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Dr. Dhiraj Gopal Agrawal, Consultant Medical Gastroenterologist, and Liver Specialist provides a comprehensive overview of liver transplantation, from donor options to post-surgery care.
- What is liver transplantation, and what does it involve?
Liver transplantation involves replacing a diseased liver with a healthy one. The healthy liver can come from either a living donor (often a family member) or a deceased donor who is brain-dead but has a viable liver.
- What are the two types of liver transplants?
The two types of liver transplants are Living Donor Liver Transplantation and Deceased Donor Liver Transplantation. In India, 85% of liver transplants are from living donors.
- Who needs a liver transplant?
Patients with severe liver diseases such as liver cirrhosis (caused by alcohol, fatty liver, hepatitis B or C, autoimmune diseases), fulminant liver failure, or liver cancer may require a liver transplant.
- How is the liver transplantation surgery performed?
The surgery is performed after a thorough evaluation by a multidisciplinary team, including liver surgeons, liver specialists, anesthesiologists, social workers, and psychologists. Both the recipient and donor undergo extensive assessments to ensure suitability for the procedure.
- What is the risk for the donor in a liver transplant?
The risk to the donor is minimal, and the donated portion of the liver typically regenerates within three months.
- What are the success rates and potential complications of liver transplantation?
The five-year survival rate for liver transplant recipients is between 80-90%. Complications can occur in the early or late post-transplant phases, including issues with blood vessels, bile ducts, or bleeding. Post-surgery, it's crucial to follow medical advice, maintain a healthy lifestyle, and continue necessary medications.
- What should be done after a liver transplant?
After the transplant, it’s essential to regularly follow up with your doctor, perform periodic blood tests, maintain a healthy weight, avoid alcohol, and, if hepatitis B-positive, continue antiviral medications.
- What are the common causes of liver cirrhosis that may necessitate a liver transplant?
Liver cirrhosis, a significant reason for liver transplants, can be caused by alcohol abuse, fatty liver disease, chronic hepatitis B or C infections, autoimmune liver diseases such as autoimmune hepatitis and primary biliary cirrhosis, as well as metabolic disorders like Wilson's disease and hemochromatosis.
- Can liver transplantation be a treatment for liver cancer?
Yes, liver transplantation can be a curative option for patients with liver cancer, particularly when the cancer is confined to the liver and cannot be removed surgically.
- How has the success rate of liver transplantation improved over time?
The first liver transplantation was performed in 1963, and since then, there have been significant advancements in the field. Today, the five-year survival rate for liver transplant recipients has dramatically improved to 80-90% due to better surgical techniques, post-operative care, and advancements in immunosuppressive therapies.
- What are some potential complications after a liver transplant?
Complications can be categorized into early and late post-transplant phases. Early complications include issues such as hepatic artery thrombosis, portal vein thrombosis, biliary leaks, or strictures, and bleeding. Even after a successful transplant, patients need to follow strict post-operative care protocols, including regular blood tests and lifestyle adjustments, to minimize risks and ensure long-term health.
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