Liver Transplant

Organ donation is a great breakthrough in the medical field that allows professionals to replace diseased organs with donated ones to save millions of lives. Organ donation is also used for research. Most organs can survive a few hours after the death of the donor and can be transported to the recipient in need of it. According to U.S. Department of Health & Human Services, about 116,830 people are in need of an organ transplant to survive and a large number of them are active on the waiting list.

What is Liver Transplantation?

Liver donation and transplantation is one of the extensively used technique to replace a diseased liver and involves a major surgery. Since the liver is one of the vital organs in our body, that is, we cannot survive without it, various liver diseases may reduce its functioning resulting into poor health and death. A liver transplantation can help in saving lives by restoring its normal functioning after the transplantation. The first liver was transplanted by Starzl et al in 1963 with a very low success rate, but medical advancements and solution to the technical problems have made the process more rewarding. In 1989, the reported life expectancy became one to five years in 1,179 patients who underwent the transplantation surgery.

Types of liver donor

It all depends on the type of donors, that is, living or dead, liver donors can be grouped into two categories.

 Living-Donor liver transplantation

A living donor liver transplantation involves removing a part of a liver from a living person and transplanting it into a person in need of it. It is usually done in children who may need a small part or graft of a healthy liver. The donor and the receiver have the capability of growing the part of liver into a full grown organ. In both the people, the liver starts functioning well in a short duration of time. Living donors may also reduce the waiting time involved in obtaining a transplantation on the basis of the national waiting list and may save a life. Anyone can become a donor, although a written consent is needed if the donor is below 18 years of age.

Deceased-donor liver transplantation

A liver can also be transplanted from a deceased donor who had a fully functional and healthy liver before their death. The transplantation can be done regardless of the age, sex, and race of the donor. The entire liver is taken out within a few hours after the death of a person and is placed in a solution to preserve it. The preserved liver is then transported to the recipient and is transplanted within 24 hours after taking it out from the donor. As the organ cannot survive for too long outside the body, the recipient may be called overnight or urgently for the transplantation surgery.

Advantages of Living donor liver transplantation

Although both living and deceased donor liver transplantation has a high value in saving human lives and increase the life expectancy, there are certain benefits of living donors over the deceased ones.

Reduced waiting time

Obtaining a liver from a deceased donor may involve a waiting time which may sometimes become longer than usual affecting the condition of the recipient. On the other hand, a living donor can quickly donate a part of the liver that can be instantly transplanted to the recipient. The liver is transplanted as soon as it is taken out of the body which reduces the number of complications.

Better liver functioning

It has been observed that the liver obtained from a living donor functions better and lasts longer than the organ obtained from a deceased person. The recovery is usually fast and the recipient has an improved long term outcome.

Saving lives

Living donors may increase the number of liver available for transplantation and reduce the waiting time for people on transplantation waiting list. This saves many lives from severe liver diseases and prevents it from getting worse. Scheduling the transplant before the onset of life threatening complication can prevent worsening of condition due to high waiting time.

Convenient

It is always convenient to have a living donor as the surgery can be scheduled beforehand at a suitable time and place. The donor and the recipient are operated side by side and the transplantation is done in a fast and effective way.

Risks involved in donating a liver

As with any transplantation surgery, liver transplantation may possess certain complications and risks. Even though the transplantations are carried out in a highly controlled environment with specialized surgeons and advanced technologies, it should be kept in mind that the surgery involves grafting the liver and making the new connections for it to work in the new body. Some of the risks include:

Infection

Infection may commonly occur at the incision sites and may worsen if left untreated. Living donors may get an infection at the surgery site that can be easily treated to overcome any health condition.

Bile leakage

Since new connections are made to promote an easy flow of bile, some bile leakage can be seen. Depending on the exact condition, the problem may resolve itself over time or may require the placement of the tube in the liver.

Organ Damage

In rare cases, organ damage may occur due to complications involved in liver donation surgery.

Risks involved for receivers

Liver rejection and failure- According to a publication in NHS Choices, one out of three liver transplantation may experience the symptoms of liver rejection which includes high fever, vomiting, yellowing of the skin, pale stools, itchy skin, abdominal pain, and diarrhea. Most of these cases can be successfully treated with immunosuppressant medicines. In some cases, blood clots may disrupt the flow of blood to the new organ, leading to complete organ failure.

Side effects of anti-rejection drugs

After receiving the liver from the donor, the patient is giving anti-rejection medicines to prevent the body from rejecting the new organ. Such medicines may have side effects such as bone thinning, high cholesterol, high blood pressure, diabetes, headaches, and diarrhea.

Cancer

Although rare, there is a slight chance of developing certain types of cancer among the recipients such as melanoma and non-melanoma skin cancer or cervical cancer. It is advised to attend the follow ups and undertake the screening test to find out any such complications.

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Sources:

https://optn.transplant.hrsa.gov/
https://www.ncbi.nlm.nih.gov/pubmed/25993082
http://www.nhs.uk/Conditions/Liver-transplant/Pages/Complications.aspx