Who needs a liver transplant?
People with liver failure often need to undergo Liver Transplant. Liver failure can be acute (liver fails over few days to few weeks) or chronic (liver fails over many years, also known as liver cirrhosis).
What are the causes?
The most common cause of chronic liver failure or cirrhosis is non-alcoholic steatohepatitis (fatty liver disease). Other common causes are alcohol abuse and some viral infections like Hepatitis B and C virus infections. Some cases of cirrhosis can be caused by genetic and metabolic disorders.
Acute liver failure is most commonly due to some drugs, poisons, and infections.
Is liver failure preventable?
Many cases of liver failure can be prevented. Fatty liver disease, alcohol, and Hepatitis B and C virus infections cause almost two-thirds of all cases of cirrhosis. These are potentially preventable by following a healthy lifestyle and getting vaccinated against Hepatitis B.
Hepatitis C infections can be screened by simple blood tests and can be treated successfully with medicines.
Acute liver failure can be prevented by avoiding indiscriminate use of medicines. A lot of drug-induced acute liver failures are due to the use of alternative medicines, and hence, medicines should be taken only on the advice of registered medical practitioners.
Can children undergo liver transplantation and what is the upper age limit for a transplant?
There is no lower age limit for liver transplantation. Many genetic and metabolic diseases will require children to undergo a life-saving liver transplantation procedure within a few weeks of birth. They have successfully transplanted children less than 5 kilograms weight, at Apollo Hospitals, Hyderabad.
Nowadays, liver transplantation is also routinely carried out in the elderly. Patients with liver disease need to undergo a battery of investigations to assess their fitness to undergo liver transplantation. If found fit, they can undergo transplantation successfully. The oldest patient to be transplanted at Apollo Hyderabad was 72 years old at the time of transplant. He is 75 years old now.
How successful is liver transplantation?
Nine out of 10 patients who undergo a liver transplant are expected to live a healthy life at the end of a year. More than 75 per cent of patients will be healthy even after five years and long term survivors are quite common.
How is life after liver transplantation?
Liver transplant patients lead a normal and healthy life after the transplant. Children go back to their regular school and people get back to work within three to four months of the transplant. There are some restrictions and precautions, mostly related to prevention of infection. And, they are asked to take medicines throughout their life. These medicines ensure that the liver is not rejected by the patient’s body and functions normally.
Who can donate Liver?
Liver can be donated after death (cadaveric donor) or a part of the liver can be donated by a healthy person while alive (living donor). In case of the living donor, the remnant liver grows to compensate for the donated part and almost full volume of liver is restored within three months of donation.
Dr. Manish C. Varma M.S (AIIMS, New Delhi),
ASTS Fellowship in Transplantation (Harvard Medical School, Boston)
Adjunct Professor of Liver Transplant and HPB surgery (AHERF)
Head of Department of Liver Transplantation at Apollo Hospitals, Jubilee Hills, Hyderabad