A liver transplant is an operation to take away your damaged or impaired liver and swap it with a healthy organ from someone else, named a donor. If your liver ceases to function adequately, a condition referred to as liver failure, a liver transplant may be the only means of survival.

How common are liver transplants?

Approximately 7,100 liver transplants occurred in the United States in 2015. Of these procedures, almost 600 were conducted on individuals who were 17 years old or younger.1

What are the types of liver transplant?

Deceased donor transplants

In the majority of cases, organs for transplant are taken from people who have passed away, otherwise known as deceased donors. In a dead donor organ transplant, medical professionals take away the hurting or damaged liver and put in the liver from a deceased donor. In most cases, adults get a full liver from a dead donor. Surgeons may divide the liver of a deceased donor into two sections. The majority may be allocated to an older person, and the rest may be given to either a smaller adult or a child.

Living donor transplants

At times, a healthy individual can donate a portion of their liver, usually to a relative who needs a liver transplant. This type of donor is called a living donor. At a living donor transplant operation, doctors remove a portion of the donor’s healthy liver. Surgeons take out the medically unwell or damaged liver and exchange it with a portion from a living contributor. The donor’s liver regenerates back to its normal size shortly after the operation is complete. You will get a piece of the liver which will grow back to its normal size. Organ donor transplants that involve a living donor are less usual than those where the donor has passed away.

Why would someone need to have a liver transplant?

You can’t live without a functioning liver . If you have a malfunctioning liver or primary liver cancer, receiving a liver transplant could be the solution to saving your life. Your liver can malfunction as a result of immediate problems such as toxic exposure, or long-term illnesses like chronic liver diseases. Demand for liver transplants far exceeds the amount of donor livers available.

What conditions can a liver transplant treat?

Liver transplant surgery is usually reserved for:

It’s usually a last-resort treatment. The demand for donated livers is intense, and even if you are able to obtain one, it is not guaranteed to heal the fundamental illness. In some cases of chronic liver diseases, the negative effects on the organ will persist when a new liver is transplanted. Nevertheless, as difficulties with these afflictions usually occur gradually, obtaining a healthy liver gives a lot of time worth having.

Acute liver failure

A previously healthy liver can suffer drastic harm that results in an acute liver failure. The damage may come from toxic poisoning or infection. If you have a severe liver failure, you will have signs that your liver isn’t functioning correctly – a sign that your liver has ceased its operations. This is an emergency. In some cases, the liver can make a full recovery from acute failure; however, in other cases this does not happen.

Chronic liver failure

The final result of prolonged, worsening liver damage is chronic liver failure. A large amount of your liver fiber has been replaced by scar tissue, which has no blood circulation. This is also called cirrhosis of the liver . When the normal activities of your liver start to decline, you will show signs that indicate that your liver disease is worsening.

Primary liver cancer

Primary liver cancer, also known as hepatocellular carcinoma, is a cancer that originates in the liver. If the spread of cancer is confined to the liver, having the organ taken out can eradicate the disease. Your doctor may sometimes be able to take out only part of your liver that contains the tumor (partial liver resection). If your liver is not in good health, you may require a transplant.

What are the survival rates after a liver transplant?

Survival rates for people who get liver transplants from deceased donors are one.

• 86 percent at 1 year
• 78 percent at 3 years
• 72 percent at 5 years

The 20-year survival rate is about 53 percent.3

The outcome of a successful liver transplant and one’s lasting survival depends on a person’s particular circumstances.

Transplant Process

Discussing with your doctor, going to a transplant center, and being assessed are all parts of the liver transplant procedure.

Talk with your doctor about a liver transplant

Discuss with your physician to determine if you are suitable for an organ transplant. Physicians will look at the possibility of a liver transplant after they have exhausted all other potential methods of care. However, a liver transplant is not for everyone. Your physician may inform you that you are not sufficiently fit to undergo surgery. It is possible that you possess a health issue that would make it improbable for a transplant to be effective. If your and your physician deem a liver transplant to be a suitable option for you, they will send you to a transplant facility.

Visit a transplant center

On your initial trip to a transplant clinic, medical staff will provide details about

• the evaluation and approval process
• placement on the national waiting list
• reasons for being removed from the national waiting list
• the waiting period
• how people are selected for liver transplants
• surgery and recovery
• the long-term demands of living with a liver transplant, such as taking medicines for the rest of your life

Get evaluated for a liver transplant

An array of tests will be conducted at the transplant center, and there you will encounter the individuals that will make up your transplant team. It is possible that you will have to go to the transplant center multiple times over a period of a few weeks or even months.

Get approved for a liver transplant

The selection board at the transplant center will take a look at the outcomes of your examination. Every transplant facility has its own regulations about who can receive a liver transplant. Transplant centers often post their guidelines on their websites. The centers also follow national guidelines.

Remember that it is your right to decide not to go through with a transplant even if you have been given the green light.

Get placed on the national waiting list

If you receive approval for a transplant and do not have an organ donor who is still alive, your name will be put down on the government’s registry of people who are waiting for a liver from a deceased donor. If you are fortunate enough to receive an organ transplant from a living donor, you will not need to be placed on the national waiting list.

The Organ Procurement and Transplantation Network’s website includes a system that connects all local organ acquisition entities to transplant facilities. UNOS, a non-profit organization, has been chosen by the Federal Government to manage the United Network for Organ Sharing (OPTN). Once UNOS has officially enrolled you in the nationwide waiting list, they will inform both you and your transplant center.

UNOS regulations allow you to sign up to multiple transplant centers to improve the odds of getting a liver transplant. Each transplant center may require a separate medical evaluation.

Wait for a match

The time frame to receive a transplant from a deceased donor can be from as little as 30 days up to 5 years. The amount of time that it takes is dependent upon the urgency or necessity of the operation. Other circumstances like age, location, blood type, body size, general well-being, and the presence of a potential donor liver could potentially lengthen or shorten the amount of time one needs to wait. The UNOS system finds a deceased donator’s liver that can be compatible with a person, according to their blood type and physical dimensions.

UNOS regulations put individuals with the direst necessity for a fresh liver at the highest point on the national waiting list to prevent fatality.

Your transplant team coordinator will phone you immediately when an appropriate liver from a cadaveric donor is found. They will let you know what to do before heading to the hospital, and will request that you come to the hospital in a hurry.

How is the liver transplant waiting list ranked?

A limited amount of individuals who are in life-threatening straits due to a severe form of liver failure will be given utmost consideration. These individuals get sick without warning, and their names stay on the roster for only a matter of days. The majority of individuals on the list suffer from either chronic liver failure or liver cancer. If you are amongst those affected by a medical condition, then your medical practitioner will utilize a rating system to evaluate the seriousness of your condition.

The MELD (Model for End-Stage Liver Disease) and PELD (Pediatric End-Stage Liver Disease) are both methods of calculating the degree of chronic liver disease. It’s calculated by blood test results. The tests measure:

• Bilirubin . High bilirubin levels indicate that bile is leaking into your bloodstream.
• Prothrombin Time . This is how long it takes for a sample of your blood to clot.
• Creatinine . This is a measure of how well your kidneys are functioning. It’s used for adults.
• Albumin . This measure of kidney function is used instead of creatinine for children.

Different factors that can give an indication of how well the liver is performing its functions. Points can be added to your score due to extra circumstances, known as exception points. These consist of additional ailments and issues that make your necessity even more imperative. In children, low growth rates add exception points. The amount of points you obtain determines your ranking on the waitlist.

If you have been diagnosed with hepatocellular carcinoma (the most common form of liver cancer), your doctor looks at the size of the tumor and the elapsed time since it was discovered in order to accurately calculate your mortality risk.

Confirm living donor match if you choose this type of liver transplant

The transplant team will check if you and the potential living donor, such as a relative, spouse, or friend, are compatible for the procedure by verifying if you have a similar blood type and body size. The transplant team will

• ask the potential donor about his or her medical history
• perform medical tests to make sure the person is in good general health, with no major medical or mental illnesses

The ideal donor for a liver transplant must satisfy three qualifications: they must comprehend and comply with all directions prior to and after surgery, be between 18 and 60 years old, and have an emotional attachment to the individual receiving the liver organ transplant.

The OPTN and UNOS furnish abundant facts about the organ transplant procedure.

How are donor livers matched with transplant recipients?

The sequence of names given priority on the liver transplant waiting list is not exclusively determined by how urgent the need is. It’s also sorted by:

• Blood type.
• Body size.
• Geography.

It is beneficial for one to possess a matching blood type when receiving a liver from a donor in order to stop the body from refusing the organ. Having a body size comparable to yours will guarantee that the new liver is the exact size that your body needs. Being close by geographically will make certain that the donor liver can be delivered to you while it is still alive and in good condition (in the eight to nine hour mark).

One must generally be compatible in all three classifications in order to receive a donor liver. For pressing necessity, you could obtain a liver if one becomes available, even if it is located up to 500 miles away. Generally, a complete liver is allocated to a single recipient, however it is sometimes possible to find two people who can both make use of the same liver.

How long can you live without a liver transplant?

It is impossible to foretell if someone with acute liver failure will be able to recover. Those who don’t recover may die within days. Chronic liver failure is a more gradual process. Individuals with cirrhosis may have a lengthy wait for a liver transplant, although the requirement for the operation becomes more pressing when issues like portal hypertension come about.

If you’re on the waitlist for a liver transplant to cure primary liver cancer, the disease might still be in its introductory phase. A liver transplant is only a viable option as a treatment for liver cancer if the disease has not progressed beyond the liver. Nevertheless, the majority of individuals diagnosed with primary liver cancer have long-term liver problems. The conclusion you draw is based on numerous individual circumstances.

How common are liver transplants?

Around 8,500 people a year receive liver transplants. Approximately 12,500 individuals are put on the list of people needing a donor annually. The vast majority (95%) of liver transplantations are utilizing a whole organ taken from a departed individual. Nevertheless, a growing number of individuals are opting for partial organ donation from living donors. The number of living donor liver transplants performed in 2019 was 30% higher than in 2018.

How serious is liver transplant surgery?

Surgery to remove some or all of the liver is thought to be a challenge to perform. A justification for why liver surgeons need to be trained in special techniques is due to the large amount of blood loss that can occur during a liver operation. Those who suffer from liver failure tend to experience a greater amount of bleeding due to the liver’s inability to fulfill one of its roles, which is to stop excessive bleeding by clotting the blood.

It is possible that you will have to receive several blood transfusions as part of your surgery procedure, which can take as long as half of a day or an entire day. The extended time of the procedure increases the likelihood of potential issues that could arise during and after the operation. Following the procedure, you will be carefully monitored for 24 hours and must stay at the hospital for between one and three weeks.