When is a liver transplant necessary?

~ by Jo Jordan

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A liver transplant, also known as hepatic transplant, provides the only chance of survival for someone whose liver has been destroyed by injury or illness. Surgery provides the organ recipient with a healthy liver so that the body can return to relatively normal functioning. Transplantation may be recommended in the following instances:

Birth defects of the liver or bile ducts (such as biliary atresia, a condition in which the bile ducts inside or outside the liver do not have normal openings)
Liver damage (such as cirrhosis or primary biliary cirrhosis)
Long-term active infection (hepatitis)
Metabolic disorders associated with liver failure (such as Wilson's disease)
Thrombosis (hepatic vein clot)

The liver stores vitamins and body fuels, manufactures plasma proteins, and regulates blood volume. Our largest organ, the liver manages products from normal red blood cell breakdown, and orchestrates their conversion into bile – a thick, digestive fluid that helps break down fats into fatty acids.

The liver also detoxifies poisonous bodily waste into less toxic forms that can be safely excreted through urine.

Because the liver is responsible for such crucial functions, without it life could not be sustained.

How is a liver transplant performed?

A healthy liver is sometimes obtained from a recently deceased donor who has experienced no liver injury during their lifetime. It is vital that the donated liver, or liver segment, be accepted by the patient's body, so liver tissue from a close relative – which is less likely to be rejected by the recipient's immune system – is becoming another accepted option.

The liver has excellent regenerative faculties, so a close family member or friend can donate a segment of his or her liver. Once it is properly transplanted, the segment can regenerate, increasing in size to accommodate the recipient's bodily needs.

Liver transplantation surgery may take up to twelve hours. The diseased liver is removed through an incision in the upper abdomen. The donor liver, or liver tissue, is then attached to the patient's bile ducts and blood vessels.

What are the risks?

Because of the nature of a liver transplant operation, there are major risks for recipients and living donors. During any operation requiring the use of an anesthetic, there is the possibility a patient may react to medication and/or experience problems breathing. Bleeding is also a surgery risk.

Immunosuppressive medications must be taken by the recipient to prevent transplant rejection, which increases the chance of infection. Signs of infection include diarrhea, fever, jaundice, redness, swelling, and tenderness.

Recovery and long-term prognosis

The average recovery period for a liver transplantation is twelve weeks. After consultation with their health care providers, patients are usually encouraged to get back to their normal daily routines as soon as possible.

While transplant rejection and the life-long need for immunosuppressive drugs are serious considerations, liver transplants can save the lives of people who might otherwise die.

Nationally, the overall patient survival rate one year post-surgery is over eighty-six percent, and almost seventy-eight percent after three years.¹

For more information on the liver, please review the liver cleansing overview article, or search for related articles by using the search box.

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Notes:
1. University of California, San Francisco Medical Center, "The UCSF Liver Transplant Service Synopsis," gidiv.ucsf.edu/gi/trhepservice.pdf (accessed November 2, 2007).