The liver is the body's largest internal organ, weighing about 3 pounds in adults. It is located below theLIVER TRANSPLANTATION diaphragm on the right side of the abdomen.
The liver performs many complex functions in the body, including:
Liver transplantation is considered when the liver no longer functions adequately (liver failure). Liver failure can occur suddenly (acute liver failure) as a result of infection or complications from certain medications or it can be the end result of a long-term problem. The following conditions may result in liver failure:
Candidates for Liver Transplant
Evaluations by specialists from a variety of fields are needed to determine if a liver transplant is appropriate. The evaluation includes a review of your medical history and a variety of tests. Many healthcare facilities offer an interdisciplinary approach to evaluate and to select candidates for liver transplantation. This interdisciplinary healthcare team may include the following professionals:
You will need to bring all of your previous doctor records, X-rays, liver biopsy slides and a record of medications to your pre-evaluation for a liver transplant. To complement and to update previous tests, some or all of the following diagnostic studies are generally performed during your evaluation.
If specific problems are identified, additional tests may be ordered.
There are two types of liver transplant options: living donor transplant and deceased donor transplant.
Living donor liver transplants are an option for some patients with end-stage liver disease. This involves removing a segment of liver from a healthy living donor and implanting it into a recipient. Both the donor and recipient liver segments will grow to normal size in a few weeks.
The donor, who may be a blood relative, spouse, or friend, will have extensive medical and psychological evaluations to ensure the lowest possible risk. Blood type and body size are critical factors in determining who is an appropriate donor.
Recipients for the living donor transplant must be active on the transplant waiting list. Their health must also be stable enough to undergo transplantation with excellent chances of success.
In deceased donor liver transplant, the donor may be a victim of an accident or head injury. The donor's heart is still beating, but the brain has stopped functioning. Such a person is considered legally dead, because his or her brain has permanently and irreversibly stopped working. At this point, the donor is usually in an intensive-care unit.
The identity of a deceased donor and circumstances surrounding the person's death are kept confidential.
For an orthotopic transplantation, a segment of the inferior vena cava attached to the liver is taken from the donor as well. The same parts are removed from the recipient and replaced by connecting the inferior vena cava, the hepatic artery, the portal vein and the bile ducts.
In a situation where the afflicted liver may recover, a heterotopic transplantation is performed. The donor liver is placed in a different site, but it still has to have the same connections. It is usually attached very near the original liver, and if the original liver recovers, the donor shrivels away. If the original liver does not recover, it will shrivel, leaving the donor in place.
Liver transplants usually take from six hours to 12 hours. During the operation, surgeons will remove your liver and will replace it with the donor liver. Because a transplant operation is a major procedure, surgeons will need to place several tubes in your body. These tubes are necessary to help your body carry out certain functions during the operation and for a few days afterward.
During the operation, a tube will be placed through your mouth into your windpipe (trachea) to help you breathe during the operation and for the first day or two following the operation. The tube is attached to a ventilator that will expand your lungs mechanically. A nasogastric tube will be inserted through your nose into your stomach. The N/G tube will drain secretions from your stomach, and it will remain in place for a few days until your bowel function returns to normal. A tube called a catheter will be placed in your bladder to drain urine. This will be removed a few days after the operation. Three tubes will be placed in your abdomen to drain blood and fluid from around the liver. These will remain in place for about one week.
In most cases, the surgeon will place a special tube, called a T-tube, in your bile duct. The T-tube will drain bile into a small pouch outside of your body so it can be measured several times daily.
The other Organ Transplant Procedures are
Few Major Hospitals for Liver Transplantation are
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