What is cadaver liver transplant procedure ?
Cadaver liver transplant is a procedure initiating transplant of liver harvested from a brain-dead person with the consent from his immediate family members. While liver is more accessible to harvest from a brain-dead person, it is difficult to retrieve the same from a live donor unless he is a blood-relation.
Liver and its primary functions:
Liver can be termed as the power-house of Human anatomy. It is the largest internal organ of the body, placed above the stomach and below the diaphragm performing various functions such as :
- Producing bile which breaks down fats
- Storage of vitamins, minerals and other items such as copper, iron
- Filtering toxins
- Fights infections
- Making proteins that help blood to clot
Reasons for liver failure :
“Liver-related ailments are mainly caused due to alcohol abuse, Hepatitis B, C and non-alcoholic fatty related issues such as
- Excessive intake of pain killers or un-prescribed medications
- Any drug reaction
- Persistent infections
- Consumption of heroin, cocaine or contraband drugs may affect or alter the liver function instantaneously.
- Hepatitis A that’s not been treated properly and has relapsed
- Infections that arise out of any recent surgeries such as gall stones or kidney stones removal
- Bariatric surgery associated complications or infections
- Liposuction that has not been performed properly
- Any injury to the liver caused by accidents
- Bilary Artesia in children or bilary ducts that are not formed properly
- Autoimmune hepatitis
- Wilson’s disease
- Scarring or cirrhosis of the liver
Liver transplant is suggested if 70% of the liver stops functioning. It is a multi-tasking organ performing nearly 400 activities per day.
Cadaver transplant procedures in India :
Transplantation of human organ act in 1994 covers all the aspects of cadaver transplants in India. With the enactment of this Act Multi organ harvesting from a brain dead person has become possible. Cadaver transplantations have been done successfully over the past few years. Very few government or private hospitals specialize in such transplants which need to pick up momentum.
Cases in which liver transplants are recommended:
Patients who have acute liver failure or are suffering from end stage liver diseases are eligible for liver transplants as the ailment may not be cured through medications.
Evaluation before the procedure :
The recipient is evaluated by an inter-disciplinary team of doctors ranging from cardiologists to paramedical staff. Blood tests are conducted to see if the patient is otherwise stable. A patient is given a MELD (Model for end stage Liver Diseases) score on a scale of 6 to 40 (less ill to gravely ill). This score is arrived on the results obtained from
- Bilirubin, which measures how effectively the liver excretes bile as per limits
- INR (prothrombin time), which measures the liver's ability to clot blood
- Creatinine test to determine functioning of the kidneys. Impaired or reduced kidney function is often associated with severe liver disease or impaired liver.
Based on the urgency of the score arrived, the most needy recipient is given preference.
Patients who may not qualify for liver transplant :
- Patients suffering from cancer
- Patients who have had a heart failure recently
- Patients with persistent infections
The Procedure :
Firstly the harvested liver from the cadaver donor is carefully kept in a saline solution until it reaches the operation theatre.
A liver transplant usually takes 12 to 14 hours and is a complicated and lengthy procedure. The patient is prepared for the surgery after giving anesthesia; a tube is inserted through the trachea to aid in the breathing process while the surgery is performed. Various other artificial tubes are inserted to ensure the vital functions of the body are not disrupted. The damaged liver is removed and a segment of liver harvested from the cadaver donor is implanted. After the surgery the ailing patient is carefully monitored in the ICU, until he or she recovers with ventilator support if deemed needed. Usually three tubes will be placed in the abdomen to drain blood and fluid from around the liver, until normalcy returns. T-tube may be inserted to drain bile from the duct of the liver, in certain cases. The patient may have to stay in the hospital for a week or more than two weeks.
Infection :There may be chances of infection around the liver which may cause death of the ailing patient in very rare cases. Most of the infections can be treated.
Rejection :The body’s immune system may reject the new liver as it is foreign object, anti rejection medicines or immune suppressants are given to overcome the rejection episode which may last up-to one year. Readmission in to hospital to treat this rejection episode is recommended as better care is available.
Hospital stay and precautions to be taken post transplant:
The stay in the hospital is usually two weeks or longer. Hygiene and cleanliness prevent spread of infections. Diet as per norms should be followed, medications must never be stopped or dosage altered. Straining the liver must be avoided. Alcoholics and smokers must abstain themselves from drinking or smoking. Any discomfort or fever that does not subside must be notified immediately.
Why KIMS ?
The procedure of liver transplant is delicate and requires utmost care and precision. AT KIMS we ensure it is possible with expert team of doctors and care-givers round the clock. Our teams of cadaver liver transplant experts ensure cent percent success rates and follow up visits are strictly monitored and adhered to ensure the patient comes back to his normal living.
- Already established and NABH certified hospital in cadaver liver transplants.
- Patient counseling and preparation of the family members like care-givers
- Management of logistics like, insurance, government aid involving cadaver transplantations.
- Impeccable infra structural facilities with well trained medicos
- Track record of successfully completed transplants
- Patient recovery focal care is provided round the clock
- Robotic aided surgery with latest equipments
- Comprehensive homely care provided, that makes the patient feel at ease
- Tailor made budget friendly options available
- A hospital where is Research is Researched 24*7 to enhance customer care
- One of its kind in cadaver liver transplants in south Asia
- Satisfied patients leading normal lives after transplant
- An unbiased and working network with cadaver donation organizations to facilitate emergency transplants
- Strictly adheres to the norms prescribed under the THO Act of 1994
- Web-based support and counseling as a part of our post-operative care is a mile-stone in medical history.
- Treatment sans boundaries is our motto; hence we have welcomed patients from Pakistan, Nigeria, Nepal, and Srilanka.
- Our patient testimonials are our best valued efforts and assets
- We value our patients, we just don’t treat but ensure he enjoys the quality of life