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Liver Transplant: All you need to know – procedure, efficacy and myths

With the right candidate for the transplant and the procedure being done at the right time, the success rate of the procedure can be very high.

Written by : TNM

Shruti, a five-year-old girl from Nagercoil, suffered from a chronic health issue that prohibited her from living a typical preschooler's life. She had Primary Hyperoxaluria, a rare kidney condition caused by an enzyme shortage.  She had several kidney stones, a high creatine level, and deteriorating kidneys as a result of her disease.  

After reviewing her case, the doctors decided to do a liver transplant to prevent her kidneys from failing. Her mother donated a part of her liver and a live liver donor transplant was done. Shruti made a speedy recovery. 

The transplant has given the young girl a new lease of life. Shruti's kidneys have improved dramatically in the three months since her surgery. She is now in kindergarten and experiencing the joys of childhood. 

Dr Swaminathan Sambandam, Lead – Multi-Organ Transplant, Kauvery Group of Hospitals says that with the right candidate for the transplant and the procedure being done at the right time, the success rate of the procedure can be very high. Dr. Swaminadhan also spoke to us about the myths surrounding the transplant and its efficacy. 

Q: What is the Liver and its importance?

The liver is the largest solid organ in the body, and it is positioned in the right upper region of the belly, directly below the diaphragm. The liver is vital to the body’s metabolic, detoxification, and immune system functions.

Q: What is a Liver Transplant?

A: Liver Transplant, a surgical procedure is a highly specialised treatment that is done to place a healthy liver from a deceased or a live donor into a person whose liver no longer functions properly. Its most often done for end-stage liver disease and acute liver failure. 

Q: What are the types of Liver transplants?

A: There are three types of Liver Transplant.

Cadaver Transplant:

It is the most common type of liver transplant where the whole liver is taken from a recently deceased donor.

Living donor Transplant:

A living-donor liver transplant is a surgery in which a portion of the liver from a healthy living person is removed and placed into a person whose liver is not functioning properly. 

Split Liver Transplant:

In this procedure, the donated liver is split between two patients. This is commonly done when recipients are an adult and a child waiting for a liver transplant. 

Q: How much of a portion of the liver is needed from a live donor?

The amount of liver required for the patient is determined by their body weight.  A typical adult's liver weighs between 1 and 1.4 kilogrammes. Two-thirds of a liver can be safely removed without causing any harm to the donor. An individual weighing 60 kilograms, for example, would require approximately 480 grammes of liver. That is the absolute minimum. 

Q: How long does it take for the liver to regenerate after transplant?

A: The liver is the only visceral organ that can regenerate. Within a few months of surgery, a donor's remaining liver regrows and returns to normal size and capacity. As the patient recovers, the transplanted liver component grows and gains significant volume, restoring liver function.

Q: What happens during a liver transplant?

A: The liver transplant is performed under general anaesthetic. A team of doctors works on both the donor and the patient getting the liver transplant at the same time. To gain access to the liver, a large incision is made across the abdomen. The surgeon removes the non-functional liver and inserts the donated liver into the recipient's body. It takes roughly three to four hours to remove the liver and another four hours to replace it. The entire procedure takes roughly 12 hours.  

Q: What causes liver damage?

A: Many different diseases and conditions cause liver failure. Some of the common causes include: Hepatitis B, Hepatitis C, Non-alcohol related fatty liver disease and Cirrhosis

Q: What does Cirrhosis mean?

A: Cirrhosis is the scarring of your liver caused by long-term harm, such as heavy alcohol consumption over time or chronic hepatitis infection. The liver's capacity to operate deteriorates as scar tissue replaces healthy liver tissue.

Q: What contributes to fatty liver disease?

A: People develop fatty liver at some point that they are unaware of, and it can last for several years until it progresses to cirrhosis or fully ruins the liver. This is evident in people with diabetes, high cholesterol, a sedentary lifestyle, poor diet, and obesity, all of which are risk factors for developing fatty liver disease.

Q: Who qualifies for a living donor liver transplant?

In India only family members can be a potential donor.  Legal documents, government-issued IDs are used to establish the link.  Every week, a legal government committee convenes a meeting where donors' documents are scrutinised and approval for live donor liver transplant is granted. The donor should be between the age of 18-55 and medically fit to donate the liver. There should be no coercion or money involved in a live liver donor transplant. 

Q: What is the postoperative period for a donor?

A: The donor is hospitalised for 5-8 days following surgery. The donor will be able to move and perform everyday activities normally after discharge. They are advised to resume work within 3 weeks. Since the donor operation is done via a key hole surgery the hospital stay is reduced along with speedy recovery and less pain. 

Q: How are patients waitlisted for Liver Transplant in Tamil Nadu?

A: Patients are listed on the state transplant data managed by a legal government committee. The liver is distributed in rotation to all centres in the state. Based on the severity of the patient's condition a liver is allocated. The waiting period varies between three months to one year depending on blood group and several other factors. 

Q: What is the cost of the Transplant?

A: A liver transplant would cost around 20-25 lakhs depending on the centre. At Kauvery Hospital, we provide world-class facilities to our patients at the most affordable price. Most of our transplants are done for free under the Chief Minister’s Health Insurance Scheme. 

Q: What are some of the myths associated with liver Transplant?

A: The most common misconception about liver transplants is that they are unsuccessful. This, however, is not the case. Liver Transplants have excellent outcomes. More than 95% of patients live for several years without complications.  

Q: What does a patient's recovery look like after a liver transplant?

A:  With advancements in technology the recovery time for patients who have undergone a liver transplant has improved significantly. Following the transplant, the patient is transferred to the Intensive Care Unit and monitored for three days. The patient will be in the hospital for another week after this. As a result, most patients will be discharged from the hospital within 10 days. Occasionally sick patients tend to stay a little longer at the hospital.  

Q: Can you share some tips for maintaining a healthy liver?

  • Maintain a healthy weight and exercise regularly
  • • Eat a balanced diet and avoid saturated fat.
  • • Be watchful of alcohol consumption
  • • Get vaccinated against Hepatitis A, B

This article was published in association with Kauvery Hospital.

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