
- Acute liver failure
Let us briefly discuss both of these conditions.
End-stage liver disease (cirrhosis)
Usually, the disease shows no signs or symptoms at the early stages, and the clinical presentation is not complete until the liver loses most of its function.
Common causes of cirrhosis include alcohol, hepatitis B, hepatitis C, and non-alcoholic fatty liver disease.
Acute liver failure
Acute liver failure, or fulminant liver failure, is an abrupt loss of hepatic function in a few weeks.
The patient becomes symptomatic rapidly, and signs of liver failure will be apparent. It is usually due to losing 80-90% of hepatocytes.
The most common cause of acute liver failure is acetaminophen (paracetamol) toxicity. Other causes include severe alcoholic hepatitis, infectious hepatitis (B or C), idiopathic (no apparent reason),
and Reye syndrome is mainly seen in children who take Non-Steroidal Anti-Inflammatory Drugs (e.g., aspirin, ibuprofen) shortly after a viral infection.
The procedure for a liver transplant
This procedure involves replacing the patient’s liver with a donor’s, the major obstacle to transplantation.
The most common surgical technique used is the orthopedic approach. This technique involves completely removing and replacing the patient’s liver with the donor’s liver while maintaining the same anatomical position.
It is a highly complex surgery that requires a deep understanding of the liver and surgical procedures and considerable experience.
The surgeon will apply general anesthesia. Next, your surgeon will make a large incision in the upper abdominal area; they will remove all the anatomical structures that bind the liver to its position.
For instance, ligaments, the bile duct, veins, and arteries will be separated from the liver to prepare for the ablation.
This procedure is incredibly challenging if the patient has portal hypertension, the vein that goes through the liver.
Depending on the outcome, the surgery may take 4-8 hours, and the patient is usually admitted to the hospital the night before.
Once the surgery is completed, the patient will be admitted to an Intensive Care Unit (ICU) for a few days to be monitored.
Contraindications of liver transplantation
Unfortunately, many patients who suffer from liver failure have other disease processes, such as cardiovascular disease, blood hypertension, and diabetes.
This is especially unfortunate because some diseases can contradict liver transplantation.
- Uncompensated cardiopulmonary disease
- Cancer outside the liver
- Alcohol consumption before surgery (patient must stop drinking alcohol for at least six months)
- Advanced age (relative contraindication)
- AIDS (relative contraindication)
Complications of the surgery
The most feared complication of a liver transplant is rejecting the new organ. But, you see, our bodies can recognize any foreign object that comes in contact with our immune cells, even if the object is an organ from another human being.
We have known about graft rejection for a long time, and this is why your surgeon will prescribe immunosuppressive drugs,
such as corticosteroids to stop your immune system from attacking the new organ.
Nevertheless, some patients’ immune systems will attack the new organ even after taking potent immunosuppressive drugs.
Other complications include infection of the site of surgery, internal bleeding, damage to the collecting bile duct, blood clot formation,
and side effects from taking the immunosuppressants for long periods.
Recovery from the liver transplant
Unfortunately, we do not have a method to accurately calculate the survival rates after liver transplantation. This is due to the variable factors involved,
such as the patient’s overall health status, technical surgical success, and underlying liver disease.
Nevertheless, it is estimated that 10-15% of patients will experience transplantation failure due to various reasons.
According to the Johns Hopkins Hospital, patients who undergo liver transplantation will start feeling better a few days after the surgery.
However, real improvement is not witnessed until three months post-surgery.
liver transplant cost
Like any other cosmetic procedure,
liver transplant cost differs depending on the following:
- The individual needs and the method used.
- Geographic hospital location.
- The surgeon’s experience.
The essential point is that you choose the best Organ transplant surgeon at an affordable price. However, do not be attracted to only the low-cost offers without paying attention to the quality of the provided services.
Istanbul has become the destination for many people from all over the world to perform cosmetic procedures.
The reasons behind that are the competitive prices, the experienced surgeons in this field, and the specific medical services.
In Turkey, liver transplant surgery costs approximately $60000 to $85000.
You can save more and get stunning results with experienced hands at HayatMed for medical services in Istanbul.
Liver transplantation has revolutionized the fields of hepatology and general surgery. It is the only viable treatment for end-stage liver disease and acute liver failure patients.
Before the invention of this surgical procedure, patients had to suffer for years (cirrhosis) from severe signs and symptoms,
including hepatic encephalopathy, jaundice, itching, esophageal varices, and ascites.
However, despite the marvelous benefits of this technique,
there are still limitations, such as the low number of liver donors, rejection of the organ, and post-surgery complications.
Scientists constantly conduct experiments and clinical trials to improve liver transplantation and create new drugs to facilitate patient outcomes.
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