Diseases Of The Liver And Liver Transplants - Causes, Indications, Diagnosis & Tests, & Procedures

The Yashoda Hospital department of diseases of the liver and liver transplant are a part of the centre for digestive and liver diseases. Our department consists of the best and most experienced liver transplant teams in the region. We follow a patient-centric approach, and thus we treat patients with all type of chronic liver failure conditions.

Our Unit is equipped with state-of-the-art facilities and the best equipment and the latest infrastructure. Our department also has the best and most well equipped Liver Transplant ICU in the region with a separate AHU for each bed, thereby minimising the risk of infection.

We offer seamless, comprehensive, and integrated world-class healthcare to the community under our care with comprehensive pre and post-liver transplant management. Our hospital strives to deliver world-class healthcare to the patient suffering from chronic liver conditions.

What are the Causes of Liver Diseases?

There are times when there are problems with your liver that leads to inflammation. Some of the common causes for liver, including:

Infections

• Hepatitis A: You can get affected by eating or drinking something that infected by faecal matter.
• Hepatitis B: You can get infection through unprotected sex or taking drugs with common needles and through infected mother to her baby at the time of birth.
• Hepatitis C: shared needles from using drugs or infected blood can lead to HIV and liver diseases. It's also commonly passed on from a mother to her baby during birth.

Immune System Problems

• If your one or more parts of the body get affected, then your immune system attacks off invaders including bacteria and viruses, but sometimes it also attacks your own organs.
• Autoimmune hepatitis inflames your liver
• Primary biliary cholangitis fights tiny tubes in your liver called bile ducts.
• Primary sclerosing cholangitis results in scarring of your bile ducts, and it can eventually block them.

Cancer and Tumors

• Liver cancer affects women more than men.
• Hepatocellular carcinoma in chronic liver disease
• Bile duct cancer affects when the tubes, which helps to carry the bile which digests the food.
• Liver cell adenoma is a tumour which affects women taking birth control pills for a long time.

Some inherited liver disorders include,

• Hemochromatosis, where your body stores too much iron. This iron builds up in the liver resulting in life-threatening conditions.
• Wilson's disease causes accumulation of liver and other organs buildup. It affects the liver and also causes nerve and psychiatric problems.
• Alpha-1 antitrypsin deficiency affects the liver.

Other Causes of Liver Disease

• Alcohol abuse (It leads chronic liver disease, ascites hemelements & liver cancer)
• Drug overdoses.
• Nonalcoholic fatty liver disease (NAFLD)

What Is Liver Transplant?

The liver is the most important part of the body which performs several critical functions. Liver failure can occur if chronic conditions or diseases affect the functioning of the liver. Here, the liver is then replaced with a healthy liver from a living or deceased donor. This process is called as a liver transplant.

• Deceased Donor (Cadaver): The donor is usually an unfortunate person who has experienced irreversible brain injury/ brain death or a living
• Living Donor: The liver is donated from a healthy donor to the person in need, as the liver comes with a capability of regeneration.

What Are The Several Indications For Liver Transplant?

A person experiencing liver failure due to end-stage liver diseases (ESLD) must undergo the process of a Liver Transplant. These diseases include:

Most complicated liver disease include:

• Acute liver failure: If the liver quits working within a very short span of time, then acute liver failure occurs. It is also known as fulminant hepatic failure, which occurs when a healthy liver gets hit from a massive injury that leads to clinical signs and symptoms of liver insufficiency.
• Cirrhosis is the buildup of scars in your liver, which causes the functioning of liver difficult. It is caused due to injury or repeated harm to the liver for many years. Here, the liver can no longer repair itself.

Are You A Candidate For Liver Transplant?

The doctor will examine the patient’s current medical condition to assess whether he/she fits for Liver Transplant or not. You are an eligible candidate for Liver Transplant if you experience:

• Blood in Vomit
• Blood in Stools (Black colour stool)
• Abdominal swelling due to Ascites
• Altered Sensorium
• Kidney injury due to liver diseases
• Hepto- Cellular Cancer

A patient with end-stage liver disease is not a candidate generally for a liver transplant if he/she suffers from:

• Serious, irreversible medical illness with a short-term life expectancy
• Systemic or uncontrollable
  • Infection
  • Psychiatric disease
  • Pulmonary hypertension
• Last stage Cancer ( which has extended outside of the liver)
• The abnormal risk or Active substance abuse (drugs and/or alcohol)
• Inability to limit to a strict medical regimen

What Are The Several Diagnosis Tests Required Prior To Liver Transplant?

Before recommending a Liver Transplant, our doctor will ask you to undergo a few medical examinations. These medical examinations will help the doctor to create a personalised treatment plan. The diagnostic tests you may be asked to undergo are:

• Imaging tests:
  • Magnetic resonance imaging (MRI) of abdomen/pelvis
  • Computed tomography (CT) scan of abdomen/pelvis
  • Ultrasound of abdomen/pelvis
  • Electrocardiogram/chest X-ray
• Colonoscopy
• Dobutamine stress echocardiogram (DSE)
• Mammogram or Pap smear for women
• Other Blood tests

What Is The Expected Procedure For Liver Transplant?

Liver Transplant Preoperative Details

Before proceeding with the surgery, the doctors will perform a series of tests and screening process to make sure that the patient is fit for the procedure. A week or two before the surgery, the patient might be prescribed certain medications to avoid any sort of infection during or after the surgery.

The patient will be given general anaesthesia before moving to the operation theatre. This will help the patient to sleep through the Liver transplant procedure.

Liver Transplant Operative Details

The liver transplantation is the procedure that usually consists of three operations.

First Operation: Receiving the Liver from the donor for a liver transplant procedure, a donor liver’s is replaced from the patient damaged liver. There are two forms of liver donors:

• • Deceased Donor (Cadaver): A donor is generally an unfortunate person who has gone through an irreversible brain injury/ brain death.
  • Living Donor: Since liver comes with a capability of regeneration. Therefore, the living donor can donate a small part of its liver to another person in need.

Our team of doctors help in keeping the donor’s organ working with the help of medications and other "life support" devices. Using ice and special solutions until they can be implanted, the team removes the donated organs and keep them alive. The liver transplant must take place within six hours of the removal of the liver.

• Second Operation: Removing the recipient's defective Liver

Depending on the medical condition of the patient, the liver transplant procedure can be challenging and complex or very simple and easy. Here, the doctor will make a curved incision in the upper part of the patient’s abdomen and extracts the patients liver.

• Third operation: The implantation of the donor’s Liver Inside the Recipient Body

In the final step of implantation, the patients’ liver diseases is replaced with the donor’s liver. After the liver transplantation, the suture (stitch) is connected with the patient’s new liver, blood vessels and bile ducts.

Liver Transplant Postoperative Details

After the liver transplantation, the patient has to spend 6 to 10 days in the intensive care unit for monitoring purpose. After the liver transplantation surgery, the regeneration of the liver usually takes about 5 to 7 weeks. After liver transplantation surgery, most people are symptoms free and feel much better; however, the patient needs to take some lifelong precautions and medication to improve their quality of life.

What Are The Precautions One Have to Take After The Liver Transplant?

After the liver transplant procedure, the patient must follow the following precautions:

• Do not consume alcohol if you have undergone Liver Transplant
• Eat a healthy diet
• Restrict the number of fried foods and spices you eat.
• Maintain a healthy weight/BMI
• Take your medicines on time
• Go for a regular checkups
• Exercise to stay fit
• Stay hydrated

Are There Any Complications Involved?

The liver transplant surgery might come with mild complications, such as:

• Bile duct complications
  • Bile duct leaks
  • Shrinking of the bile ducts
• Bleeding
• Blood clots
• Infection at the site of incision
• Complications with donated liver
  • Rejection
  • Failure
• Seizures
• Recurrence of liver disease

Anti-rejection medication side effects

After a liver transplant procedure, your doctor might ask you to take anti-rejection medications for the rest of your life which can result in side effects such as:

• Headaches
• Diarrhoea
• Diabetes
• Bone thinning
• High blood pressure
• High cholesterol

These anti-rejection drugs come with an increased risk for infection by suppressing the immune system. To fight the infections caused by these anti-rejection drugs, doctors even prescribe the medications.