Liver transplantation involves surgical removal of the liver, which is no longer functioning properly, and replace it with a healthy liver or part thereof from a donor.
Most donated organs come from registered organ donors, or people whose immediate family members agree that they become a donor. Less commonly, liver transplantation involves a living donor, often a friend, family member or stranger, whose fabric is suitable to the patient.
Typically, surgeons only perform a liver transplant, when all other treatment options are excluded. However, a liver transplant is the second most common type of transplant surgery after renal transplantation, and since 1988 more than 157 000 people were operated on in the United States.
Only 7,100 liver transplants were performed in 2015, and 600 of these operations were carried out for persons aged 17 years or younger.
Although liver transplantation carries the risk of significant complications, the procedure has a high success rate. The surgery usually helps save or greatly extend the life of the people.
Liver transplant survival is over 50% after 20 years. An estimated 72 percent of the people are still alive 5 years after liver transplant.
Because of the many complex factors is virtually impossible to predict a person's chances of a successful liver transplant, or how long they will survive.
However, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) lists the following average survival rates for people undergoing surgery for a liver transplant from a donor who died:
- 86 percent are still alive after a year after surgery;
- 78 percent were still alive after 3 years of operation;
- 72 per cent are still alive after 5 years of operation;
- 53 percent were still alive 20 years after surgery.
While liver transplantation has a high success and survival chance of a person depend on a combination of critical factors:
- body mass index (BMI) and major fluctuations in body weight;
- how healthy a person before the operation;
- the severity of liver failure and amount of other organs, particularly the kidney;
- cause liver failure;
- disease history;
- additional health conditions.
Age and BMI
Age and BMI are two important factors that affect the survival rate after liver transplantation.
A study conducted in 2017 showed that long-term survival in the elderly were lower as well as those whose BMI was above the norm.
The reason for liver failure
According to a study in 2013, the cause of liver failure can affect the outcome of liver transplantation.
The study found that children and adults whose liver failure caused by genetic conditions, have higher survival rates than those whose terms are due to lifestyle choices, or infection.
Waiting for a donor
It is estimated that each year approximately 15,000 Americans are in the queue for a liver donor each year. The process of finding a donor liver can be extremely complex and lengthy stress.
As soon as someone is approved for liver transplant, their physician will contact the non-profit organization United Network for Organ Sharing (UNOS) and will ask the recipient's name was added to the waiting list of the national authorities. Some people have to wait for up to 5 years or longer.
When searching for a suitable donor liver doctors consider several factors, including:
- the severity of liver failure the person;
- blood type;
- general state of health of the person;
- the size of the human body;
- the availability of matching organs in the national system of expectations.
How many people are waiting for organ
On average, about 15,000 Americans are estimated to annually get on a waiting list for a liver donor.
While the number of people requiring a liver transplant, increasing the number of new donors vicissitudes reduced.
The number of people dying while waiting for a donor liver or removed from the queue, because they were too sick to undergo treatment, also increased by 30 percent over the last decade.
Liver transplantation generally includes surgical excision of any diseased, dead or damaged hepatic tissue, including the removal of an entire organ. The surgeon then again be connected whole donor livers or liver segment deceased donor.
Segmental liver transplantation allow the use of living donors and for two people receiving transplants from a donor liver. However, this procedure is a higher risk because of the more frequent complications.
In 2013, 96 percent liver transplantation dead donor liver was used, and only 4 percent of used segments from a living donor.
Liver transplantation - this is a serious operation that involves several risks and potential complications, depending on the severity, including:
- Blood clots in the hepatic artery, which supplies blood to the liver;
- organ rejection, when the body does not accept donor liver (usually within the first 3-6 months after surgery);
- bile duct leakage or damage;
- bacterial infection;
- hernia or tearing incisions made in the surgery during the healing;
- the failure of the lungs;
- multiple failures bodies;
After surgery, most people remain in intensive care for several days.
Immediately after surgery, most people will be in the intensive care unit (ICU) for a few days. They will remain on a ventilator to help them breathe and to watch closely to ensure that the new liver is working properly.
They will be given immunosuppressive (anti-rejection) to help prevent the destruction of the liver donor. People who have organ transplants must take immunosuppressant drugs for the rest of life.
To many people it takes 2 or 3 months before they feel well enough to return to daily activities. In addition, it can take years for the full effect of the operation, which will be implemented.
Most people who have a donor liver will have to make certain changes in lifestyle to maintain your new healthy liver. These changes include:
- healthy, balanced diet, provided they nutritionist;
- drinking water;
- quit smoking;
- avoid alcohol;
- take all medications as prescribed;
- visits to the doctor;
- Avoid raw or undercooked eggs, meat and seafood;
- Avoid unpasteurized dairy products;
- cutting products which are difficult to digest in the liver, such as fats, cholesterol, sugar and salt;
- Avoid contact with sick people;
- Avoid contact with dirt, wearing shoes, socks, long pants;
- Avoid known allergens;
- avoid contact with reptiles, rodents, insects and birds;
- avoid eating grapefruit and drinking grapefruit juice;
- avoid strenuous activity for the first 3 months after surgery;
- consult your physician before using any new OTC medications, vitamins or supplements;
- wear insect repellent;
- avoid swimming in lakes and other freshwater bodies;
- talk to your doctor before planning trips, especially to developing countries;
- talk to your doctor before using contraceptives or trying to conceive.
Infection and rejection
Infection and organ rejection can lead to sepsis, multiple organ failure and death. It is therefore important that people with a donor liver to know how to recognize the signs of potential complications. They should always seek medical help as soon as possible to prevent further complications.
Signs of infection include:
- fever or chills;
- stuffy nose;
- vomiting and nausea;
- sore throat.
Failure of the body does not always cause noticeable symptoms, but the symptoms may include:
- depletion, regardless of the amount of sleep;
- yellowing of the skin and whites of the eyes;
- abdominal pain;
- very dark urine;
Liver transplantation - is a reasonable safe procedure with good survival. However, many factors can influence a person's chances of successful surgery and to determine how long they live after the operation. These factors include their overall health, lifestyle habits, and additional conditions.
Recovery time proshedschih liver transplantation will vary, but will mean a 3 to 6 months before they can return to daily activities.
As they take immunosuppressive drugs, as prescribed by them, and follow the recommendations, the majority of people can enjoy a good quality of life for decades after the liver transplant.