Liver Transplant

Liver Transplant

Know your Liver!
The liver is a reddish brown organ with four lobes of unequal size and shape. A human liver normally weighs 1.4'1.6 kg (3.1'3.5 lb), and is a soft, pinkish-brown, triangular organ. It is both the largest internal organ (the skin being the largest organ overall) and the largest gland in the human body.

The transplant kidney provides enough kidney function. After a successful transplant, there is no need for dialysis, provided the transplant continues to work well.

It is located in the right upper quadrant of the abdominal cavity, resting just below the diaphragm. The liver lies to the right of the stomach and overlies the gallbladder. It is connected to two large blood vessels, one called the hepatic artery and one called the portal vein. The hepatic artery carries blood from the aorta, whereas the portal vein carries blood containing digested nutrients from the small intestine and the descending colon. These blood vessels subdivide into capillaries, which then lead to a lobule. Each lobule is made up of millions of hepatic cells which are the basic metabolic cells.

Function of Liver
The liver regulates most chemical levels in the blood and excretes a product called "bile," which helps carry away waste products from the liver. All the blood leaving the stomach and intestines passes through the liver. The liver processes this blood and breaks down the nutrients and drugs into forms that are easier to use for the rest of the body.

Liver Diseases
Alcoholic Liver Disease
Hepatitis C
Alpha-1-Antitrypsin Deficiency
Hepatitis D
Autoimmune Hepatitis
Hepatitis E
Bleary Artesia
Primary Bleary Cirrhosis
Cancer of the Gallbladder and Bile Duct
Liver Diseases & Pregnancy
Chronic Hepatitis
Liver Abscess
Cirrhosis
Liver Adenoma
Drug Induced Hepatitis
Liver Cancer
Haemochromatosis
Hepatitis A
Hepatitis B

Liver Cirrhosis
Cirrhosis is a prevalent liver-related condition that most people are acquainted with. Liver cirrhosis is a term that refers to a group of chronic diseases of the liver in which normal liver cells are permanently damaged and replaced by scar tissue. When scar tissue develops in the liver, the amount of normal liver tissue decreases and the liver is unable to function normally. Liver cirrhosis is a serious condition, for the liver is a very important part of the digestive system.

Cirrhosis blocks the flow of blood through the liver and prevents it from working as it should. Liver damage cannot be reversed, and unfortunately, cirrhosis does not always produce symptoms in its early stages. As the disease progresses liver function is increasingly diminished. It is the end stage of many different forms of liver disease and is known to cause a number of other health problems, including variceal bleeding, ascites and hepatic encephalopathy

Symptoms of cirrhosis

The most common symptoms an individual may notice include:

Loss of appetite
Nausea
Weight loss
Fatigue
Weakness
Exhaustion

Major causes of cirrhosis

Cirrhosis can be caused by a number of conditions, such as

Chronic alcoholism
Viral infections caused by chronic viral hepatitis (types B, C and D)
Metabolic diseases such as alpha-1-antitrypsin deficiency, galactosemia and glycogen storage disorders
Inherited diseases such as Wilson's disease and hemochromatosis
Bleary cirrhosis resulting from diseases such as primary bleary cirrhosis (PBC) and primary sclerosing cholangitis (PSC)
Toxic hepatitis caused by severe reactions to prescribed drugs or prolonged exposure to environmental toxins
Repeated bouts of heart failure with liver congestion

Diagnostic Procedures of Cirrhosis

The steps in making the diagnosis of cirrhosis will include medical analysis of the following:

Identifiable symptoms
Physical examination
CAT scan (computerized axial tomography)
Ultrasound
Radioisotope liver/spleen scan
Liver Biopsy
LFT
ERCP
MRCP

Once it is determined that liver disease is present, immediate treatment is recommended

Who needs Liver Transplant?
Absolute indications for liver transplant
Ascites (fluid in the belly) Recurrent collection, not responding to diuretic medicines or repeated removal by needle
GI bleed Vomiting blood or passing blood in stool, more than once
SBP Spontaneous infection in the fluid in the belly (Polymorph cell count >250/cc)
Coma Repeated admission to hospital for loss of orientation and conscious state
Serum Albumin Measurement consistently below 3.5 Gm/dl
Prothrombin time Measurement in patient sample 5 seconds above the control lab value (or INR>1.5)
Total bilurubin Serum total bilurubin >6 mg/dl, especially in patients with bile outflow problems like- PSC & PBC

Liver donor requirements

Any member of the family, parent, sibling, child, spouse or a volunteer can donate their liver. The criteria for a liver donation include:

Being in good health
Having a blood group that matches or is compatible with the recipient's
Having a charitable desire of donation without financial motivation
Age between 18 and 60 years old
Being of similar or bigger size than the recipient
Before one becomes a living donor, the donor must undergo testing to ensure that the individual is physically fit. Sometimes CT scans or MRIs are done to image the liver. In most cases, the work up is done in 2'3 weeks

Complications
Living donor surgery is done at major centers in India. Very few individuals require any blood transfusions during or after surgery. Even though the procedure is very safe, all potential donors should know there is a 0.5 to 1.0 percent chance of death. Other risks of donating a liver include bleeding, infection, painful incision, possibility of blood clots and a prolonged recovery. The vast majority of donors enjoy complete and full recovery within 2'3 months.

Pediatric Transplantation
In children, living liver donor transplantations have become very accepted. The accessibility of adult parents who want to donate a piece of the liver for their children/infants has reduced the number of children who would have otherwise died waiting for a transplant. Having a parent as a donor also has made it a lot easier for children - because both patients are in the same hospital and can help boost each other's morale.

Benefits of living donor transplantation
The advantages of living liver donor transplantation have several benefits over cadaveric donor transplantation, including:
Transplant can be done on an elective basis because the donor is readily available
There are less possibilities for complications and death while waiting for a cadaveric organ donor

Arrangement of donor for transplants
We at Explore won't be able to provide you a living donor for transplantation. Donor should be arranged from your side as the human organs transplant acts are very strict. In the entire process of donation of Liver, monetary exchanges are not at all accepted and are illegal. So, it's your responsibility to arrange a donor for the transplantation within your relatives preferably with in first blood relation.

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