Liver transplant: Healing, hope, and new life

The liver is one of the most vital organ in our body. It performs numerous crucial functions, including detoxifying harmful substances, synthesising proteins, producing bile for digestion, and storing essential nutrients. When the liver becomes severely damaged or diseased, it can no longer perform these tasks efficiently, leading to life-threatening complications. In such cases, a liver transplant might be necessary to save a life.

According to the NOTTO report for 2024, Deceased Donor Liver Transplants: 952 performed and Living Donor Liver Transplants: 3946 performed.

Source: https://notto.mohfw.gov.in/WriteReadData/Portal/News/924_1_2013_to_2024.pdf

What is a liver transplant?

Several medical conditions can cause liver failure or irreversible liver damage, making a transplant the only viable option. Here are some of the common causes

1. Common causes of liver failure

• Alcoholic liver disease: Alcoholic liver disease most often occurs after years of heavy drinking. Over time, scarring and cirrhosis can occur. Cirrhosis is the final phase of alcoholic liver disease.
• Non-alcoholic steatohepatitis disease (NASH): This condition occurs when fat builds up in the liver without alcohol consumption. It can progress to cirrhosis and liver failure, especially in individuals with obesity or diabetes.

2. Non-cirrhotic cause of liver failure

Acute liver failure occurs rapidly, within days or weeks, often due to viral infections, drug toxicity (such as acetaminophen overdose), or autoimmune diseases. Unlike chronic conditions that develop over many years, acute liver failure requires immediate intervention and may necessitate a liver transplant to save the patient.

3. Other causes

1. Hepatitis

• Chronic hepatitis B or C: These viral infections can lead to long-term liver damage, cirrhosis, and even liver cancer. Despite antiviral treatments, some people develop severe liver disease that requires a transplant.
• Autoimmune hepatitis: In autoimmune hepatitis, the immune system mistakenly attacks the liver, leading to inflammation and potential liver failure. If the condition is not controlled with medication, a transplant may be necessary.

2. Genetic disorders

Certain genetic conditions can cause long-term damage to the liver if left unmanaged. These include

• Hemochromatosis: A disorder where excess iron builds up in the liver.
• Wilson's disease: A condition that leads to copper build-up in the liver.
• Alpha-1 antitrypsin deficiency: A genetic disorder that can cause liver damage and cirrhosis, which leads to liver failure.

3. Biliary atresia in infants

Biliary atresia is a condition present at birth where the bile ducts in the liver are blocked or absent. It prevents bile from flowing properly and leads to liver damage. For infants with this condition who do not respond to surgery, a liver transplant is often necessary to prevent life-threatening complications.

Indications for liver transplantation

The need for a liver transplant is typically determined by how much the liver is damaged. Liver transplantation may be indicated when liver cirrhosis causes severe symptoms and complications like-

• Repeated build-up of fluid in the abdomen requiring frequent removal of fluid (refractory ascites)
• Unconsciousness due to the build-up of ammonia in the blood (hepatic coma)
• Deranged kidney function due to liver disease (hepatorenal syndrome)
• Infection in abdominal fluid (spontaneous bacterial peritonitis)
• Development of cancer in the liver (hepatocellular carcinoma)

Liver transplantation process

When a liver transplant is required, a surgeon removes the damaged liver and replaces it with a healthy liver from a donor. There are two primary sources of liver transplants

• Living donor liver transplant: In some cases, a living person can donate a portion of their healthy liver, which will regenerate over time.
• Deceased donor liver transplant (cadaver): If a living donor is not an option, a liver from a deceased donor is used. Due to the high demand for organs, the waitlist for a liver transplant can be long, depending on a person's medical urgency, blood type, and other factors.

In a nutshell

A liver transplant can offer a second chance at life for individuals suffering from severe liver failure or end-stage liver disease. Although it is a complex procedure, it remains the most effective treatment for patients with no alternative options. KD Hospital is the best liver transplant centre in Gujarat, with a dedicated & experienced team of doctors with advanced state-of-the-art technology under one roof.