By Rajiv Lochan, Liver Transplant Surgery
Liver is one of the most vital organs in the human body and there is no known way yet to compensate for its absence. Therefore, Liver Transplant Surgery becomes absolutely essential in case of failure of the organ or to cure its insufficiency. This procedure replaces a diseased or failing liver with one which is normal and healthy, whole or partial. People who require such transplants have serious liver dysfunction due to acute or chronic liver failure.
Acute liver failure is said to have occurred when an absolutely healthy liver suddenly gets diseased due to a massive injury to the organ. Such patients require transplants immediately as they cannot survive without it. Chronic failure occurs when the regenerating capacity of the liver is compromised due to repeated injuries leading to ‘cirrhosis’ and an inadequate liver function. In such circumstances, a transplant is the only permanent solution.
Types of Transplant:
It should be noted that the liver is a miraculous organ, any part of which regenerates itself to form a new whole of normal capacity. Also, it is required for a transplant to occur that the donor’s liver matches with the recipient’s tissue type, blood group, and size. Donors can be brain dead, cardiac death donors, or living donors.
There are three categories of liver transplant, any one of which might be offered to the patient depending upon the circumstances.
A living donor transplant is the type in which the donor is a living, willing person, part of whose healthy liver is removed from either the left or the right side or the lobe. The left lobe is smaller than the right lobe and hence is suitable if the recipient is a pediatric patient whereas the bigger, right lobe is used in case of adults. The diseased liver of the recipient is replaced with a lobe deemed suitable, making connections with bile ducts and blood vessels inside the body. The liver, both of the donor and of the recipient, regenerates itself quickly in a matter of a few weeks.
Orthotopic transplants are performed when the whole liver is sourced from a recently deceased donor who is free from infections, cancers, and transmissible diseases; and put into the recipient after removing the diseased liver. It is the most commonly adopted procedure.
Split Liver Transplant:
Split liver transplants help two patients at the same time. In this type, a single, healthy deceased donor liver is divided into left and right parts and implanted into two patients. The recipient of the smaller left lobe is a pediatric patient, while that of the larger right lobe is an adult. This is an innovative surgical technique which benefits two patients simultaneously.
The Liver Transplant Surgery involves removing and preparing the donor liver, removing the diseased liver or part of the liver, and implanting the new organ into the recipient. It has to be ensured that the key connections of the liver are re-established so that the new liver or part of the liver receives optimum blood flow and is able to drain off the bile which it produces. The exact methodology is very complicated and depends on the specific case of the patient.