Liver transplant

Donor liver attachment

Liver transplant

Definition:

Liver transplant is surgery to replace a diseased liver with a healthy liver from a donor.

Alternative Names:

Hepatic transplant; Transplant - liver

Description:

Liver transplants have become common operations worldwide.

The healthy liver is usually obtained from a donor who has recently died, but has not suffered liver injury. The healthy liver is transported in a cooled saline solution that preserves the organ for up to 8 hours, thus permitting the necessary analyses to determine blood and tissue donor-recipient matching.

The diseased liver is removed through an incision made in the upper abdomen. The new liver is put in place and attached to the patient's blood vessels and bile ducts. The operation can take up to 12 hours to complete and requires large volumes of blood transfusions.

In some cases, living donors may donate a piece of their liver for transplant to someone else, often a family member or friend. This poses some risk to the donor because of the nature of the operation, but since the liver can regenerate itself to some extent, both parties will end up with fully functioning livers after a successful transplant.

Indications:

A liver transplant may be recommended for:

liver damage not due to alcoholism (cirrhosis or primary biliary cirrhosis)
long-term (chronic) active infection (hepatitis)
liver (hepatic) vein clot (thrombosis)
birth defects of the liver or bile ducts (biliary atresia)
metabolic disorders associated with liver failure (e.g., Wilson's disease)

Liver transplant surgery is not recommended for patients who have:

heart, lung, or kidney disease
insulin-dependent diabetes mellitus (IDDM)
other life-threatening diseases

Risks:

Risks for any anesthesia are:

reactions to medications
problems breathing

Risks for any surgery are:

bleeding
infection

Liver transplants carry major risks. There is an increased risk of infection because of the immunosuppressive medications that must be taken to prevent transplant rejection. Call your doctor if there are signs of infection (redness, drainage, fever, swelling, tenderness, jaundice, diarrhea) or if the condition worsens.

Expectations after surgery:

Liver transplants can save the lives of people who might otherwise die. Approximately 75% of patients survive 3 years or more after the transplant. The major problems with any transplant is:

finding a healthy organ
graft rejection
life-long need to take immunosuppressive drugs, which weaken the body's ability to fight infections
cost

The patient is encouraged to resume normal activities as soon as possible.

Convalescence:

The recovery period averages 12 weeks. Move legs often to reduce the risk of deep vein thrombosis. Resume normal activity as soon as possible after consulting with your physician.

Review Date: 5/1/2002
Reviewed By: Jenifer K. Lehrer, M.D., Department of Gastroenterology, Graduate Hospital, Philadelphia, PA. Review provided by VeriMed Healthcare Network.

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