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When should it be done? of Liver transplant
The liver performs many functions to keep us healthy.
These functions include:
- controlling levels of fats in the blood,
- storing vitamins and minerals,
- breaking down food and turning it into energy,
- and dealing with and breaking down alcohol. It is one of the largest and most complex organs in the body.
A healthy liver can repair itself from infection and from the effect of alcohol or drugs. However, liver cells can be gradually destroyed if too much strain is placed on it. This can cause chronic (long-term) liver disease such as hepatitis, cirrhosis, liver cancer and alcohol-related illnesses.
There are treatments available for the symptoms of liver disease. A transplant will only be considered if these treatments are no longer helpful, or if liver disease is at an advanced or irreversible stage and your life is at risk.
Liver transplants will be considered for patients with the following conditions:
- Acute (short-term) liver disease where the patient has liver failure, including viral hepatitis.
- Chronic (long-term) liver disease such as alcoholic liver disease, biliary cirrhosis, chronic hepatitis, autoimmune hepatitis, some metabolic disorders (wilson’s disease) and sclerosing cholangitis.
The reasons why a certain patient may need a transplant vary and the timing of the procedure is often difficult due to the patient’s condition and because there is a shortage of donors.
Reasons for not doing a transplant may be if the patient is not mentally and emotionally committed to having surgery or if other diseases are present in the body. For example, cancer of another organ, cancer in the liver, severe infection (sepsis), and HIV infection.
A detailed assessment is used to see if a liver transplant is an appropriate treatment and that all other medical treatments have been considered. The assessment will involve various tests such as:
- blood tests,
- to test how your liver is functioning and for any viruses or bacterial infections,
- a liver biopsy, where a small amount of liver tissue is removed to be examined,
- chest X-rays,
- a dental examination (it is important that your gums and teeth are healthy),
- breathing tests, to check how well your lungs are working,
- and an endoscopy, which is an abdominal ultrasound scan that can look at the blood-flow through your liver.
During the assessment you will also be told about the risks and benefits of a liver transplant and have the chance to ask questions.
The assessment will involve a stay in hospital and if it is decided that a transplant is necessary, you will be placed on the waiting list for a suitable donor.
The wait for a suitable donor could be anything from hours to months, even years. A suitable liver will be matched to you by the blood group, height, weight and body size of the donor . When a suitable donor is found, you should be ready to get to the hospital in a matter of hours so the transplant can take place soon after the new liver is removed from the donor’s body. Donated organs can be kept for around 20 hours after they have been removed from the donor.
