The first and most important assessment is to see if you really need a transplant. If your doctor has recommended a liver transplant, you have the option of choosing your own transplant center or going to the one recommended by your doctor. Consider the following factors while selecting a transplant center:-
- Examine the amount and types of transplants that the center has performed.
- Compare the costs of the transplant with those of numerous other centers, as well as if the center has been upgraded with current and updated technology, to choose the best option at an accessible price.
- Don’t forget to inquire about additional services such as local stay lodging, transportation options, medicine availability, and so on.
The next step, as indicated by your doctor, is to have a few particular tests and procedures performed, such :
- Blood, urine, and stool tests are used to evaluate the health of your organs, including the liver.
- Cardiology tests are used to determine the state of your heart.
- Imaging tests, often known as ultrasounds, are used to examine your liver.
- A basic checkup to see if there’s anything else going on in your body that could affect the transplant.
- Nutritional guidelines, including a balanced food chart, to guide you before and after the transplant, as well as a supportive family to care for you and assist you in your recovery.
- Psychological and addiction counseling can assist you in overcoming depression, anxiety, and tobacco or alcohol abuse.
- Last but not least, a financial check to ensure that you are financially qualified to meet the cost parameters set forth.
The Waiting List Process:
Doctors use the results of the tests and procedures to assess the severity of your illness and, as a result, evaluate whether you need a liver transplant right away and your place on the liver transplant waiting list, which is decided by two scoring systems.
MELD (END-STAGE LIVER DISEASE MODEL) FOR ADULTS AND PELD (PEDIATRIC END-STAGE LIVER DISEASE MODEL) FOR CHILDREN UNDER THE AGE OF 12. A high MELD score indicates that you require a transplant right away. The MELD scores are significant because they summarize the likelihood of death within 90 days of a transplant.
Donors:
Because finding a living donor is difficult, most come through a bloodline or a friend. Living donor liver transplants are most commonly performed on children, but their high success rates have allowed adults, particularly those with end-stage liver disease, to benefit from this novel treatment.
A living liver donor can donate a section of the liver and still live a healthy lifestyle because both the donor and the recipient have a full-grown sized liver after the transplant, whereas a deceased donor’s liver can be ruptured and used by two people because a healthy liver has two lobes, one of which is about 60% and the other 40%.
Above all, the safety of the donor and recipient is paramount, as both should be of appropriate blood group type, age, and organ size, and the donor is prepared to donate without hesitation or selfish intent. If the outcomes of all of these courses of action are positive, a surgical date is set and confirmed. The risk factor for the donor is the same as it is for the transplant recipient.
It is frequently observed that acceptable deceased donor organs for children are in short supply.
The intensive care unit (ICU) will be your first stop after surgery until you regain consciousness and are able to breathe on your own. Throughout your ICU stay, you will be kept under continual supervision because your blood pressure, internal fluids, and electrolytes might all be significantly off. Immunosuppressive agents, or medications, will be infused into you to make your body less likely to reject a transplanted organ by weakening the immune system, and the dosage of the drugs will be changed accordingly.
After you regain consciousness, you will be transported to an inpatient ward where you will be monitored closely and the tubes that have been implanted in your body will be kept in place for the next few days. At the time of discharge, your family member will be given a list of dos and don’ts, as well as recommended drugs to take, as well as an appointment for an overall checkup. It normally takes six months to fully recover, but depending on your condition, you may be able to resume your daily activities or employment within a few months.
When it comes to diet and nutrition after the transplant, it’s critical to eat a well-balanced diet to keep your liver healthy and help it recover quickly. Generally, your diet should consist of low-sugar, low-fat, low-cholesterol, low-salt, and readily digestible foods. The drinking of alcohol should be severely prohibited. A visit to a dietician for a detailed food chart is always recommended. A brief diet instruction is provided below for your convenience:
- Choosing lightly cooked boiling foods, as well as whole-grain foods, above processed foods.
- consuming a variety of fruits and vegetables, as well as fiber-rich foods
- Instead of fried and richly cooked foods, red meat eaters should opt for chicken and fish.
- Drinking enough water to stay hydrated.
- Grapefruit avoidance can have negative effects on immunosuppressive agents and alcohol withdrawal.
Low-fat dairy products should be consumed to maintain a healthy calcium level in the body.
Exercising
Mild physical activity is always recommended, even after surgery (within a few months), to maintain a physically and mentally fit body. Then, after checking with your doctor, you can begin to include more activities based on your progress.
The procedure’s potential dangers and complications.
The transplant surgery method, as well as the medicines or treatments supplied, include significant risks in order to avoid the donor’s liver from being rejected following the transplant. The following are some of the risks associated with the transplant procedure:
- Biliary tract issues i.e., bile duct leakage and shrinking of bile ducts.
- Hemorrhage
- Coagulum
- Infection
- Rejection and failure of the donated liver.
- Nausea
Although these are short-term effects, long-term consequences include the recurrence of liver problems.
Anti-rejection antidote aftereffect
You will be on drugs for the rest of your life to prevent your body from rejecting the donated liver after the procedure. Anti-rejection antidotes suppress the immune system, which increases the risk of infection. Your doctor may prescribe you anti-rejection antidotes. The following are some of the possible adverse effects: –
- Bone resorption
- Arthritis
- Vomiting
- Anemia
- High blood pressure
- High cholesterol
- Diabetes
- Diarrhea
Transplant surgery is a complicated operation that might make you feel tense and apprehensive, but it can be overcome with the help of family and friends. Seeking assistance from family and friends can help you cope with the circumstance. Choosing a surgeon who excels at what he does and a facility that provides high-quality services, care, and a good environment will aid in your rehabilitation and improvement.
Precaution that need to take before Surgery :
The success of each surgical procedure is determined by the patient’s recovery aftercare and precautions. The doctor’s instructions for postoperative care must be rigorously followed because the therapy would be inadequate if the recovery period is skipped, especially in the case of a transplant procedure that involves extensive surgical interventions.
At the hospital, precautions are taken.
After the surgery, the anesthetic effect will wear off in a few hours, and you will begin to experience pain for which you will be given drugs and pain relievers. The hospital staff will keep a close eye on you, and your diet will be restricted to liquids. Your doctor will give you a list of suggestions, food habits, do’s and don’ts, and the next visit date when you are discharged. It is also ensured that you will be transported back to your house.
Recovery at home
The patient’s primary focus while at home should be hygiene. Cleaning the surgical area with water and dressing it is critical, while keeping in mind that the patient should be maintained in a well-ventilated aery room that is cleaned on a frequent basis. The drugs offered should be taken exactly as prescribed by the doctor, and they must be eaten on time and without delay. Visiting the doctor for an overall checkup on a regular basis is also essential.
Do not expose oneself to substances that may cause or exacerbate infection. Your diet and nutrition should be well-balanced and healthy in order to help you recover quickly, as detailed in the article. Once you’ve fully recovered, you can resume your normal activities. You can exercise to keep your mind sharp by consulting your doctor and following his advice. Avoid heavy lifting, weight training, and swimming. Meditating will not only improve your mood but will also keep your thinking sharp.
What Happens During Laparoscopic Liver Transplant Surgery?
The technique entails the excision of the diseased liver and the nidation of the new organ. Because the organs are linked, it’s critical to re-establish the connections so that the new liver may function properly and healthily. The technique for connecting the veins and tissues differs from person to person, depending on the condition or structural concerns of the recipient, but the basic blood flow and bile drainage from the liver remain the same. The surgery technique is extremely important and entails the insertion of multiple tubes into your body.
Deceased Liver Donor
A liver transplant is normally performed under general anesthesia, which means you will be sedated throughout the procedure. To access your liver, a lengthy incision is created across your belly (the size and placement of the cut depending on your doctor’s recommendation). The damaged liver is then replaced with a liver from a donor. The doctor also makes connections in the veins, blood vessels, and biliary tract. Finally, the incision is sealed with staples and stitches, and you will be transported to an intensive care unit for a faster recovery.
Living Liver Donor
In the case of a living liver donor transplant, the surgical date is usually set in advance. The alive liver donor transplant process is identical to the deceased liver donor transplant surgery. During this procedure, the donor is operated on first to remove a portion of his or her liver for transplant. The surgeon then removes the damaged liver from the patient’s body and replaces it with the donated portion, as well as re-establishing veins, blood arteries, and the biliary tract’s internal connections.
The liver that is left in the donor’s body, as well as the patient’s body, takes many weeks to develop and repair. The surgery takes between 6 and 12 hours to complete.
