Your liver plays a vital role in your body’s everyday functions. Protected by your rib cage on the right side of your abdomen, your liver weighs about 3 pounds and is rubbery to the touch. Its main job is to filter the blood coming that comes from your digestive tract before passing it on to the rest of the body. However, the liver also has many other functions including:
- Producing proteins needed by the body
- Breaking down food that is consumed to make energy for the body
- Storing vital nutrients such as vitamins, minerals, and sugars for later use
- Producing bile to digest fat and absorb vitamins A, D, E, and K
- Making blood clotting materials
- Fighting infection by removing bacteria from the blood as it is filtered
- Removing toxic byproducts from things such as medication
Your liver is important to your survival in many ways. That is why when it starts to fail as a productive organ within your body and shut down, it is crucial you get a liver transplant as soon as possible.
Today, we explore when a liver transplant is needed, what a liver transplant surgery entails, as well as possible complications that can arise afterwards, and the general outcome to be expected post-transplant surgery.
When Is A Liver Transplant Needed?
Your physician will begin considering a liver transplant the minute your liver stops functioning adequately. This is known in the medical world as liver failure.
Liver failure can occur suddenly as a result of a severe infection or from complications due to certain medications. It can also be the result of a long-term liver illness. Here are some of the most common reasons people experience liver failure:
- Chronic hepatitis with cirrhosis
- Primary biliary cirrhosis
- Sclerosing cholangitis
- Biliary atresia (a rare disease affecting newborns)
- Wilson’s disease (an inherited disease with abnormal copper levels throughout the body)
- Hemochromatosis (an inherited disease with abnormal iron levels throughout the body)
- Liver cancer
Liver Transplant Surgery
Liver transplants are highly complex surgeries that require the expertise of a dedicated team of physicians specializing in transplants.
The actual surgery usually takes between 6 and 12 hours to complete. During the surgery, the surgeons will remove the failing liver and replace it with a donor liver that is healthy and compatible with your blood type.
Because a liver transplant is so complex and can often disrupt other normal functions of your body, the surgeons will need to strategically place several tubes in your body during the operation. These tubes not only help your body to continue functioning throughout the transplant surgery, but for a few days afterwards as well.
Here is a look at what tubes are required during a liver transplant and how they will help your body during this serious time:
- Trachea tube. A tube will be placed in your mouth into your trachea (also known as the windpipe) to help you breathe using a machine called a ventilator. This machine automatically and mechanically expands your lungs so they can fill with oxygen.
- Nasogastric tube. A tube will be inserted into your nose and down your throat into your stomach to drain any secretion from your stomach. This will be kept in place even after surgery until your bowel movements return to normal.
- Catheter tube. Placed in your bladder to drain urine, the catheter will be removed a couple days post-surgery.
- Abdomen tubes. Three tubes will be inserted into your abdomen near the new liver to help drain blood and fluid from around the liver. These will remain for approximately one week after the transplant.
- T-tube. Sometimes a T-tube will be inserted into your bile duct during surgery to drain bile into a small pouch located outside of your body for monitoring. Measured several times a days, and only used on certain liver transplant patients, the T-tube will remain in place for about 5-6 months after the surgery.
The average hospital stay after a liver transplant is 2-3 weeks. Depending on how your body reacts to its new liver and how you recover from such an invasive surgery will determine when you get to go home.
Liver Transplant Complications
As with any major surgery, liver transplants can come with serious complications. Here is a look at the two most commonly occurring complications seen in patients post-operatively.
Rejection of the Donor Liver
Your immune system is designed to destroy any foreign substances that invade your body. Unfortunately, sometimes your immune system will attack the donated liver because it does not recognize it as a part of your body but as a foreign invader. If this happens your body will begin to attack the donor liver and attempt to destroy it. This is what is called a “rejection episode.”
About 65% of all liver transplant patients experience some level of organ rejection within the first 6 weeks after the transplant. This does not however mean that the liver will be fully destroyed. There are effective anti-rejection medications that can help suppress these attacks and allow the new liver to do its job. Some of these include:
These medications must be taken as prescribed for the rest of your life to continuously prevent your body from attacking the new liver. If you fail to adhere to the strict medication schedule your physician prescribes, you risk a full attack and permanent damage being done to your liver. This can result in liver failure if it gets too serious.
Because anti-rejection drugs are usually required for all liver transplant patients, and because these drugs suppress your immune system to prevent it from attacking your new liver, you are a higher risk of infection. Not all patients have issues with infections and most can be treated easily and quickly if detected early enough. It is also good to know that as time passes and your body regains its health, your risk for infection lessens.
For patients that are healthy going into a liver transplant, the one year survival rate is about 90% and is about 60% for those who are very ill at the time of surgery. After that, the 5-year survival rate is about 80%. Since liver surgeons have become more skilled in liver transplants and treating rejection episodes has become very advanced (thanks to the variety of immuno-suppressive drugs that are available), the survival rates of liver transplant patients continues to rise.
Most liver transplant patients can return to their normal daily activities within 6 months of receiving their new liver. Eating a healthy diet, exercising regularly, and taking the prescribed anti-rejection medicines can greatly increase the overall length and quality of life of liver transplant patients.
In the end, liver transplants are a serious surgery not to be taken lightly. Your life truly depends on having the right donor liver and the right liver surgeon performing the operation.
If you or someone you know is in need of a liver transplant, consider enlisting the help of Dr. Fraiman and his specialized team at The Liver and Pancreas Center in Towson, Maryland. With years of experience and an individual approach to every patient he sees, Dr. Fraiman will have you on your way to better health in no time.