A liver transplant is the surgical replacement of a patient’s diseased liver that no longer functions properly with a healthy liver from a donor. Liver transplant has been credited as a revolutionary procedure for the treatment of various kinds of liver diseases such as cirrhosis, chronic liver failure, or liver injury. The liver is the largest and one of the most critical organs of the body that is responsible for more than hundreds of metabolic processes for the healthy functioning of the body. When the liver loses its ability to perform metabolic activities, it is called liver failure and transplant surgery is an option for such patient. Liver transplant surgery in Turkey is a safe and effective operation performed as per the international guidelines and nation transplantation protocols. The top hospitals routinely offer this life-saving surgery to international patients from all parts of the world.
A lot of people have concerns about the success rate and survival rates of liver transplant surgery. This article addresses what to expect during and after liver transplant surgery to help patients understand and prepare before the operation.
Why is a liver transplant done?
A liver transplant is done in case of liver failure, which means the liver has lost majority of its functions. Chronic liver failure can occur due to various conditions but the most common one is cirrhosis (scarring of the liver tissues). Some other common causes of chronic liver failure or scarring are following:
- Viral infection by Hepatitis B virus (HBV) and Hepatitis C virus (HCV)
- Alcoholic liver disease
- Accumulation of fat resulting in fatty liver disease
- Genetic disorders such as hemochromatosis and Wilson’s disease
- Bile duct diseases
- Liver cancer
A liver transplant will be considered by the surgeons only when no other treatment shows results.
Survival rates of liver transplant
Predicting the exact survival period after the surgery is complex due to various complications and factors that influence the survival rate. A study states that people who have undergone liver transplant surgery have an 86 percent chance of survival after one year. Here is a list of survival rates by years:
- The survival rate after one year is 86 %
- 78 percent of patients live up to 3 years after the surgery
- 72 percent of patients live up to 5 years after the surgery
- 53 percent of patients live up to 20 years after the surgery
Though the survival and success rate of a liver transplant is higher, the chance of an individual surviving after the surgery depends on various critical factors including :
- Age
- BMI (body mass index)
- The overall health of a person before the surgery
- The severity of chronic conditions
- Cause of liver failure
- Medical history of the patient
Age and body mass index
Age and BMI play a pivotal role in governing the survival rates of a liver transplant. According to a study published in 2017, older people and people with above-normal BMI have lower survival rates.
Wait for the donor match
You have to understand the survival rates are bound to change based on the patient’s condition. However, finding the right donor match and following proper care after the surgery has a positive influence on the success rate of the transplant.
Finding or waiting for the right donor is a stressful process. Once you are approved for a liver transplant, you will be on the waiting list for a suitable donor. The waiting period may extend to more than 5 years to find the perfect match. The severity of liver failure is measured based on a model for end-stage liver disease (MELD) score for adults. Patients with higher scores are sicker and are placed higher. The MELD score is updated regularly to update the position of the patient.
The liver graft might come from a deceased donor who died with a healthy liver. This liver graft taken from the donor can be used for treating two patients (split liver transplantation). The right lobe is used for adult patients while the left lobe is mostly used for children. Liver segments can be obtained from a living donor for transplant of the infected area.
As liver has the unique ability to regenerate itself, a part of healthy liver can be taken from a living donor and transplanted into the patient. The recipient and donor undergo a series of tests to determine compatibility and tissue matching.
Procedure
A liver transplant is the replacement of diseased liver with healthy liver or its segment. The liver transplant surgery is done under general anesthesia. The steps followed during the procedure are as follows:
- The surgeon makes an incision across your abdomen to reach the liver.
- The site of the incision depends on the anatomy of your body.
- The surgeon then removes the diseased liver and replaces the donor’s liver.
- Once the graft is placed, the incision is closed.
- You will be taken to the intensive unit care following eight to ten hours long surgery.
Recovery
The period after the liver transplant is crucial to prevent failures and reduction in success rates.
- You will stay at the intensive care unit while the doctor monitors your improvement and results.
- Frequent tests will be performed to evaluate the functions of the liver and to find out any signs of infection or rejection.
- Even after you get discharged, frequent tests will be performed to analyze the new liver.
- Several medications will be administered to support acceptance of the liver. Immunosuppressant drugs are given to prevent your immune system from attacking the new liver and result in graft-host rejection.
The recovery time will range between 6 months to one year based on the age and condition of the patient. Lack of proper care during the recovery period may lead to the formation of infection, GVHD, or any other complications, ultimately failing transplant.
Complications of liver transplant
- Bleeding
- Blood clots
- Infection
- Transplant failure
- GVHD
- The leak of bile ducts
Bottom line
Liver transplant surgery is a relatively safe procedure with good survival and success rates. However, a wide array of factors including overall health, habits, medical conditions, age, the surgeon, and the clinic at which surgery is performed influence the success rate of surgery.