FAQ - Liver Transplantation

1. Who needs a liver transplant?

Anyone with a long-standing (chronic) or sudden onset (acute) severe liver disease leading to liver failure needs to be considered for a liver transplant.
The common diseases requiring transplant are advanced liver disease due to Hepatitis C, Hepatitis B, or alcohol induced damage. The other diseases for which this is done are biliary problems like primary sclerosing cholangitis, primary biliary cirrhosis and biliary atresia (children), metabolic diseases, and primary liver cancer.

2. What are the symptoms of liver disease?

Mild or moderate liver disease may cause no symptoms at all.
Severe liver disease causes water retention (swollen ankles, water in the abdomen or ascites), loss of energy and weakness, jaundice, blood vomiting or black stools, drowsiness, confusion or some behavioural changes, and repeated infections especially in the abdominal fluid (ascites).
The common abnormalities in the blood tests are low blood counts (Hb, TLC, platelets), prolonged prothrombin time, low serum albumin and increased serum bilirubin. In advanced stages, serum sodium and creatinine are also affected.

3.What is the procedure for proceeding with liver transplant?

 Dr. Subash Gupta who will assess the need for a transplant, your fitness for it and counsel you regarding all aspects of the procedure.

If a transplant is thought suitable, you will then need a suitable donor from the family. The other option is to wait for a cadaveric organ (organs donated voluntarily by families of brain dead patients before artificial life support is withdrawn) but that wait can be very long since the cadaveric organ donation rates in India are very low.

4.Who can be a liver donor?

For living donation, the person must be a close relative aged between 18-55 years, have a matching blood group, and weigh between 50-90kg (110 - 198 pounds).

5.Is liver donation safe?

Liver donation is very safe since the liver has great reserve and regenerates to its original size quickly (within 2-3 months) after a part of it is removed. The donor suffers from no long-term effects, does not have to take any medication beyond 2-3 weeks, and is back to normalcy in a month. He/she can resume strenuous physical activity (weight lifting etc) in 3 months

6.What is the success rate of liver transplantation?

The success of the transplant procedure depends on the expertise available at a given centre. In most well established centres across the world including Dr. S.Gupta's Unit at Indraprastha Apollo Hospitals, Delhi, when a liver transplant is performed before the patient becomes too ill with liver disease, it is successful in more than 90% patients and gives an excellent quality of life with a normal life expectancy for age.

7.Are life-long medicines necessary after liver transplant?

Yes, but the number of medicines and the doses decrease with passage of time. Most patients are only on small doses of 1 or 2 medicines at about a year after transplant, and down to a single medicine in 2-4 years which needs to be taken life-long.

8.After a liver transplant, does a person have high infection rates and lead a very restricted life?

This is not true. Although such persons do have a higher susceptibility to infection than usual, this rapidly diminishes by 3-6 months after transplant when the doses of the immunosuppressive medicine are reduced. So they have to be a little cautious initially, but later, even though the infection rate remains a little higher, this does not interfere with normal daily activities. The infections that do occur can be treated easily in most cases.

Source: Apollo Hospitals