What is a liver transplant?
A liver transplant is a complex surgical procedure in which the doctor removes a diseased liver from a body and replaces it with a healthy liver taken from the deceased donor, or a portion of liver from a living donor.
The liver is one of the largest internal organs and performs various functions:
Metabolizing nutrients, medications, and hormones
Producing bile
Making proteins that help the blood clot
Removing bacteria and toxins from the blood
Preventing infection and regulating immune responses
A liver transplant is the last treatment option for people who have complications due to end-stage liver disease.
Why is a liver transplant happen?
A liver transplant is the only treatment option for people who have liver failure and the condition can’t be control with other treatments. A liver transplant might also be the only option in some liver cancer cases.
Liver failure can happen quickly or may take a long period of time. Acute liver failure is otherwise very uncommon and can result because of some medication’s side effects.
Although a liver transplant can treat acute liver failure, more than often it is used to treat chronic liver failure. Chronic liver failure takes over the years and months to develop.
Chronic liver failure can be cause by a variety of conditions. The most common cause of liver failure is scarring of the liver, which is called cirrhosis. When cirrhosis occurs, some scar tissues are form which then replaces the normal liver tissue and causes improper functioning. Cirrhosis is the most frequent reason for a liver transplant.
Major causes of cirrhosis include:
Hepatitis B and C.
Alcoholic liver disease, causing damage to the liver due to excessive alcohol.
Nonalcoholic fatty liver disease, in which fat builds causing inflammation or liver cell damage.
Genetic diseases that affect the liver, such as hemochromatosis, causing an excessive iron build-up in the liver, and Wilson’s disease, resulting in an excessive copper build-up.
Diseases affecting the bile ducts (tubes carrying bile away from the liver). These could be primary biliary cirrhosis, primary sclerosing cholangitis, and biliary atresia. Biliary atresia is the most common reason for pediatric liver transplants.
Reasons for why a patient might be decline for a transplant:
Active Alcohol or Drug Use
If a person is on the waiting list for a liver transplant or has a family member who is donating to them, there are a number of tests that will be done on the body before the surgery. These will include an in-depth analysis of the organs and the cause behind the liver failure. Transplant candidates are told to abstain from alcohol and all drugs before the transplant.
These measures are taken to provide efficient post-transplant recovery for the patients.
Also, for the cases where a patient has a failed liver due to alcoholism, the doctor tends to avoid the surgery as they can resume drinking which will harm them again.
Cancer
If a patient has pre-existing cancer in any part of the body, the doctors will first try to manage the malignant condition. This is done in order to preserve the newly transplanted organ in the body.
If previous cancer in the body was malignant, it can metastasize and spread to newer places and organs, undergoing a transplant might not be the best option for the patient.
This is also because if liver cancer has spread, it will get back to the liver through the gall bladder and other nearby organs.
People who are not commit to a better lifestyle
For patients who are unable to follow the instructions and manage their life after a transplant, the chances are lesser to get a transplant done. This is done in order to maintain the quality of life.
A liver transplant is an extensive procedure, and it requires strict follow-ups and a maintained lifestyle after the transplant. If during the evaluation, the doctors think that the patient might not be able to cope with the transplant-related lifestyle, they might deny the transplant to him/her.
No Support System
The aftercare required after a liver transplant is very extensive. Caregivers are necessary for a long duration of time, and the patient might not be able to do a lot of things. These parameters are consider when a family is planning to undergo a transplant for their patient. In cases, where adequate support cannot be provided for the patient after the surgery, the transplant might be denied.
Poor Health
Liver transplant in India is treat only when a patient is healthy. The surgeries are avoid on patients who are obese, smoke, or have otherwise a serious medical condition, and they are not able to manage it. This is because liver transplants in themselves will put a lot of stress on the body, and with the other underlying complications, there can be an elevated risk to life.
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