Introduction:
In modern day surgical practice, transplantation of organs and tissues has been serving to cure medical illnesses in vast number of disease entities. Out of all, one of the costliest transplants is the transplantation of the human liver.
The indications and contraindications:
The surgery involves the transplantation of a complete liver or a part of the liver obtained from a living donor or else from a cadaver, into a patient who suffers from irreversible liver damage who do not possess absolute or relative contraindications. Thus, patients with cirrhosis of the liver and liver cancer who do not have active infections, persisting alcoholic behavior, cancers outside the liver and other co-morbid conditions are considered for transplant. Due the older age as well as heart and lung complications, certain individuals may not be eligible to undergo this type of surgery and are considered ‘relative contraindications’. But in instances where the positive aspects of the transplant may outweigh the risks involved, these patients will also be considered to undergo liver transplant.
The process of liver transplant:
In the process of transplant, the existing liver will be removed from its original place through an incision in the upper abdomen following severing the blood vessels, bile duct as well as the ligaments of the liver. Following removal, an allograft liver will be placed in the same position and the blood vessels as well as the common bile duct will be reconnected to the new liver. Soon after the liver transplant, the patient will be started on immune-suppressive treatment since similar to any other transplant, the liver will also undergo rejection from the human body.
Apart from complete liver transplant, a part of the liver can also be transplanted and this is performed mainly in infants or in children. The principle is to graft the allograph liver into the recipient and following its establishment to remove the damaged or non functioning liver from the same.
Factors for success:
The liver seems to possess an important characteristic by which it’s able to grow after transplanting into a recipient. This is same for a living donor in which the liver will try and re-grow to compensate for the section that was removed. Apart from this, the liver can build its own resistance towards rejection using certain chemicals and cells. Thus, it’s less prone for rejections and has been seen to accommodate more as time passes than any other transplant organ.
Prognosis:
Following a liver transplant, the research have shown that a recipient can have almost 60% of chance of 15 years of survival and this has shown to be improved with modern day surgical practices as well as treatment options.
