By Dr. Girish N. Thorat, Gastroenterology
Hepatitis C is a viral infection of the liver that is spread through contact with an infected person’s blood and bodily fluids. No vaccine currently exists for Hepatitis C and hence it is crucial to avoid exposure to the virus; if it does not go away in six months, it can become chronic, leading to scarring, cirrhosis, cancer and in extreme cases, even death. What makes hepatitis c infection deadlier is that most people do not have any symptoms until liver damage is caused and if left untreated can cause liver failure. At times like these, a liver transplant becomes the only option to prolong life, although it is not a cure.
Before The Transplant
Firstly, your doctor (hepatologist, infectious disease specialist or gastroenterologist) will determine whether you are an eligible candidate for getting a liver transplant through analysis of your medical tests, your overall health, the strength of your immune system and support system for postoperative care.
Then, depending on your blood type, body size and medical condition (how severe the illness is), you will be placed on a waiting list for a healthy liver. Based on three blood tests, creatinine, bilirubin and INR, every patient is assigned a priority score called MELD (model of end-stage liver disease). Patients with the highest MELD scores and severe liver failure are given more priority for a transplant.
Liver Transplant – The Process
A new liver is most often acquired from a recently deceased donor who matches the requirements of the patient. In some rare cases, a partial liver transplant is done from a living donor, who is usually a relative, since liver cells regenerate. In such partial liver transplants, both the donor’s and the recipient’s liver portions will grow into normal-sized livers in a few weeks.
Once a healthy liver is found and additional tests and examinations are conducted, the liver transplant process takes place in the operation theatre after putting the patient under general anesthesia. The process follows:
- An incision is made in the abdomen, and it is examined for any abnormalities such as undiagnosed infections or cancerous tumors.
- The diseased liver is detached from the abdominal cavity by dissecting the arteries and veins and bile ducts linking it.
- The diseased liver is removed from the body.
- The new, donor liver is placed inside the body and the blood vessels and bile ducts are reattached.
- Bleeding is controlled and the abdominal incision is stitched to close it.
Surgery can take 6 to 12 hours, after which you will be moved to the intensive care unit for recovery. A successful liver transplant allows you to live longer than a diseased liver would have, however, your total life expectancy will depend upon your age, overall health and other factors like the condition of the donor’s liver, etc.