Institute of Liver, Pancreas Diseases& Organ Transplantation

Know the facts...

Liver Transplantation

breathes for the patient, and will have a tube in the

windpipe bringing oxygen to the lungs. Once the

patient wakes up and can breathe alone, the tube and

respirator are removed. The patient will have several

blood tests, x-ray films, and ECGs during the hospital

stay. Blood transfusions may be necessary. The patient

leaves the intensive care unit once he or she is fully

awake, able to breathe effectively, and has a normal

temperature, blood pressure, and pulse, usually after

about 3-4 days. The patient is then moved to a room

with fewer monitoring devices for a few days longer

before going home.

The average hospital stay after surgery is 1-3 weeks.

The patient may be required to remain in Bangalore for

up to three months for close follow-up.

The patient will be on immune suppressive medication

for the rest of his or her life to prevent the body rejection

of the new liver.

Acute rejection. Most rejection happens while you are

How long will I stay in hospital after transplantation?

What medications does one need to take after

transplantation?

What are the common complications after a liver

transplantation?

still in the hospital, but it can happen at any time.

Rejection can be treated with drugs. The patient may

need a liver biopsy.

Recurrence of liver disease. The diseases that

damaged your liver in the first place may come back in

the new liver. They can damage the new liver a little bit or

a lot. The disease can often be treated easily, but

sometimes a second transplant is needed.

Cancer. People who have organ transplants are at a

higher risk for some cancers, especially skin cancer.

These cancers may spread faster than they do in

people without transplants. Because of this, the patient

will need to get screened for cancer.

Medical complications. Transplant patients can get

infections, high blood pressure, diabetes, high

cholesterol, thinning of the bones, and become obese.

Lifelong medical follow-up is required. You will be

required to remain in contact with our transplant centre.

Our coordinators will contact you periodically and

advise you about blood tests and follow-up visits. We

will maintain a database of all your laboratory results so

that we can follow you closely and advise changes in

dose of medications over time. We will also advise you

general health checks on your follow-up visits.

What medical follow-up is required after liver

transplantation?

Global Hospitals6-1-1070/1to4, Lakdi-ka-pul,Hyderabad - 500 004.Ph: +91 40 2324 4444 (10 lines)

Aware Global HospitalsSagar Road, L.B.Nagar,Hyderabad - 500 035,Ph: +91 40 2411 11

Hyderabad | Chennai | Bengaluru | Mumbai

Emergency: 040 2324 4444

Specialties:

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Liver Diseases Neurosciences Medical Gastroenterology Therapeutic Endoscopy Bariatric Surgery

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Hepatobiliary SurgeryOncology Critical Care Minimal Access Surgery

And other services

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Cardiac Sciences Multiorgan Transplantation Surgical Gastroenterology Endocrinology Pancreatology

www.globalhospitalsindia.com

Prof. Mohammed Rela, MBBS, MS, FRCS (Edinburgh)Head of Multi-organ Transplantation and HPB SurgeryGlobal Hospitals Group

THE HYDERABAD TEAMDr. Dharmesh Kapoor (Transplant Hepatologist)Dr. Balbir Singh (Transplant and HPB Surgeon)

� Autoimmune liver diseases

Liver transplants are also done for treatment of liver

cancer, acute liver failure and certain bile duct diseases

Most patients return to a regular lifestyle six months to a

year after a successful liver transplant. Eating a healthy

diet, exercising regularly, and taking recommended

medications are important factors to staying healthy.

Nearly 90 percent of liver transplant patients are alive at

one year after their transplant and nearly 75 percent

alive five years after their transplants.

People who have advanced liver disease may have

many of the following problems:

- Jaundice - yellowing of the skin or eyes

- Itching

- Dark, tea-coloured urine

·- Ascites - an abnormal amount of fluid in the abdomen

- Vomiting of blood

- Tendency to bleed

- Encephalopathy - mental confusion, forgetfulness

Most transplant livers come from a donor who has died.

This type of donor is called a deceased donor.

Sometimes a healthy person donates part of his or her

liver for a specific patient. In this case the donor is called

a living donor. All donated livers and living donors are

tested before transplant surgery. The testing makes

sure the donor liver works as it should, matches your

What are the results of liver transplantation?

What are the signs of advanced liver disease or

cirrhosis?

What are the kinds of a liver transplant?

blood type, and is the right size, so it has the best

chance of working in your body.

Adults usually receive the entire liver from a deceased

donor. Sometimes only a portion of a whole liver from a

deceased donor is used to fit a smaller person (split

liver transplantation). In some cases, a liver from a

deceased donor is split into two parts. The smaller part

may go to a child, and the larger part may go to an adult.

Sometimes a healthy living person will donate part of his

or her liver to a patient, usually a family member. This

type of donor is called a living donor. Avoiding a long

wait is possible if a person with liver disease has a living

donor who is willing to donate part of his or her liver. This

procedure is known as living donor liver transplantation.

The donor must have major abdominal surgery to

remove the part of the liver that will be transplanted into

the patient. The amount of liver that is donated will be

about 50% of the recipient's current liver size. Within 6-8

weeks, both the donated pieces of liver and the

remaining part in the donor grow to normal size. Both

types of transplants usually have good results.

If a liver transplant is recommended, the Integrated

Liver Care team will perform a transplant evaluation.

The ILC team consists of a transplant coordinator, a

hepatologist (liver specialist), transplant surgeons,

dietician, physiotherapist and social worker. It may be

necessary to consult other specialists depending on

the recipient's age and health problems.

A social worker assesses and helps develop the

patient's support system, a central group of people on

whom the patient can depend throughout the

transplantation process. A positive support group is

very important to a successful outcome. The social

worker also checks to see that the recipient is taking

Who will evaluate me for a liver transplant at

Global Hospitals?

Did you Know?The Liver is the only organ that can regenerate itself

medications appropriately.

On completion of evaluation, the ILC team discusses

the case in a multidisciplinary meeting and takes a

decision on whether the recipient is suitable for a

transplant.

The liver specialist and the primary doctor manage the

person's health issues until the time of transplantation.

Liver transplantation is a major operation that takes

place only in specialized transplant centers. During a

liver transplantation, the surgeon removes the diseased

liver and replaces it with a healthy one. The diseased

liver is removed through an abdominal incision. The

liver's blood supply (portal vein, inferior vena cava, and

hepatic artery) and the biliary system are all connected

to the new liver after it is placed into the abdominal

cavity. Persons who have liver transplants require

intensive care and close monitoring after their

operation.

After surgery, the patient is taken to the intensive care

unit, is monitored very closely with several machines.

The patient will be on a respirator, a machine that

What is done during a surgery for liver

transplantation?

What does the liver do?

What is a liver

transplant?

Who needs a liver transplant?

The liver is the largest internal organ in your body. The

liver has a lot of vital functions. The liver is necessary for

survival and there is currently no way to compensate for

the absence of the liver.

� It produces bile, a mixture of chemicals, which help

in digestion.

� It helps in breaking down food to turn it into energy.

� The liver also acts as a filter and removes harmful

substances from your blood.

� It makes chemicals that help in fighting infection.

� It makes chemicals that

are important for blood

clotting.

� It stores iron, vitamins

and other essential

substances.

A liver transplant is the process of replacing a sick liver

with a donated, healthy liver. Liver transplants require

that the blood type and body size of the donor match

the person receiving the transplant. Currently about 600

liver transplants are being performed each year in India.

A liver transplant is needed when a person's liver fails to

perform its functions and there is no hope that the

functions will recover with medical treatment. Many

diseases can cause liver failure. The commonest

indication for a liver transplant is cirrhosis (scarring) of

the liver. Common causes of liver cirrhosis are

� Chronic Hepatitis B

� Chronic Hepatitis C

� Alcoholic liver disease

� Fatty liver disease

� Genetic diseases