About Liver Transplantation

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What is a liver transplant? — A liver transplant is a type of surgery in which a doctor replaces a diseased liver with a healthy liver.
Why might I need a liver transplant? — You might need a liver transplant if you have severe liver disease. This is a condition in which the liver does not work the way it should. It can cause symptoms such as tiredness and swelling in the legs and belly. It can also make the skin or whites of the eyes look yellow. This is called “jaundice.” People with some types of liver cancer might also need a liver transplant.Before you have a liver transplant, your doctor will try other treatments. Your doctor will only recommend a liver transplant if no other treatments work.
What happens before I can get a liver transplant? — Before you get a liver transplant, you need to go through several steps.
Since liver transplant is only performed in a small number of specialized hospital you will have to visit a center of your choice where liver transplantation are performed. At the transplant hospital you will be asked some questions, and examined by the transplant surgeon before you are considered for a liver transplantation. You will be asked questions about:-
●Your other medical conditions and medicines you take
●Your lifestyle (for example, alcohol, drug use, or smoking)
●Your family and other support systems
Not everyone who goes to a liver transplant center gets a transplant. To be considered, you must meet certain conditions. For example, you must:
●Have severe liver disease that has not gotten better with other treatments
●Not have serious heart and lung disease, such as COPD
●Not have certain forms of cancer now or in the last 5 years
●Not use alcohol or drugs
●Be willing to take medicines for the rest of your life after surgery
Once it is decided that you  need a liver transplantation and that you are fit to undergo one, you will be explained about the two possible ways to have a liver transplantation, which are either a Deceased donor Liver transplantation, or a Living donor liver transplantation. The decision about which transplant to opt for is not simple and is determined by a lot of medical and social factors. Please refer to my pages on the 2 different types of liver transplantation surgeries.
What happens after a liver transplant? — After surgery, most people stay in the hospital for a few weeks before going home. Your doctors will do tests regularly to make sure that your new liver is working correctly.After a liver transplant, people need to take medicines for the rest of their life. These medicines are called “anti-rejection medicines.” They help the body’s infection-fighting system accept the new liver. Normally, the infection-fighting system helps people stay healthy by attacking objects in the body that came in from the outside (“foreign objects”). Anti-rejection medicines help keep the body from attacking the new liver.
What problems can people have after a liver transplant? — Some people do well after surgery. They can go to work and be active. But other people have problems right after the surgery or a few years later. These problems can include:
●Rejection of the new liver – Even though people take anti-rejection medicines, their body might still reject and attack the new liver.
•Technical problems like blocking off of the blood vessels supplying the liver, or blockage or leak from the bile ducts
●Liver disease that comes back – Some liver diseases can come back after a transplant, though not all do.
●Side effects from the anti-rejection medicines – These medicines have short-term side effects. For example, they increase a person’s chance of getting infections. They also have long-term side effects. For example, they can damage your kidneys or increase the chance of certain types of cancer.
What is the success rate of liver transplantation-? The success rate of liver transplantation depends on a whole lot of factors like your age, how advanced your liver disease is, do you have any other illnesses other than liver disease, is the transplant being done in an emergency or as a planned procedure, the experience of the doctors doing your transplantation etc. Generally on an average experienced centers  around the world like ours have a success rate ranging from 85-90%.
What is the cost of the liver transplant surgery-?The cost of liver transplantation is again variable and depends on a lot of factors like the degree of your illness before the transplant, other illnesses that you might suffer from, the hospital where you get the transplant etc. The cost of a liver transplant at our center ranges between 16-18 lac rupees (24,500USD-27,500USD).
The Author Dr. Abhishek Yadav is a senior consultant liver transplantation and GI surgery at VPS Lakeshore hospital Kochi.