Question 1

Who needs liver transplant?

Accepted Answer

Liver transplant is required for Acute liver failureChronic liver failurePeaditric liver disease When liver failure occurs suddenly within few weeks is called as acute liver failure. Acute liver failure is caused by viruses or drugs cause sudden liver damage and results in brain swelling requiring urgent liver transplant. Chronic liver failure is caused by Hepatitis B, Hepatitis C, alcohol, nonalcoholic fatty liver disease (NASH), autoimmune liver disease, genetic diseases affecting the liver like hemochromatosis and Wilson's disease and diseases that affect the bile ducts ( primary biliary cirrhosis, primary sclerosing cholangitis). Need of liver transplantation in chronic liver disease is decided by MELD score which is calculated based on patients bilirubin, creatinine, INR and sodium. MELD score should be more than 15 in most of cases. Liver transplant also indicated for liver cancers. Peaditric liver disease — liver transplant is recommended for children who have serious liver dysfunction. The commonest liver disease in children for which transplants are done is biliary atresia, and other indication includes metabolic diseases, congenital cholestatic disorders, Alagille syndrome, Hemochromatosis, Alpha-1 anti-trypsin.

Question 2

What are types of liver transplant?

Accepted Answer

Deceased donor liver transplant-worldwide most commonly liver graft is taken from deceased donor; however, only 15-20% transplant in India are from deceased donor. When an individual is declared brain dead by brain dead deceleration committee and his or her family chooses to donate the organs for transplantation. Those who are to receive a deceased-donor organ are registered with the competent authority  that maintains the blood group wise database of individuals listed for a deceased-donor organ. The number of patients waiting for a liver transplant greatly exceeds the number of available deceased-donor livers.   Living-donor liver transplant-involves transplanting a portion of the liver from a related living donor. This is most common type of liver transplantation in India.  The donor's remaining liver regenerates itself and returns to its normal volume and capacity within a couple of months after the surgery. Meanwhile, the transplanted liver portion grows and restores normal liver function in the recipient. Living-donor liver transplant provides an alternative to waiting for a deceased-donor liver to become available. Living donor liver transplant allows the recipient to have transplant on time without potential health complications associated with waiting for transplant.

Question 3

How is Life after liver transplant?

Accepted Answer

After liver transplant patients usually stay in the intensive care unit for a 3-5 days. Doctors will monitor condition to watch for complications and test liver function frequently for signs that new liver is working most of patients are discharged on 5 to 15 days. Success liver transplant and long-term survival depend on cause of liver disease and condition before liver transplant. In general, about 90% of people who undergo liver transplant live at end of one year and 70% for at least five years. No survival difference is found in patients who receive a liver from a living donor and those receive a deceased-donor liver.

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