Liver Transplantation Over View Education Article By DR. R.V. RAGHAVENDRA RAO

Liver is an important organ in The digestive system located right upper side of abdominal cavity. Such an important organ in the body which is continuously working is also prone for disease due to various causes like viral infection, alcohol, drugs, cancer, birth defects etc., some of which may be treated by medicines (or) sometimes minor operations. But in some major afflictions a stage may come when the liver cannot function to the optimum extent to sustain the bodily requirements. In such conditions when the liver is irreparably damaged, we can replace the nonfunctioning liver with a functioning equivalent by a surgical procedure called Liver transplantation. This procedure is all the more important in patients with end-stage liver disease (ESLD) because there is no effective artificial replacement system. The liver used for transplantation is generally procured in one of the three ways from the donors.

A. Deceased donor liver

transplantation (DDLT): In this procedure popularly called as Cadaveric liver transplantation the liver is procured from a patient who is brain dead but

his lungs and heart are still functioning.

B. Nonheart beating donors 

(NHBD ): In this, the organ is procured from a patient who is completely dead (i.e. all body organs viz. brain, heart, lungs, etc., have ceased to

function). But in these patients, the organs have to be procured within 20 minutes after death so as to preserve the viability of retrieved organ.

C. Living Related Liver Transplantation (LRLT): In these cases, the part of the liver is procured from the kith and kin of the patient requiring transplantation (Reciepient). Over the years the surgical techniques to retrieve part of donor liver without harming in any way the donor have evolved to perfection and today this surgery can be done with minimal complications and without jeopardizing the donor's health. The liver in the living related donor generally grows back to its original size within a few months and they are generally back to their routine work in a matter of few weeks with very high self-esteem due to their supreme donation. By law this type of donation is only accepted from only first degree relative of the patient.

Once the organ is taken from the donor, this is transplanted into the body of the patient suffering from End-Stage Liver Disease (Reciepient) by a complicated surgical procedure by a team of doctors including Transplantation surgeons, Anaesthetists, perfusionists, Hepatologists etc. 

Transplantation of liver is a technically demanding work and involves coordination between various branches of medicine and is a best example of success through team work in current day medical practice. There needs to be an established system with state of the art theaters, ICUS, blood bank and a whole array of supportive lab services apart from well trained manpower. Because of these factors even though Liver transplantation is an expensive procedure it is comparatively much cheaper in India. 

Once transplanted the new liver takes over the regular functions required by the body and slowly helps the body to recover to near normal functioning over a period of ew weeks to few months Since liver is the least immunogenic out of all the transplanted organs the long term maintanence costs of immunosuppressive medicatio are much cheaper in these patients. One important side effect of these immunosuppressive medications is infection and these patients are administere various vaccines for viral and bacterial disease prior to transplantation.

DR. R.V. RAGHAVENDRA RAO

MS,M.CH.(SGPGI), FHPB,FLT(SNUH)

Surgical Gastroenterologist &

Liver Transplantation Surgeon

Director, National Institute Of

Gastroenterobgy and Liver Diseases

Phone: 98664 58511