Liver Transplant

Depending on your age and other medical conditions, your doctor might suggest a liver transplant if you’ve developed decompensated cirrhosis or liver cancer.

A liver transplant is surgery to give you a healthy liver from another person. You may get a whole new liver or just part of a new liver. The new liver may come from someone you know. Or it may come from a stranger or a person who’s died.

The waiting time for a new liver may be uncertain and stressful. The sickest patients receive highest priority. Priority is based on the severity of the liver disease as measured by a MELD (model for end-stage liver disease) score. This is simply a score calculated from four different blood tests. It helps liver transplant doctors determine which patients are at greatest danger of dying and should therefore receive transplants first.

The Procedure

A liver transplant is a major surgery that lasts 6 to 8 hours. To do the surgery, the doctor makes an incision (cut) in your upper belly. The doctor removes your liver and all its attachments. Next, they connect the blood vessels and bile duct of the new liver to your blood vessels and bile duct. The surgery is finished by closing the incision with stitches or staples. You will then be taken to the intensive care unit for close monitoring until the doctors feel you are well enough to go to the surgery unit.

After the Procedure

After a liver transplant, regular lab tests are important to check for signs of the body rejecting the new liver. Sometimes liver biopsies are also done to see if rejection is occurring. You can expect to stay in the hospital for 1 to 4 weeks and sometimes longer if there are complications. Your staples will be removed about 3 weeks after your surgery. Before you go home, your healthcare team will give you detailed information about your follow up care. You’ll need to take immune suppressing medicines and be carefully monitored for life. However, the monitoring will reduce in frequency the further out you are from your transplant.

Risks and Side Effects

People who get a liver transplant have to take drugs that suppress their immune system to prevent their body from rejecting the new liver. These drugs have their own risks and side effects, especially the risk of serious infections.

For those who had liver cancer, these drugs might allow any remaining cancer to grow faster than before. This is because the drugs suppress the immune system.

Some of the drugs used after a liver transplant can also cause:

• diabetes
• high blood pressure
• high cholesterol
• weakening of the bones and kidneys
• a new cancer

Liver transplants have been hugely successful in saving the lives of patients with end-stage liver disease. Although complications may occur that will have to be managed, 85 – 90% of patients will survive the first year. Most survive to five years and beyond.