Liver Transplant Guidelines

The liver is a the major organ that functions to store fats, catabolize proteins and metabolism of drugs to provide safety from toxicity. The liver becomes damaged and scaring forms from continual abuse. Alcohol and drugs are metabolized by the liver, and when cells die, the liver regenerates. The regeneration can also leave scars, which is characterized as cirrhosis. When damage is severe, a liver transplant may be needed.

Evaluation

Before being added to the wait list, an evaluation is performed to decide if a transplant is the best option. Evaluation is also done to decide if the patient is healthy enough to survive the surgery. Several tests including MRI and CT scans, blood and urine tests, x-rays and bone scans are performed. Renal function and bone density are evaluated to ensure that any damage from diseases like cancer have not spread to other parts of the body.

Waiting

The process of finding a liver takes time. A suitable liver must match the patient's biochemistry before the surgery is performed. The patient is advised to pack a suitcase in preparation. The doctor will provide medication during this time, so it's important for the patient to continue taking prescribed medication until surgery. The surgeon and anesthesiologist will have directions for medications prior to surgery.

When a Liver is Found

When a liver is found for the patient, a phone call is made to the patient. When the phone call is received, the patient is advised not to eat or drink prior to surgery. The stomach needs to be empty for surgery. An enema is performed to clear the stomach and intestines from content to avoid constipation. The patient's chest and abdomen are shaved in the area where incisions are made.

The Surgery

During the surgery, the patient is put under anesthesia. An incision is made to remove the old liver and replace it with the new one. The blood vessels are reattached to the new liver and the ducts between the gall bladder and the liver are reestablished.

After the Surgery

After surgery, patients are placed in an intensive care unit to carefully monitor progress. There is pain after surgery, so medication is given to relieve the discomfort. Once healing has progressed to the doctor's satisfaction, the patient is able to go home, but care and observation are still needed. Care for the wounds by preventing infection from microbes. A healthy diet and limited exercise to strengthen the body after surgery is also advised.