Department of Liver Transplant

FAQ'S

Why choose SHALBY Sanar International Hospitals for Liver Transplant Procedure?

The Liver Transplant Unit at SHALBY Sanar International Hospitals is backed by unparalleled surgical excellence. We use of the finest technology for simplifying the most complex procedures and adhere to stringent quality and safety benchmarks. With fully equipped operation theatres, state-of-the-art intensive care facilities, best-in-class innovations and leading-edge technology, we strive to deliver the best possible outcome for patients. Our transplant team consists of expert liver specialists, transplant surgeons, anaesthesiologists, specialised nurses and medical technicians, all having years of experience in the field.

What is Liver Transplant?

Liver transplant is a complex procedure that involves the surgical replacement of the damaged liver of a patient with a healthy liver, or a part of it, taken from a living or deceased donor. Over the years, liver transplant has helped countless people who had been living with end-stage liver disease, by adding quality and more years to their life. Liver transplants can be performed on adults, as well as children. The procedure is performed under the influence of anaesthesia and can take anywhere between 6 to 12 hours. 

Who needs LTP?

• Liver transplant is typically considered as a treatment option for individuals with advanced liver disease or liver failure. The need for a liver transplant can be determined by various factors:
• Chronic liver diseases: Chronic liver diseases, such as cirrhosis, hepatitis, fatty liver disease, and others, can progress to the point where liver transplant is the only option.
• Acute liver diseases: Certain acute liver diseases, such as acute liver failure, can rapidly progress and cause liver failure, leading to the need for a liver transplant
• Metabolic liver diseases: Metabolic liver diseases, such as Wilson's disease or alpha-1-antitrypsin deficiency, can lead to liver failure and the need for a liver transplant 
• Viral Hepatitis : Viral hepatitis is a term used to describe inflammation of the liver caused by a viral infection. There are several types of viral hepatitis, including Hepatitis A, B, C, D, and E. These viruses can cause both acute and chronic infections and can lead to liver damage, cirrhosis, and liver cancer. The most common transmission routes are through contaminated food or water (hepatitis A), blood and bodily fluids (hepatitis B and C), and poor sanitation (hepatitis E). Treatment options for viral hepatitis vary depending on the type of hepatitis and the stage of the disease, but may include antiviral medications, immunoglobulin, and liver transplant in severe cases. Preventive measures include getting vaccinated, practicing safe sex, avoiding shared needles, and proper hygiene.
• Autoimmune Hepatitis : Autoimmune hepatitis is a chronic autoimmune disease that occurs when the body's immune system mistakenly attacks and damages the liver cells. This leads to inflammation and scarring of the liver, which can eventually lead to liver failure.

It's important to note that the need for a liver transplant is determined on a case-by-case basis, and a liver transplant may not be necessary for every individual with liver disease. The decision to proceed with a liver transplant is made by a team of healthcare providers, including liver specialists and transplant surgeons, after careful evaluation of the individual's medical condition and other factors.

What are the different types of Liver Transplant?

Living Donor Liver Transplant: Living donor liver transplant is a surgical procedure in which a portion of a healthy liver from a living donor is transplanted into a recipient with liver disease. The liver is the only organ in the body that can regenerate, so both the donor and the recipient can expect their livers to return to full function within a matter of weeks after the transplant.

Living donor liver transplant is typically considered when a person with liver disease has exhausted all other treatment options and there is no suitable deceased donor liver available. The procedure may also be performed electively if the recipient's liver disease is not yet at an advanced stage. The living donor undergoes a thorough evaluation to determine if they are  a suitable candidate for liver donation, including physical exams, blood tests, and imaging studies. 

If the donor is cleared for the procedure, they will undergo surgery to remove a portion of their liver, which will then be transplanted into the recipient. The recipient will also undergo a liver transplant procedure, in which their diseased liver is removed and replaced with the portion of the healthy liver from the living donor. After the transplant, both the donor and the recipient will need to stay in the hospital for several days for monitoring and recovery.

Living donor liver transplant offers several benefits, including a shorter wait time for a transplant and the ability to customise the transplant to the specific needs of the recipient. However, as with any major surgery, there are also potential risks and complications, so it's important for both the donor and the recipient to fully understand the procedure and its outcomes before proceeding.

Diseased Donor Liver Transplant : Deceased donor liver transplant, also known as cadaveric liver transplant, is a surgical procedure in which a liver from a deceased donor is transplanted into a recipient with liver disease. The deceased donor liver transplant is the most common type of liver transplant performed worldwide.

Deceased donor liver transplant is typically considered when a person with liver disease has exhausted all other treatment options and there are no suitable living donors available. The procedure may also be performed for individuals with advanced liver disease who are not suitable for living donor liver transplant .

The deceased donor liver is carefully screened and evaluated to determine if it is suitable for transplant . The recipient will undergo a liver transplant procedure, in which their diseased liver is removed and replaced with the deceased donor liver. After the transplant, the recipient will need to stay in the hospital for several days for monitoring and recovery.

Deceased donor liver transplant offers life-saving treatment option for individuals with liver disease. However, as with any major surgery, there are also potential risks and complications, including rejection of the transplanted liver by the recipient's immune system. It's important for the recipient to fully understand the procedure and its outcomes before proceeding with a deceased donor liver transplant.

Dual Lobe Liver Transplant : Dual lobe liver transplant, also known as split liver transplant, is a type of liver transplant procedure in which a single deceased donor liver is divided and transplanted into two separate recipients. This type of transplant is performed when two recipients are in need of a liver transplant, but there is only one deceased donor liver available.
In a dual lobe liver transplant, the liver from the deceased donor is surgically divided into two portions, each of which is suitable for transplant into a separate recipient. The recipient of the smaller portion of the liver, known as the left lateral section, will typically be a child, while the recipient of the larger portion, known as the right lobe, will typically be an adult.

Both recipients will undergo liver transplant procedures, in which their diseased livers are removed and replaced with the portion of the deceased donor liver. After the transplant, both recipients will need to stay in the hospital for several days for monitoring and recovery.
Dual lobe liver transplant offers the potential for life-saving treatment for two recipients with liver disease when there is only one deceased donor liver available. However, as with any major surgery, there are also potential risks and complications, including rejection of the transplanted liver by one or both recipients' immune systems. It's important for both recipients to fully understand the procedure and its outcomes before proceeding with a dual lobe liver transplant.

ABO Incompatible Liver Transplant : ABO incompatible liver transplant, also known as ABO-incompatible transplant or ABOi transplant, is a type of liver transplant procedure in which the blood type of the donor and the recipient are not a match. ABO blood typing is a system used to classify blood into different groups based on the presence or absence of certain antigens on the surface of red blood cells. Traditionally, a liver transplant could only be performed between a donor and recipient with compatible blood types. However, advancements in immunosuppressive treatments have made it possible to perform ABO incompatible liver transplants with a lower risk of rejection.

In an ABO incompatible liver transplant, the recipient is given immunosuppressive drugs to help prevent their immune system from rejecting the transplanted liver. The recipient is also closely monitored for any signs of rejection or complications.

ABO-incompatible liver transplant offers the potential for life-saving treatment for individuals with liver disease who have exhausted all other treatment options and do not have a suitable donor with a compatible blood type. However, as with any major surgery, there are also potential risks and complications, including rejection of the transplanted liver by the recipient's immune system. It's important for the recipient to fully understand the procedure and its outcomes before proceeding with an ABO-incompatible liver transplant.

Paediatric Liver Transplant: Pediatric liver transplant is a surgical procedure in which a liver transplant is performed on a child. It is typically considered when a child has a liver disease or condition that has not responded to other forms of treatment and has progressed to the point where a liver transplant is the only option.

A paediatric liver transplant is a complex procedure that requires careful evaluation of the child and the donor's liver to determine suitability for transplant. The procedure involves removing the child's diseased liver and replacing it with a healthy liver from a deceased or living donor.
After the transplant, the child will need to stay in the hospital for several days for monitoring and recovery. The child will also need to take immunosuppressive drugs to help prevent their immune system from rejecting the transplanted liver.

A paediatric liver transplant offers the potential for life-saving treatment for children with liver disease. However, as with any major surgery, there are also potential risks and complications, including rejection of the transplanted liver by the child's immune system. It's important for the child and their family to fully understand the procedure and its outcomes before proceeding with a paediatric liver transplant.

How to prepare for a Liver Transplant?

• Evaluation: The first step in preparing for a liver transplant is a comprehensive evaluation by a liver transplant team to determine if you are a good candidate for transplant. This evaluation will include a physical exam, medical history review, and various tests, such as blood tests, imaging studies, and a liver biopsy.
• Medical preparation: If you are deemed a suitable candidate for transplant, you may need to undergo various medical treatments or procedures to prepare for the transplant, such as controlling infection, managing other medical conditions, or undergoing a liver cleanse.
• Psychological preparation: A liver transplant can be a stressful and emotional experience, and it's important to have support from loved ones along with a positive attitude. You may also benefit from speaking with a counsellor or support group to help cope with the physical and emotional aspects of the transplant.
• Lifestyle changes: To maximize the success of your transplant and to ensure the best possible outcome, it's important to make healthy lifestyle choices, such as following a balanced diet, exercising regularly, and avoiding alcohol and drugs.
• Finding a donor: In some cases, you may need to find a living donor to provide a portion of their liver for transplant. This can involve a screening process to determine if the donor is a suitable match and to ensure their safety.
• It's important to remember that each transplant is unique and the specific preparation steps may vary based on individual circumstances. Our transplant team will provide you with personalised guidance and support throughout the process to ensure a successful transplant outcome.

What happens during the procedure?

Anaesthesia: Before the procedure, you will receive general anaesthesia to ensure you are completely unconscious and unable to feel any pain during the surgery.
Removal of the diseased liver: The surgical team will make an incision in your abdomen and carefully remove your diseased liver.
Implantation of the new liver: The new liver will then be carefully implanted in your abdomen and connected to your blood vessels and bile ducts.
Monitoring: After the transplant, you will be closely monitored in the Intensive Care Unit (ICU) for several days to ensure that your body is accepting the new liver and that there are no complications.
Recovery: You will need to stay in the hospital for several weeks to recover from the surgery and to receive follow-up care, such as physical therapy and medications to prevent rejection of the new liver.
It's important to remember that liver transplant is a major procedure and recovery can be a long and challenging process. However, with proper care and support, many individuals are able to make a full recovery and enjoy a high quality of life after transplant.

What to expect after the procedure?

• After the procedure you will be kept under observation in the observation room. Once you regain consciousness you will be taken to your room. 
• It is normal to feel pain and discomfort prior to the procedure. This can be managed with the help of prescribed pain medication
• You will need to make certain dietary modifications which will be recommended by an expert dietician 
• You will need to take prescribed medication, which includes anti-rejection drugs. 
• Doctors may recommend some changes in your daily activity level, which are to be followed religiously.

What is a liver transplant?

A liver transplant is a surgical procedure in which a failing liver is removed and replaced with a healthy liver from a deceased donor or a piece of a healthy liver from a living donor. Your liver is your largest internal organ and performs several critical functions, including processing nutrients, medications, and hormones; producing bile, which helps the body absorb fats, cholesterol, and fat-soluble vitamins; making proteins that help the blood clot; removing bacteria and toxins from the blood; and preventing infection and regulating immune responses.

Who needs a liver transplant?

Candidates for liver transplantation often have severe liver illnesses, such as cirrhosis (induced by alcohol, hepatitis, or fatty liver disease), acute liver failure caused by infections or toxins, liver cancer that has not spread, and genetic conditions such as Wilson's disease.

How is the eligibility for a liver transplant determined?

Eligibility is determined by the severity of liver disease (as measured by the MELD or PELD scores), overall health, ability to undertake surgery, and the absence of certain diseases, such as severe heart disease or active substance misuse.

What is the MELD/PELD score?

MELD (Model for End-Stage Liver Disease) is a scoring system that helps adults prioritize liver transplants. On the other hand, PELD (Pediatric End-Stage Liver Disease) is a treatment for children. Higher scores indicate more severe liver disease and greater need for a transplant.

Where does the donor liver come from?

The donor liver comes from two types of donors: deceased donors and living donors.

• Deceased Donors: The majority of transplants use livers donated by people who have passed away.
• Living Donors: A healthy liver from a living person (typically a relative) can be transplanted.

How long is the wait for a liver transplant?

The wait time is determined by factors such as blood type and organ availability, MELD/PELD score and urgency, geographical location, and transplant facility policies.

What exactly happens during the surgery?

During surgery, the diseased liver is removed and a donor liver is implanted in its place. The procedure usually lasts 6-12 hours, and the patient is kept in the hospital for recovery and monitoring.

What are the risks of liver transplant surgery?

The risks of liver transplant surgery are classified into two categories: short-term risks and long-term risks.

• Short-term risks include bleeding, infection, organ rejection, and anesthetic complications.
• Long-term risks include recurrent liver disease, chronic rejection, and immunosuppressant side effects.