How long can you live after a liver transplant? Explore the success rates, factors influencing survival, and the challenges of finding a donor liver.

Liver Transplants: An Overview

Liver transplants are a critical medical procedure that involve the surgical removal of a damaged or diseased liver and its replacement with a healthy liver, or a portion thereof, from a donor. The vast majority of donated livers come from individuals who have passed away, either registered organ donors or those whose next of kin have consented to donation. Less frequently, liver transplants may involve a living donor, often a friend, family member, or stranger whose tissue is compatible and who is willing to donate a segment of their own liver.

Liver transplants are typically considered only when all other treatment options have been exhausted. Despite the risks involved, the procedure has a high success rate and can significantly extend or save the lives of those with severe liver conditions. In 2015 alone, over 7,100 liver transplants were performed in the United States, with 600 of those surgeries performed on individuals 17 years of age or younger.

Survival Rates After Liver Transplant

The survival rates for liver transplant recipients are generally quite high. According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), the average survival rates for those who have received a liver transplant from a deceased donor are:

• 86% still alive 1 year after surgery
• 78% still alive 3 years after surgery
• 72% still alive 5 years after surgery
• 53% still alive 20 years after surgery

However, it is important to note that individual survival rates can vary greatly depending on a number of critical factors.

Factors Influencing Liver Transplant Survival

The success and long-term survival of a liver transplant recipient is influenced by a variety of factors, including:

• Age: Older recipients tend to have lower long-term survival rates compared to younger individuals.
• Body Mass Index (BMI): Those with a BMI above the normal range are more likely to have poorer long-term outcomes.
• Health Before Surgery: Individuals who are healthier prior to the transplant generally have better chances of success.
• Severity of Liver Failure: The more advanced the liver disease, the more complex the transplant procedure and the higher the risk of complications.
• Cause of Liver Failure: Genetic conditions tend to have better survival rates than those caused by lifestyle factors or infections.
• Additional Health Conditions: The presence of other underlying medical issues can negatively impact the transplant’s success.

The Waiting List and Finding a Donor

The process of obtaining a suitable donor liver can be extremely challenging, stressful, and lengthy. On average, around 15,000 Americans are on the waiting list for a liver transplant each year. The severity of a person’s liver failure is measured using the MELD (Model for End-Stage Liver Disease) or PELD (Pediatric End-Stage Liver Disease) scoring system, which ranges from 6 to 40.

Several factors are considered when matching a recipient with a donor liver, including blood type, overall health, body size, and location. The limited availability of donor livers, combined with the growing number of individuals in need of a transplant, has resulted in a significant increase in the number of people who have died or been removed from the waiting list due to becoming too sick to undergo the procedure.

Segmental Liver Transplants

In some cases, surgeons may perform a segmental liver transplant, which involves the use of a portion of a deceased donor’s liver rather than the entire organ. This approach allows for the efficient use of the available donor livers and can help increase the number of successful transplants.

The Importance of Liver Transplants

Liver transplants are a vital medical intervention that can save or significantly extend the lives of individuals with severe liver conditions. While the procedure carries risks and challenges, the high success rates and positive long-term outcomes make it a critical option for those facing life-threatening liver failure. By understanding the factors that influence survival, the waiting list process, and the advancements in segmental transplants, we can better appreciate the life-saving power of this remarkable medical procedure.

Liver transplant survival rate: Statistics and recovery

A liver transplant involves surgically removing a liver that is no longer functioning properly, and replacing it with a healthy liver, or a portion of one, from a donor.

Most donated livers come from people who have died. They come from registered organ donors or people whose next of kin consent to them becoming a donor. Less commonly, liver transplants involve a living donor, often a friend, family member, or stranger whose tissue matches, and who donates a segment of their liver.

Typically, surgeons will only perform a liver transplant when all other treatment options have been ruled out. Nevertheless, liver transplants are the second most common type of transplant surgery after kidney transplants, with more than 157,000 carried out in the United States since 1988.

In 2015 alone, 7,100 liver transplants took place, with 600 of those surgeries performed on people 17 years of age or younger.

Though liver transplants carry a risk of significant complications, the procedure has a high success rate. The operation typically helps save or greatly extend the lives of people with severe liver conditions.

Share on PinterestAn estimated 72 percent of people are still alive 5 years after liver transplant surgery.

Due to a variety of complicated factors, it is almost impossible to predict an individual’s chances of having a successful liver transplant or how long they will survive afterward.

However, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) list the following average survival rates for people who have had liver transplant surgery from a deceased donor:

• 86 percent still alive 1 year after surgery
• 78 percent still alive 3 years after surgery
• 72 percent still alive 5 years after the surgery
• 53 percent still alive 20 years after the surgery

Reported survival rate estimates vary depending on the type of information used, as well as when and how they were calculated.

Although liver transplants have high success and survival rates, an individual’s chances of surviving and thriving after the surgery depend on a mix of critical factors.

Factors include:

• age
• body mass index (BMI) and major fluctuations in body weight
• how healthy a person is before the surgery
• severity of their liver failure and how many other organs are involved, especially the kidneys
• cause of the liver failure
• medical history
• additional health conditions

Age and BMI

Age and BMI are two significant factors that influence survival rates after liver transplants.

A 2017 study found that long-term survival rates were lower in older people and those whose BMIs were above normal and who were designated as overweight.

Cause of liver failure

According to a 2013 study, the cause of the liver failure may also influence the outcome of a liver transplant.

The study concluded that children and adults whose liver failure was caused by genetic conditions had higher survival rates than those whose conditions were due to lifestyle choices or infection.

Share on PinterestAround 15,000 Americans are estimated to be on the waiting list for a liver donor each year.

The process of finding a donor liver can be extremely challenging, stressful, and lengthy.

Once someone is approved for a liver transplant, their doctor will contact the non-profit organization United Network for Organ Sharing (UNOS), and ask for the recipient’s name to be added to the national organ donor waiting list.

Some people have to wait up to 5 years or longer for a match with a donor liver.

When looking for a matching donor liver, doctors consider several factors, including:

• severity of a person’s liver failure
• their blood type
• a person’s overall health
• a person’s body size
• location, as some U.S. states have bigger populations, donor bases, and donor centers than others
• availability of matching livers in the national waiting list system

The severity of someone’s liver failure is measured according to a model for end-stage liver disease (MELD) score, or pediatric end-stage liver disease (PELD) score for those under 12 years of age. The scores range from 6 to 40.

How many people are waiting

On average, roughly 15,000 Americans are estimated to be on the waiting list for a liver donor each year.

While the number of people needing a liver transplant is increasing, the number of new donor livers available is decreasing.

The number of people who have died while waiting for a donor liver or have been taken off the waiting list because they have become too sick to undergo the treatment has also increased by 30 percent in the last decade.

Liver transplants typically involve the surgical removal of any diseased, dead, or injured liver tissue, including removal of the entire organ. Surgeons will then reconnect a whole donor liver or a segment of a deceased donor’s liver.

Segmental liver transplants allow the use of live donors and for two people to receive transplants from one donor liver. However, this procedure is higher risk due to more frequent complications.

In 2013, 96 percent of liver transplants used deceased donor livers, while just 4 percent used segments from a living donor.

As more people become aware of segmental liver transplant surgery, it may occur more frequently and become safer.

A liver transplant is a major surgery that comes with several risks and potential complications, ranging in severity and including:

• bleeding
• scarring
• blood clots in the hepatic artery that supplies blood to the liver
• organ rejection, where the body does not accept the donor liver (most common during the first 3 to 6 months after surgery)
• failure of the donor liver
• bile duct leakage or damage
• bacterial infection
• hernia or rupturing of the cuts made in surgery during healing
• lung failure
• multiple organ failures
• sepsis
• death

Share on PinterestAfter surgery, most people will remain in the intensive care unit for several days.

Immediately after surgery, most people will stay in the intensive care unit (ICU) for a day or two. They will remain on a ventilator to help them breathe and be closely monitored to ensure the new liver is working properly.

They will also be given immunosuppressant (anti-rejection) medications to help prevent their body from destroying the donor liver. People who have an organ transplant must take immunosuppressant drugs for the rest of their lives.

When the person is ready, doctors will move them from the ICU to a regular room in the hospital. After the surgery, a person who has had a liver transplant will need to spend around 2 weeks in the hospital before going home.

Many people require 2 or 3 months before they feel well enough to return to everyday activities. Also, it can take years for the full effect of the surgery to be realized.

Lifestyle changes

Most people who have donor livers will also need to make certain lifestyle changes to keep their new liver healthy.

These changes include:

• eating a healthful, balanced diet, given to them by a nutritionist or dietitian as part of the transplant process
• staying hydrated
• quitting smoking
• avoiding alcohol
• taking all medications exactly as prescribed
• attending all medical appointments
• avoiding raw or undercooked eggs, meats, and seafood
• avoiding unpasteurized foods
• cutting down on foods that are hard for the liver to digest, such as fats, cholesterol, sugars, and salt
• avoiding contact with people who are sick
• talking with a doctor immediately if sick
• avoiding exposure to dirt by wearing shoes, socks, long pants, etc.
• avoiding known allergens
• avoiding contact with reptiles, rodents, insects, and birds
• avoiding eating grapefruits and drinking grapefruit juice
• avoiding strenuous activity within the first 3 months after surgery and talking to a doctor before resuming vigorous activities or exercises
• talking to a doctor before using any new over-the-counter medications, vitamins, or supplements
• wearing insect repellent when outside in the spring or summer and not spending a lot of time outdoors during dawn or dusk
• avoiding swimming in lakes and other freshwater bodies
• talking to a doctor before planning any trips, especially to developing nations
• talking to a doctor before using contraceptives or trying to get pregnant

Infection and rejection

Infection and organ rejection can lead to sepsis, multiple organ failure, and death. Therefore, it is essential that people with donor livers know how to recognize the signs of these potential complications. They should always seek medical attention as soon as possible to prevent further complications.

Signs of infection include:

• fever or chill
• stuffy nose
• cough
• vomiting and nausea
• sore throat

Organ rejection does not always cause noticeable symptoms, but symptoms can include:

• exhaustion, regardless of the amount of sleep
• fever
• yellowing of the skin and whites of the eyes
• pain and tenderness in the abdomen
• very dark urine
• lighter than normal stools

Liver transplants are reasonably safe procedures with good survival rates. However, many factors can influence an individual’s chances of a successful surgery, and determine how long they live after the surgery. These factors include their overall health, lifestyle habits, and additional conditions.

Recovery time for people who receive a liver transplant will vary but mean between 3 and 6 months before they can return to everyday activities.

As long as they take immunosuppressant drugs, as prescribed for them and make the recommended lifestyle changes, most people can enjoy a good quality of life for decades after liver transplant surgery.

Survival Rates, Statistics, and More

Liver transplant

A liver transplant, also called a hepatic transplant, can help save your life when your liver no longer works. The treatment involves surgical removal of your entire liver. It’s then replaced with all, or part, of a healthy donor liver. This may come from a living or deceased donor.

Having a healthy liver is essential to longevity because your liver is responsible for filtering blood and removing toxins from your body. Liver transplant is a last-resort measure for chronic (long-term) liver diseases and severe acute (sudden onset) liver diseases.

According to a study, people who have a liver transplant have an 89% percent chance of living after one year. The five-year survival rate is 75 percent. Sometimes the transplanted liver can fail, or the original disease may return.

It’s important that your doctor monitors your recovery long after the transplant to detect any problems. You’ll likely need regular blood tests. According to Johns Hopkins, you’ll also need to take antirejection medications for the rest of your life.

According to the American Liver Foundation, around 8,000 liver transplant surgeries are performed in the United States every year.

A doctor may recommend a liver transplant for a person with end-stage liver disease. A person with this condition will die without a transplant. A doctor may also suggest a liver transplant if other treatments for liver disease aren’t enough to keep a person alive.

Liver transplants may be option for chronic liver disease or if liver failure happens very quickly. Cirrhosis is the most common reason why adults need liver transplants. Cirrhosis replaces healthy liver tissue with scarred tissue. Causes of cirrhosis include:

• alcohol abuse
• chronic hepatitis B or chronic hepatitis C
• nonalcoholic fatty liver disease
• autoimmune hepatitis
• biliary atresia, a liver disease in newborns
• metabolic disorders

Your medical team will also consider other factors when determining if you need a liver transplant. These include:

• severity of your condition
• other medical conditions you have
• a history of tuberculosis and chronic infections like HIV
• your overall physical condition
• your mental well-being
• level of support from your family or friends

Before granting a liver transplant, a doctor will weigh whether the surgery will be successful and extend a person’s life. A person may not be a likely transplant candidate if they have other chronic conditions that could affect a transplant’s success.

Examples include a person who has cancer that has spread to other body parts or has severe heart problems. As another example, if a person has cirrhosis from alcoholism, their ability to quit drinking is evaluated as part of the transplant planning.

If you become eligible for a liver transplant, you’ll be placed on a national waiting list. As of early 2015, an estimated 14,000 people in the United States were awaiting liver transplants.

List placement and waiting for a match

Where you’re placed on the list is in part decided by a Model of End-Stage Liver Disease (MELD) score. This score is based on blood tests, such as:

• measuring your level of creatinine, which shows how well your kidneys are working
• checking your international normalized ratio, which is a measure of how well your liver is making blood-clotting proteins

Those with the highest scores are sicker, and they are placed higher on the list. Regular blood tests are necessary to update your MELD score and position on the list. There is also a Pediatric End-Stage Liver Disease score for those younger than age 12. Transplant surgery’s success also depends on a good match with a qualifying donor, so your wait time may also vary based on your body size and blood type.

Various factors determine whether a person receives a liver transplant. For instance, if two people with high MELD scores qualify for a liver transplant, the person who has been on the list the longest may receive a transplant sooner. In addition, a person high on the transplant list who has a rare blood type may be less likely to match with a donor.

A person experiencing acute liver failure may be placed near the top of the list because their risk of death could be more imminent compared to someone with a chronic condition.

When a match is found

Waiting for a liver transplant is a long process, but the surgery coordination happens quickly once you have a match. The liver can come from a deceased donor who had a healthy liver. Sometimes a donated liver may be used for two recipients. The right side of the donated organ is more often used in adult recipients, while the smaller left side is more often used for children.

It’s possible that a living donor can donate a portion of their liver as well. However, the living donor must be a good match in terms of blood type and other factors.

Getting the transplant is just a part of the process of getting a new liver. According to the National Institute of Diabetes and Digestive and Kidney Diseases, a three-week hospital stay is common after a transplant. During this time, your doctor will evaluate the success of your operation, as well as determine your needs for home care.

It may take up to one year until you feel healthier. Let your doctor know what your mental and emotional health needs are before you’re discharged.

The greatest risk of this operation is transplant failure. In such a case, your body rejects the new liver, often for reasons doctors can’t determine. A liver transplant also puts you at a high risk for infection. Other long-term complications can include:

• bleeding
• damage to the bile ducts
• blood clots
• side effects from medications taken to allow your immune system to accept the new liver, including high blood sugar from steroids

After a liver transplant, your doctor may recommend lifestyle changes, including regular exercise and a healthy diet. You can incorporate habits like these at any stage to boost your strength and overall health. Being physically healthy may reduce your chances for transplant rejection.

You can also limit risk factors that contribute to liver disease. Among the most common are:

• alcohol abuse
• smoking
• acetaminophen overdose
• obesity
• high cholesterol

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More than 85 percent of the most seriously ill patients survive after liver transplantation

Updated issue

WG-Nedelya

Motherland

Thematic applications

Union

Updated issue

Society

04/08/2021 18:53

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Irina Krasnopolskaya

Today’s interlocutor of “RG” – the head of the Moscow City Center for Liver Transplantation of the Sklifosovsky Research Institute Murad Novruzbekov cites figures: from 2000 to 2008, 100 liver transplants were performed in Sklifa. From 2008 to the current year – already 800! And if earlier it was only about liver transplantation, now it has become possible in some cases to save one’s own organ by curing it . .. in a basin. And here is the basin? Sounds frivolous, unscientific? .. So what is it about?

from the personal archive of Murad Novruzbekov

Despite the pandemic, the world-famous Sklif, as always, takes on the most difficult, most unpredictable situations. Almost three months ago, Murad Saftarovich allowed me to witness the operation for a malignant tumor of the liver. Murad and his colleagues removed the liver from its rightful place, carefully moved it to a specially prepared basin with ice and a preservative solution. The basin was placed on a special table. The liver was thoroughly washed from blood. Then the tumor was removed along with the main vessels. This was followed by plastic surgery of these vessels. After that, the cured liver was returned to its original place. It all looked, I confess, like a fantasy.

While the liver was in the basin, Oleg Olisov, Konstantin Lutsyk, Vladimir Gulyaev, the participants of the operation, restored blood flow through the inferior vena cava along the route from the renal veins to the heart. That is, restored blood flow from the lower body to the heart. At the same time, anesthesiologists Sergey Zhuravel, Natalya Kuznetsova, Elena Vorobyeva carried out their magical work. After that, it was possible to re-include the liver in the blood circulation system.

What was the patient doing at that time? Slept under anesthesia. It was a 36-year-old resident of Moscow, suffering from an incurable liver tumor. It was impossible to excise it in the body, since the large main vessels of the liver and the body were affected. It was decided to completely remove the liver and these vessels in one block. A few years ago this patient was doomed. Not every surgeon will take the risk of taking such a patient on the operating table, and even in the presence of a media representative.

Why do we write about this operation only after some time? For a simple reason. Even talking about such technology is not easy. In fact, this is an extremely complex, very serious intervention in life. And in such situations, you need to wait for the result. Now we know: that patient was discharged, returned to his work, to his family. And such operations in “Sklif” are not the only ones performed.

There is another reason for this note. Agree, the native organ is always closer to the body. In addition, there is no dependence on the search for a donor. And this technology with the placement of a diseased organ in a basin finds its application not only in liver tumors, but also to save a failed kidney, pancreas.

The applied technology is somewhat old-timer in the health service: the first such operation was carried out by Rudolf Pichelmeier in 1990 in Germany. But then all the subtleties of such interventions had not yet been worked out, and the results left much to be desired. But time, as you know, does not stand still. The obviousness of the need for such operations played a role. In the world’s leading centers, not only scientific developments were carried out, but also specialists began to appear who were able to carry out such operations. So Murad Novruzbekov, having gone through the school of organ transplantation, introduced transplantation technologies into big surgery.

And yet… Still, these are probably not the operations that, as they say, are on the stream.

– Are they available in our country? Or the lot of the elect? I ask Murad.

– So far, – answers Murad, – the chosen ones. And because of the complexity of the technology. And mainly because of the qualifications of specialists. First of all, surgeons, anesthesiologists, resuscitators, nurses. There are special requirements for the coherence of the brigade, for the ability to prepare for the operation and nursing after it. Not everywhere such opportunities as in our “Sklifa”. He has a special status, a special approach to patients. “Sklif” works around the clock from year to year to provide emergency, emergency care. And this is such a school of skill, which is difficult to overestimate. More than 100 liver transplants are performed here annually. Not even all the world organ transplant centers have such figures. To get to us, you need to go through the advisory department, which receives every day, and not only Muscovites. We do not accept refusal. The Moscow City Center for Liver Transplantation justifies the name of the institute on the basis of which it is located, and is the only place where liver transplantations are performed in emergency, acute situations of liver failure.

These technologies are being introduced not only in our country, but also in neighboring countries.

– Medical assistance should not depend on borders, says Murad. – Three days ago I returned from Kazakhstan. Colleagues asked for an operation to transplant part of the liver. They flew there with a whole brigade. Successfully carried out two transplants.

Even talking about such technology is not easy. But in fact, this is an extremely complex, very serious intervention in the patient’s life.

– I did not know about Kazakhstan. But I knew that you and your team were in Tajikistan, in several cities of Russia, where organ transplant programs are successfully developing. Long-term results?

– Five- and ten-year survival rates are considered to be long-term outcomes. It depends on various pathologies. The overall survival of our patients is over 85 percent at five years and over 75 percent at ten years. This corresponds to the world level.

– I’ll tell you one secret of your clinic: you categorically forbade employees to speak rudely to patients…

– It’s not a secret. Our patients, believe me, not only ours, require polite treatment. A sick person always has a psychological trauma. And the rudeness makes it worse. Trite, but a kind word is not only pleasant for a cat. I didn’t issue any special order. It’s just our creed. That’s how it’s done. Otherwise it is impossible.

Silence. Here colleagues understand each other without words. Photo: from the personal archive of Murad Novruzbekov

Rossiyskaya gazeta – Federal issue: №76(8427)

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Liver transplant is a complex surgical procedure in which one’s own liver, damaged due to cirrhosis and liver failure, is removed and replaced with a healthy liver from a donor. The liver is the largest internal organ in the abdominal cavity and performs several important functions:

• Nutrient processing
• Production of bile, which helps the body absorb fats, cholesterol and fat-soluble vitamins
• Creation of proteins that help blood clotting
• Removal of bacteria and toxins from blood
• Prevention of infections and regulation of immune responses.

Liver transplantation is a commonly used treatment option for people with significant complications from end-stage chronic liver disease. An organ transplant may also be a treatment option for rare cases of sudden failure of a previously healthy liver.

Types of liver transplantation

There are several forms of liver transplantation:

• organ transplant from a deceased donor
• transplantation of part of an organ from a living donor
• domino liver transplant.

Liver transplant from a living donor

The number of people waiting for a liver transplant far exceeds the number of available organs from deceased donors. A living donor liver transplant is an alternative to waiting. Surgery is possible because a person’s liver has the ability to regenerate and return to its normal size shortly after surgical removal of part of the organ.

Living donor liver transplants using a small portion of a healthy person’s liver account for a small percentage of liver transplants each year. This form of transplant was originally used for children, as there are few suitable organs from deceased donors. It is now also an option for adult patients with end-stage liver disease.

The first step in transplantation is to find a living donor who is able to safely undergo a major surgical procedure to partially remove the liver. Donor age, blood type, and organ size are also important factors in determining whether a donor is suitable for transplantation. Most living liver donors are close family members.

Transplantation from a living donor gives good results, as does transplantation using livers from deceased donors. But finding a living donor can be difficult, as the operation also comes with significant risks for the donor.

Domino liver transplant

A less common type of living donor liver transplant is called a domino liver transplant. In a domino liver transplant, a patient receives a liver from a living donor who has familial amyloidosis. Familial amyloidosis is a very rare disorder in which an abnormal protein builds up and eventually damages the body’s internal organs. A donor with familial amyloidosis receives a liver transplant to treat their condition. The donor can then donate their liver with a domino liver transplant because the organ is still functioning well. Over time, the patient who received such a donor organ may develop symptoms of amyloidosis, but these symptoms usually take decades to develop. Physicians for this liver swap operation typically select patients aged 55 or older who are not expected to develop symptoms for the remainder of their natural lifespan.

Liver transplant for cirrhosis

Liver transplant is a treatment option for patients with cirrhosis, kidney failure that cannot be controlled with other treatments, and some cancer patients with liver cancer. Liver failure can develop quickly (acute liver failure) or over a long period of time (chronic liver failure). Acute deficiency is a rare condition that usually results from complications from certain medications. Although liver transplantation can treat acute liver failure, it is more commonly used to treat chronic liver failure. Chronic liver failure can be caused by a variety of conditions. The most common cause of the disease is scarring of the liver (cirrhosis). In cirrhosis, normal liver tissue is replaced by scar tissue, resulting in irreversible liver dysfunction. Cirrhosis is the most common reason for a liver transplant. The main causes of cirrhosis leading to liver failure and liver transplant include:

• Hepatitis B and C
• Liver cancer
• Alcoholic liver disease causing liver damage due to excessive alcohol consumption
• Non-alcoholic fatty liver disease, a condition in which fat accumulates in the liver, causing inflammation or damage to liver cells
• Genetic diseases affecting the liver, including hemochromatosis, which causes excessive accumulation of iron in the liver, and Wilson’s disease, which causes excessive accumulation of copper in the liver
• Diseases affecting the bile ducts such as primary biliary cirrhosis, primary sclerosing cholangitis and biliary atresia. Biliary atresia is the most common reason for liver transplantation in children.

Complications of the procedure

Liver transplant surgery carries a risk of serious complications. There are risks associated with the procedure itself, as well as the medications needed to prevent liver transplant rejection. Risks associated with the procedure include:

• Bile duct complications, including bile leakage or bile duct contraction
• Bleeding
• Thrombosis
• Donor liver failure
• Infections.

Long-term complications may also include recurrence of liver disease in the transplanted liver.

Side effects of anti-rejection drugs

After a liver transplant, you will be on medication for the rest of your life to prevent your body from rejecting the donated liver. These drugs can cause a variety of side effects, including:

• Thinning bones
• Diabetes mellitus
• Diarrhea
• Headaches
• High blood pressure
• High cholesterol.

Because immunosuppressants suppress the immune system, they also increase the risk of infections.

Preparation

Before the liver transplant operation, the patient will need to undergo a complete physical examination. The objectives of the assessment process are to determine that the person:

• Healthy enough to survive surgery and lifelong post-transplant drugs.
• Has any medical condition that could prevent a successful transplant.
• Ready and able to take lifelong immunosuppressive drugs after surgery.

A comprehensive preoperative body check usually includes:

• Laboratory tests such as blood and urine tests.
• Ultrasound of the liver or MRI of the liver
• Cardiac tests to determine the health of the cardiovascular system, such as ECG and ultrasound of the heart
• Nutrition counseling with nutritionists
• Psychological assessment.

After these tests and consultations are completed, the selection committee of the transplant center determines whether liver transplantation is a possible treatment for the patient and whether the patient is healthy enough to receive the transplant.

If both questions are answered yes, the patient is placed on the liver transplant waiting list. While the patient is waiting for a new liver, the doctor will continue to treat complications so that the patient feels as comfortable as possible.

Transplant operation

If the patient is notified that they have a liver from a deceased donor, they should immediately go to the hospital and be examined to make sure that the person is still healthy enough for the operation. A liver transplant is performed under general anesthesia and can take up to 12 hours, depending on the operating situation. During the procedure, the transplant surgeon makes a long incision in the abdomen to gain access to the liver. The location and size of the incision varies depending on the surgical plan and patient anatomy. The surgeon then removes the diseased liver and places the donor organ into the abdomen. The surgeon then connects the blood vessels and bile ducts to the donor liver. After the new liver is in place, the transplantologist applies stitches and staples to close the surgical incision.

If the patient is receiving a liver transplant from a living donor, the operation will be scheduled in advance. Surgeons first operate on the donor, removing part of the liver for transplantation. Surgeons then remove the diseased liver and place the donor portion of the liver into the abdomen. The next step is to connect the blood vessels and bile ducts to the new organ. The transplanted part of the liver in the body and the part remaining in the donor’s body quickly regenerate, reaching a normal volume within a few weeks.

After a liver transplant

After a liver transplant, the patient will take a number of drugs, many of which he will take for the rest of his life:

• Medicines called immunosuppressants help the immune system not attack the new liver
• Other drugs help reduce the risk of complications after transplantation.

After a liver transplant, it is especially important to eat a well-balanced diet to help the body recover and keep the liver healthy. The transplant diet should be low in salt, cholesterol, fat and sugar. Avoiding alcohol is important to prevent damage to the new liver. Do not drink alcoholic beverages and do not use alcohol when preparing food. The nutritionist will also provide several healthy eating options. Doctor recommendations may include:

• Eating at least five servings of fruits and vegetables every day
• Withdrawal of grapefruit and grapefruit juice due to their effects on the immunosuppressant group
• Having sufficient fiber in the daily diet
• Choose Whole Grains Over Processed
• Eating low-fat or low-fat dairy products, which is important for maintaining optimal levels of calcium and phosphorus
• Eating lean meat, poultry and fish
• Food Safety Compliance
• Drink enough water and other fluids every day.

Exercise and physical activity should be a regular part of life after a liver transplant to continue to improve overall physical and mental health. After the transplant, you should walk as much as possible. Then, depending on your progress, you can start incorporating more physical activity into your daily routine. Cycling, swimming, low-impact strength training, and other physical activities can be part of a healthy and active lifestyle after transplantation.

Survival

The chances of a successful liver transplant and long-term survival depend on the specific situation of each patient. Overall, about 75% of people who have liver transplant surgery live at least 5 years. Patients who receive a liver transplant from a living donor often have higher short-term survival rates than those who receive an organ from a deceased donor. But comparing the long-term outcomes of these two groups of patients is difficult because people who have a living donor usually have less transplant time and are not as sick as those who received a liver from a deceased donor.

Author: Sergeev Alexander Nikolaevich

Specialization: Hematologist, Toxicologist, Occupational Pathologist, Anesthesiologist-Resuscitator

Place of appointment: Research Institute of Hematology and Transfusiology 902 44

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Literature

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Pancreas transplant

Pancreas transplant is an insulin-dependent diabetic surgery in which an organ is transplanted from a recently deceased donor. According to its results, a person can produce his own insulin and do not need injections. A pancreas transplant allows people with type 1 diabetes (insulin-treated diabetes) to produce insulin again. It is usually only considered if:

the patient has severe kidney disease – in these cases, pancreas transplantation may be performed at the same time as kidney transplantation
The patient has had severe episodes of critically low blood sugar that occur without warning and are not controlled by insulin.