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When Liver Transplant is Needed?

By December 24, 2019 April 17th, 2020 No Comments

Liver Transplant is a procedure in which a non-performing or deceased liver is removed and replaced with a healthy donor liver. This is procedure is used only when the liver disease is in a critical stage and will soon lead to liver failure. The donor liver is acquired either from deceased or from living ones but generally the availability of liver is very scarce compared to the demand. The Liver transplant procedure is highly regulated and this procedure can only be performed in designated medical centers and is done under the guidance of a highly trained transplant physician.

Reasons for Liver Transplant:

As per the recent report published by leading liver foundation, around 8000 liver transplants are to happen every year in the U.S alone. A doctor after due diligence and making the patient undergo various tests, finally recommends liver transplant especially for a person with end-stage liver disease as compared to a person without a transplant. The doctor may also recommend liver transplant if all other possible options have been tried and none have given any fruitful results.

A person with chronic liver disease too may require a liver transplant or if a person’s otherwise healthy liver fails suddenly.

Common reasons for liver transplant:

  1. In adults:
    • Hepatitis B and C
    • Non-alcoholic Fatty Liver Disease
    • Alcoholic liver disease
    • Genetic diseases like hemochromatosis, Wilson’s Every time that affect the liver
    • Diseases like primary biliary cirrhosis, primary sclerosing cholangitis and biliary atresia that adversely affects bile ducts
  2. In children:
    • Liver cancer and other related liver tumors
    • Conditions present during birth like Alagile syndrome or cholestatic disorders
    • Viral Hepatitis
    • Too much Iron development in body that damages organs which are also known as hemochromatosis
    • Alpha 1 anti-trypsin, a condition that in inherited which raises the risk for liver disease
    • Sudden liver failure caused due to autoimmune disease, unknown causes, or an overdose of certain medicines like acetaminophen

Some common and rare conditions that may lead to liver failure and need a liver transplant include complications of liver cirrhosis; Primary biliary cirrhosis and so forth.

Complications of liver cirrhosis:

One of the most common reasons for liver failure in adults is cirrhosis in the liver. Cirrhosis is a type of irreversible scarring that happens on the liver which then leads to various liver-related diseases and conditions. Everytime a liver gets scarred or injured to any causes the liver tries to recover by itself. During such process scar tissue forms. So as this process repeats the number of scars tissue starts increasing which makes the functioning of the liver difficult. As this process keeps happening, the liver functioning continues to deteriorate and from decompensated cirrhosis, it could go to advanced cirrhosis which is even life-threatening.

Following are some of the complications that arise in liver cirrhosis:

  • Abnormal swelling in the abdomen and or other parts like hip, foot, thigh, leg, and ankle
  • Bleeding from varices
  • Hepatorenal syndrome
  • Hypersplenism
  • Hepatic encephalopathy
  • Spontaneous bacterial peritonitis
  • Liver Failure

What causescirrhosis?

  • Alcohol
  • Viral Hepatitis B and C
  • Cystic fibrosis
  • Glycogen storage diseases
  • Alpha-1 antitrypsin deficiency
  • Abnormal liver function
  • Autoimmune diseases of the liver
  • Blockage of the bile duct
  • Repeated bouts of heart failure
  1. Primary sclerosing cholangitis

This liver disease is known by the inflammation and scarring of the bile ducts which generally allows bile to drain from the gallbladder. This a long-term progressive disease of the liver and the patient could have no symptoms which detect yellow discoloration of skin and eyes, abdominal pain and itching. This scarring narrows the duct because of which the bile flow is affected which then leads to cirrhosis of the liver and subsequent liver failure.

  1. Liver cancer

Liver cancer is the type of cancer that starts from the cell of the liver which starts multiplying. There are many types of cancer that form in the liver. The most common type of liver cancer is hepatocellular carcinoma that originates from the main type of liver cell. There are also other types of cancer like cholangiocarcinoma and hepatoblastoma but these are rare. Most of the time cancer ideally spread from other body parts to the liver rather than originating in the liver which is called metastatic cancer.

  1. Autoimmune hepatitis

Autoimmune hepatitis is a type of liver inflammation that happens when your own body’s immune system turns against liver cells. If left untreated, autoimmune hepatitis can lead to scarring of liver i.e. cirrhosis which then could lead to liver failure. The exact cause of Autoimmune hepatitis is vague but genetic and environmental factors tend to trigger the disease over time.

  1. Metabolic diseases

Metabolism is the process that generates energy through food that’s put in the system. But sometimes due to malfunctioning of the liver, this metabolism will not function properly which causes cirrhosis. The most common metabolic diseases are hereditary hemochromatosis, Alpha-I antitrypsin deficiency(AATD) and Wilson Disease. Hereditary hemochromatosis is a condition in which the body stores too much iron which in turn causes liver cirrhosis. Alpha-I antitrypsin deficiency(AATD) is a condition in which the body stores too much protein which in turn causes liver cirrhosis. Wilson Disease is a rare condition in which the body accumulates too much copper which then causes liver cirrhosis

  1. Biliary atresia

Biliary atresia is a childhood disease of the liver in which the bile ducts are unusually narrow, or sometimes blocked or totally absent. The general symptoms in such a condition are neonatal jaundice, pale white stools and dark urine. Some infants fail to thrive this condition and those who do need immediate assistance else this condition could soon result in cirrhosis and subsequent liver failure.

  1. Sudden liver failure

Sudden liver failure is a condition in which the liver functioning starts deteriorating rapidly after the first sign of it like Jaundice. The complications that arise are hepatic encephalopathy and impaired protein synthesis.

Other conditions of liver transplant

Other conditions of liver failure include are:

  • Septic Shock – In this condition, the infection in the liver is so rapid in the body that it causes the liver to fail
  • Budd Chiari syndrome- In this condition, the blood vessels in your liver is narrowed or blocked which if not taking necessary measures could lead to further complications

We provide liver biopsy, liver function tests, an ultrasound, a CT scan or MRI, an endoscopic retrograde cholangiopancreatogram (ERCP), or an endoscopic ultrasound (EUS) to check further liver complications.

Liver care and liver transplantation at Ruby Hall Clinic

Ruby Hall Clinic is home to one of the busiest transplant programs in the country offering all forms of organ transplant under one roof – including liver transplant. Our doctors possess the passion and expertise to evaluate and treat patients with this complex disease, who are typically not considered for liver transplantation elsewhere because of factors, including age, body mass index or disease severity. We assess and treat both adults and children from all over the country and abroad.

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