Liver Transplant Surgery

Liver transplant is a surgery done for the liver that is diseased to be replaced with another liver that is healthy from the donor. The liver can be taken from either a donor, who can be a living or even a diseased donor. Any of the family members, relatives or even an unrelated donor also can become a good match to provide a small portion of the liver to the recipient or patient. After donating the liver, the donor can continue the normal life with the remaining liver in the body. The transplantation is either done with a partial or a section of liver or a complete liver. The liver will be able to regenerate, so the donor’s liver will be regenerated within a few weeks of time.

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Liver

The liver is an important organ of the body, which is located beneath the diaphragm at the upper right of the abdomen, on top of the stomach. It is shaped as a cone and looks in dark reddish-brown color weighing around three pounds.

The main functions of the liver are to change food into energy, clear the blood of poisonous or drug substances, regulate the clotting of the blood and make bile to produce the necessary proteins needed for the blood plasma.

Liver holds about 13 percent of the blood supply in the body at any specific moment. There are two main lobes contained in it, whereas each of the lobes is made from lobules in thousands of numbers. These are connected to the larger ducts, forming hepatic duct that transports the bile to the gallbladder and also duodenum.

Need of the Surgery

People, who have been going through the ESLD or end-stage liver disease which is caused from a life-threatening dysfunction of the liver are recommended for this surgery. The common diseases that need this transplant is cirrhosis, which is a long-term disease. Other diseases can be biliary atresia, liver cancer, acute hepatic necrosis, metabolic diseases or autoimmune hepatitis.

Before the Procedure

The recipient or patient seeking for the liver from the donor is placed on a waiting list. After extensive testing and diagnosis is made, the suitable donor would be allocated to the patient. Since, a lot of information is needed for attempting the match of the donor, it is necessary to perform a certain evaluation process done by a team of transplantation. The team consists of a surgeon, hepatologist, psychiatrist, nurses and a social worker. The team performs the psychological & social evaluation, diagnostic tests and blood tests.

Liver Transplant Surgery in Coimbatore Tamil Nadu, India at Best Hospital

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The patient has to remove the cloths and wear a gown. The procedure starts with an intravenous line in the hand. Catheters are then inserted into the wrist and neck for the status of the blood pressure and heart to be monitored. Other catheters used are in subclavian area. The patient is positioned on the table for operation by lying on his or her back.

The excess hair at the surgical site is clipped off and then a catheter is inserted into the bladder to drain the urine. After sedation, a tube is inserted into the lungs to control the breathing using a ventilator. The breathing, blood pressure, blood oxygen levels and heart rate are monitored during the surgery. After the skin over the surgical site is cleaned with antiseptic solution, a slanting incision is done on both sides of the abdomen, under the ribs and extended to breast bone. The diseased liver is then separated from other structures and organs after clamping the veins and arteries. The healthy liver is then attached to the blood vessels and blood flow then be established. Then it is connected to the bile duct. The incision is then closed. To reduce swelling a drain is placed in the incision and dressing is applied.

Risks

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Liver surgery, like any other surgery, the complications can possibly occur. Some of the complications are

  1. – Blocking of the blood vessels struck to the new liver
  2. – Bleeding
  3. – Lack of function of the new liver initially
  4. – Infection
  5. – Blockage of bile ducts
  6. – Leakage of the bile

Since the rejection is the natural and normal reaction shown by the body of the foreign object, there is a possibility that the new organ might be rejected. This problem can be avoided by tricking the immune system through the medication. So, the immune system would not be reacting to the foreign object for some time.

Post Procedure and Recovery

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The patient is placed in ICU for a few days after the surgery to be monitored for the blood pressure, EKG tracing, oxygen levels, breathing rate and the other pressure readings. The patient then shifts to a private room with regular nursing services, until you are recovered. He or she has to follow the recommendations and instructions about breathing and make regular follow-up visits to the hospital.

About the Author

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The above article was written by Dr. Gursharan Singh, Head of the Department & senior consultant in digestive disease and multi organ transplantation in  Coimbatore Kidney Centre and Speciality Hospitals.

You can get in touch with him at,  singhdrgursharan@gmail.com
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