LIver Transplant

Liver Transplant: Procedures, Indications, and Donor Requirements

The liver is the largest and one of the most vital organs in the human body. It performs essential functions such as selecting and storing nutrients from the food we consume, producing necessary proteins, secreting bile acids for digestion, removing toxins from the bloodstream, and synthesizing clotting factors to stop bleeding. Due to these critical roles, liver failure can be life-threatening, and liver transplantation often becomes the only option for survival.

Types of Liver Transplantation

• Cadaveric Donor Liver Transplant: This is the process of transplanting a liver from a deceased individual who has been declared brain-dead and is a registered organ donor.
• Living Donor Liver Transplant: A surgical procedure where a portion of a healthy living person’s liver is transplanted into a recipient, provided that the remaining liver is sufficient for the donor to continue functioning normally.

Requirements for a Potential Liver Donor

• Compatible blood group with the recipient:

• The donor must be physically and mentally healthy
• Aged between 18 and 60 years
• Must have a normal body weight

Conditions That Prevent Organ Donation

• Hepatitis B or C infection
• Alcohol or drug addiction
• HIV infection
• Active cancer diagnosis
• Severe untreated mental disorders
• Abnormal or complex vascular structures

Surgical Techniques Used in Liver Transplantation

1. Orthotopic Liver Transplantation: The most common method where the diseased liver is completely removed and replaced with a healthy liver in the same anatomical position.
2. Reduced and Segmental Liver Transplantation: Typically used for pediatric patients; a portion of the liver is reduced and resized to fit a smaller recipient.
3. Living Donor Liver Transplant: The left lobe of the donor liver is removed and implanted into the recipient. Modern techniques have significantly reduced complications like hepatic artery thrombosis.
4. Heterotopic Liver Transplantation: The new liver is implanted without removing the native liver. Often used in high-risk patients to gain time and support partial liver function.
5. Split Liver Transplantation: A single donor liver is split into two parts to serve two recipients, often one adult and one child.

When Is Liver Transplantation Needed?

• Severe bleeding from esophageal varices
• Uncontrollable fluid accumulation in the abdomen (ascites)
• Liver cancer (hepatocellular carcinoma)
• Hepatic coma or encephalopathy

Liver transplantation is a complex but life-saving procedure. At experienced centers, donor survival rates approach 100%, and one-year survival rates for recipients can be as high as 80-90%.