Thursday, May 22, 2008

Liver Transplant Information


A liver transplant is surgery to replace a diseased liver with a healthy liver. When a patient receives a liver transplant, his or her entire liver is removed. It is then replaced by either a complete new liver or a portion of a healthy liver. (Once transplanted, a piece of a healthy liver can grow into a normal-size liver.)

In most cases, the new liver or liver tissue comes from a deceased donor. It is becoming more common, however, for patients to receive liver tissue from a living donor, who may be a family member. In this case, the transplant surgeon removes part of the donor's liver and uses it to replace the patient's liver.
In 2005, about 6,500 liver transplants were performed in the United States.
The number of liver transplants performed per year has been increasing steadily for more than 15 years.

When is a liver transplant needed?

Liver transplantation is needed for patients who are likely to die because of liver failure. Many diseases can cause liver failure. The most common is cirrhosis, which is the scarring and death of liver cells. Cirrhosis caused by hepatitis C is the most common reason for liver transplants.

Other conditions that may ultimately require a liver transplant include:
Diseases of the bile ducts, including biliary atresia, primary biliary cirrhosis (PBC) and primary sclerosing cholangitis (PSC), which can cause liver failure if there is a backup of bile in the liver.
Some inherited diseases, such as Wilson disease, in which dangerous levels of copper build up in the body, and hemochromatosis, where the liver is overwhelmed by iron.
Primary liver cancer or cancer that affects only the liver.
Alcoholism which can cause cirrhosis.

Who is eligible for a liver transplant?

There are many more people who need a liver transplant than there are livers available for donation. Patients are examined by a team of specialists to determine if a liver transplant is appropriate and likely to succeed. If so, they are placed on a national transplant waiting list. This waiting list is prioritized so the sickest people always go to the top of the list. About 17,000 Americans are currently on a waiting list for a liver transplant.

What is the average amount of time that patients wait for a donated liver?

The time that people spend waiting for a liver transplant varies widely. Blood type, body size, severity of illness and availability of donor organs all affect waiting time. Some people who develop sudden and complete liver failure from an acute illness may only have to wait a few days for a transplant. Other people, whose condition is less severe, may stay on the waiting list for many months.

Where do donated livers come from?

Livers for transplantation can come from deceased donors or living donors. In both cases, blood type and body size are the most important factors in determining whether a donated liver may be a match for the patient.Deceased donors typically die of accidents or head injuries. Either they have arranged in advance to be an organ donor or their family grants permission for organ donation when the victim is declared brain dead.

In a living donor transplant, a segment of a healthy person’s liver is transplanted into the sick patient. This can be done because the liver is the only organ that can regenerate itself. Both the donated segment and the remaining section of the donor liver will grow to normal size within weeks. Living donors are generally family members or close relatives of the patient.

What happens during transplant surgery?

Liver transplant surgery takes between six and 12 hours. During the operation, doctors remove the diseased liver and replace it with the donated liver. Most patients stay in the hospital for up to three weeks after surgery.

What are the side effects of a liver transplant?

The most common side effects are caused by the drugs that treat or prevent rejection. These side effects can include fluid retention, raised blood pressure, headaches, diarrhea and nausea. The severity of these side effects varies among patients.

What lifestyle changes are associated with liver transplants?

Most patients can return to a normal or near-normal lifestyle six months to a year after a successful liver transplant. When practical, transplant recipients should avoid exposure to people with infections. Maintaining a balanced diet, getting regular exercise and staying on prescribed medications are all important ways to stay healthy.

What is the outlook for liver transplant patients?

The outlook for patients is often expressed as a five-year survival rate. This refers to the percentage of liver transplant patients who are still alive five years after their transplant. The five-year survival rate for liver transplant patients is about 75 percent. Patients who receive livers from living donors have a slightly higher survival rate than patients whose livers came from deceased donors.

What can healthy people do to help people who need liver transplants?

The most important and valuable thing that anyone can do is to register as an organ donor. ALF provides organ donor cards free of charge; just contact Joy Gordon at 212-668-1000 ext. 234 or jgordon@liverfoundation.org. You can also download and print a card at OrganDonor.gov.

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