Liver transplant
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Definition
Liver transplant is surgery to replace a diseased liver with a healthy liver.
Alternative Names
Hepatic transplant; Transplant - liver
Description
The donated liver may be from:
- A donor who has recently died and has not had liver injury. This type of donor is called a cadaver donor.
- Sometimes a healthy person will donate part of his or her liver to a patient. This kind of donor is called a living donor. The liver can regrow itself. Both people usually end up with fully working livers after a successful transplant.
The donor liver is transported in a cooled salt-water (saline) solution that preserves the organ for up to 8 hours. The necessary tests can then be done to match the donor with the recipient.
The diseased liver is removed from the donor through a surgical cut in the upper abdomen. It is placed into the patient who needs the liver, and attached to the blood vessels and bile ducts. The operation may take up to 12 hours. The patient will have to receive a large amount of blood through a transfusion.
Why the Procedure Is Performed
When your liver is healthy it performs more than 400 jobs each day, including:
- Making bile, which is important in digestion
- Making proteins that help with blood clotting
- Removing or changing bacteria, medications, and toxins in the blood
- Storing sugars (glycogen), fats, iron, copper, and vitamins
The most common reason for a liver transplant in children is biliary atresia.
The most common reason for a liver transplant in adults is cirrhosis. Cirrhosis is scarring of the liver that prevents the liver from working well. It can worsen to liver failure. The most common causes of cirrhosis are:
Other illnesses that may cause cirrhosis and liver failure include:
Liver transplant surgery is not recommended for patients who have:
- Certain infections, such as tuberculosis or osteomyelitis
- Difficulty taking medications several times each day for the rest of their lives
- Heart, lung, or liver disease (or other life-threatening diseases)
- History of cancer
- Infections such as hepatitis that are considered to be active
- Smoking, alcohol or drug abuse, or other risky lifestyle habits
References
Ahmed A, Keeffe EB. Current indications and contraindications for liver transplantation. Clin Liver Dis. 2007;11:227-247.
Martin P, Rosen HR. Liver transplantation. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier;2010:chap 95.
Review Date: 5/4/2010
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Alternative Names
Hepatic transplant; Transplant - liver
After the Procedure
If you received a donated liver, you will likely need to stay in the hospital for about 3 - 7 days. After that, you will need to be closely followed up by a doctor and have regular blood tests for 1 - 2 months.
The recovery period is about 6 - 12 months. Your transplant team may ask you to stay close to the hospital for the first 3 months. You will need to have regular check-ups, with blood tests and x-rays for many years.
Outlook (Prognosis)
People who receive a liver transplant may reject the new organ. This means that their immune system sees the new liver as a foreign substance and tries to destroy it.
To avoid rejection, almost all transplant recipients must take medicines that suppress their immune response for the rest of their lives. This is called immunosuppressive therapy. Although the treatment helps prevent organ rejection, it also puts people at a higher risk for infection and cancer.
If you take immunosuppressive medicine, you need to be regularly screened for cancer. The medicines may also cause high blood pressure and high cholesterol, and increase the risks for diabetes.
A successful transplant requires close follow-up with your doctor. You must always take your medicine as directed.
References
Ahmed A, Keeffe EB. Current indications and contraindications for liver transplantation. Clin Liver Dis. 2007;11:227-247.
Martin P, Rosen HR. Liver transplantation. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier;2010:chap 95.
Review Date: 5/4/2010
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Alternative Names
Hepatic transplant; Transplant - liver
Risks
Risks for any anesthesia are:
- Problems breathing
- Reactions to medications
Risks for any surgery are:
- Bleeding
- Heart attack or stroke
- Infection
Liver transplant surgery and management after surgery carry major risks. There is an increased risk of infection because you must take medications that suppress the immune system to prevent transplant rejection. Signs of infection include:
- Diarrhea
Drainage
Redness
Swelling
Tenderness
References
Ahmed A, Keeffe EB. Current indications and contraindications for liver transplantation. Clin Liver Dis. 2007;11:227-247.
Martin P, Rosen HR. Liver transplantation. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier;2010:chap 95.
Review Date: 5/4/2010
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Review Date: 5/4/2010
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.