- Liver functions normally even if 70% of the liver is damaged or removed.
- Cancer patients survive even after large portions of the affected
- liver is removed.
- It usually takes 4 to 6 weeks for the liver to regenerate to 90% of
- its original volume.
- More than half of the normal liver can be removed from liver donor as only 35% of the liver is sufficient for one's body.
Liver disease can be diagnosed early by simple tests
Liver Function Test (LFT):
They are a set of blood test that Indicate the status of the liver include:
- Serum Bilirubin-Increased levels of bilirubin often obstructs the flow of bile or a defect in the liver cells that produce bile.
- Serum Alkaline phosphatase - Elevated levels of this enzyme indicates a biliary outflow obstruction.
- AST (Aspartate Aminotransferase) or SGOT (Serum Glutamic Oxaloacetic Transaminase)
- ALT (Alanine Aminotransferase) or SGPT (Serum Glutamic Pyruvic Transaminase) AST and ALT are elevated during active hepatitis.
- GGT (Gamma Glutamyl transferase)
- LDH (Lactate Dehydrogenase)
- Serum Albumin - Low levels of albumin, are due to decrease synthetic functions of liver
- PT (Prothrombin Time): Prolong PT is indicative of defect of blood clotting due to advanced liver damage
- Viral markers are done for identifying the type of hepatitis(B or C) responsible for liver cirrhosis.
- Ultrasound (USG), Computerized Axial Tomography (CT Scan) or a radioisotope that gives information about the structure of the liver to detect any cancer development.
Why should we consider it?
- Orthotopic LiverTransplantation (OLT) has evolved over the past 35years, and has now become the highly successful therapy for acute and chronic end-stage-liver disease with five years survival rate approaching to nearly 85%.
- The development in surgical techniques. Improvement in anesthesia, perioperative care and access to newer Immuno - suppressant drugs has now resulted In 1year actual survival rate of 90% and 5-8 year survival rate of 75%-80%.
- Although there is a shortage of decreased (Cadaver) donor organs. Living donor liver transplant (LDLT) has emerged as a successful alterative. In this procedure a part of liver is donated by a close relative of the suffering patient which is transplanted in the recipient.
- Liver transplantation in India (Cadaver & LDLT) is turning out to be cost effective as compared to western countries
Selection of recipients and timing of transplant
Selection of patients for transplantation requires consideration of not only medical criteria, but also the socioeconomic and educational background of the family. This is of primary importance because in addition to the Initial expenditure, of transplant surgery it also involves a lifelong commitment and to adhere strictly to the postoperative care protocol including anti-infection precautions and long-term medication.
The cost involved in the immunosuppresion drugs, which have taken life long by the transplant recipients also has to be explained.
Selection and timing for adults
- The timing of liver Transplantation is dictated by the natural history of the underlying disease, evidence of decompensation of liver function and quality of life.
- All patients suffering from chronic liver disease who have more than one of the criteria listed below should be referred to a speciality liver care unit.
- Refractory ascites
- One or more episodes of bacterial peritonitis [SBP]
- Serum Albumin level below 3 gm/dl
- Elevated Serum Creatinine levels
- Prothrombin time 5 seconds > control
- Progressive cholestasis of PBC
- Severe Portal Hypertension (GL Bleed)
Living Donor Liver Transplantation:
Advantages of LDLT
- Any patient who has ESLD can be considered for transplant if there is a suitable donor in the family, without being put on a cadaver transplant waiting list
- Patients who cannot wait for a cadaver organ (due to conditions related to the disease) can consider LDLT
- LDLT is an elective procedure, so can be planned well in advance
- There is certain degree of assurance the quality of the liver, as it has been donated by a close relative
Equipments and Facilities at Kamineni Hospital:
- CUSA (Cavitron Ultrasound Surgical Aspirator)
- Argon-Beam Coagulator
- Harmonic Scalpel
- Specialized ICU
- 5 Bedded dedicated ICU for liver patients
1. What are the most common diseases treated by liver transplantation?
- Any patient with End Stage Liver Disease (ESLD) due to any cause
- Common indication*
- Hepatitis B & Hepatitis C related Cirrhosis
- Alcoholic Liver Disease
- Acute or chronic liver failure (Any cause)
- Cryptogenic Cirrhosis
- Liver Cancer
- Only common indications have been listed
2. Is liver transplantation a treatment of last resort?
- Yes, It is a definitive mode of treatment for the most of the patients with End Stage Liver Disease (ESLD)
3. What are the major risks? Important complication would be.
- Intra operative & post operative bleeding
- Non function of the transplanted liver
- Risk of infection (Pre & Post operatively)
- Although less in liver transplant, but changes of acute & chronic rejection should be kept in mind
4. How long does it take to recover?
- In part this depends on how ill the individual was prior to the surgery. Most patients should count on spending a few days an intensive care unit and about four weeks in the hospital, as a minimum.
- In case of LDLT, the donors are discharged within 10 days of the surgery
5. Do recipients of liver transplant need modification in their lifestyle?
- Yes, The consulting doctor is the best person to advice regarding the changes in lifestyle & diet
Appointments at Kamineni Hospitals
Kamineni Hospital provided appointments to hundreds of people a everyday, we prioritized appointments on the basis of medical needs of each patient.
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+91 40 - 3987 9999 (9am to 8pm)
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+91 40 - 6692 4444 (9am to 8pm)
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086 82 272 333 (9am to 8pm)
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