Liver transplantation is the best treatment modality for patients with end-stage liver diseases. It has been landmarked as one of the most important advances in the medical field. Its applicability is expanding tremendously worldwide, particularly in many Asian countries.
The body’s largest internal organ responsible for controlling immune responses, removing bacteria and toxins from the blood and processing nutrients, medications, and hormones among other critical functions can pose a major threat to survival of a person if damaged or injured.
Laws and Legality:
The implementation of legislation on brain death in Asian countries (Taiwan, Japan, China , Malaysia ,Hong Kong ,India and Korea) from 1987 to 1999 helped propagate the practice of cadaveric liver transplantation (CLT) in Asia.
Various amendments to this act have been passed, under which rules regarding organ donation after brain death were eased.
Current Asian statistics for transplant centers:
Japan has – 352 transplant centers
Thailand – 27 kidney, 6 liver, & 6 Cardiac transplantation centers
Iran – 22 centers most of which are kidney transplantation centers
India – 110 centers for Kidney transplantation, 5 centers for Liver transplantation, 6 Cardiac transplantation centers. Over 35 centers in India have undertaken cadaver transplants
Conditions that may strike a patient off the eligibility list for a transplant:
A person who needs a liver transplant may not qualify for one because of the following reasons:
- Active alcohol or substance abuse- Persons with active alcohol or substance abuse problems may continue living the unhealthy lifestyle that contributed to their liver damage. Transplantation would only result in failure of the newly transplanted liver.
- Cancers in locations other than just the liver weigh against a transplant.
- Advanced heart and lung disease prevent a patient with a transplanted liver from surviving.
- Severe infections pose a threat to a successful procedure.
- Massive liver failure accompanied by associated brain injury from increased fluid in brain tissue rules against a liver transplant.
- HIV infection.
- The inability to follow a treatment regimen.
- A lack of psychosocial support.
Liver transplantation is surgery to remove a diseased or injured liver and replace it with a healthy whole liver or a segment of a liver from another person, called a donor. People with either acute or chronic liver failure may need a liver transplant to survive.
In adults, chronic liver failure due to cirrhosis caused by hepatitis C is the most common reason for liver transplantation in the United States. The second most common reason is cirrhosis caused by long-term alcohol abuse.
In children, biliary atresia is the most common cause of liver failure and the need for a liver transplant.
The process for getting a liver transplant:
- The process for getting a liver transplant begins with referral to a transplant center, where a transplant team carefully evaluates candidates to determine whether they are suitable candidates for transplantation. The transplant center’s liver transplant selection committee decides whether to register a candidate on the national waiting list for a transplant.
- The national waiting list is maintained by the United Network for Organ Sharing (UNOS) Organ Procurement Organizations (OPO), facilitate the identification and procurement of livers for distribution through UNOS.
- People on the waiting list are assigned a score that indicates how urgently they need a transplant. The two scoring systems are the Model for End-stage Liver Disease (MELD) scoring system, used for people age 12 and older, and the Pediatric End-stage Liver Disease (PELD) scoring system, used for children younger than 12. A higher score indicates a more urgent need for a liver transplant.
- Critically ill patients with acute liver failure who are likely to die within a week are categorized as status 1 patients and are given highest priority for liver transplantation.
- Most livers for transplantation come from deceased donors. A small number of transplants involve living donors, who donate part of their liver, usually to a family member.
- Liver transplant surgery is complex and can take up to 12 hours. Patients usually stay in the hospital from 1 to 2 weeks after a liver transplant.
Further information about the surgical and non-surgical options, post-operative care for Liver transplant patients click Here( hyperlink to a new blog post with the details )