India has a very low rate of deceased organ donation, and lack of deceased donor livers for transplantation can be a death sentence for thousands of patients waiting for that liver transplant. To meet this demand for liver transplants and to increase the likelihood and possibility of a successful liver transplantation, most patients have no choice but to look for a Living Donor who can donate a part of their liver to them. This is the reason why Living Donor Transplants (LDLTs) constitute approximately 80% of liver transplants in India. Onlymyhealth editorial team talked to Ms. Sunayana Singh, CEO at ORGAN India, to know about the benefits and risks of a liver transplant.
Benefits and risks of liver transplant
When considering a donation or a transplant, it’s good for prospective donors and recipients to fully understand the benefits and risks. If we talk about benefits to recipients, then there are three categories of patients who will benefit from Liver Transplant.
1. Liver cirrhosis
First and foremost are those suffering from liver cirrhosis who account for around 80 to 90 percent of people going through liver transplants. Cirrhosis can come about from 4 liver diseases which permanently damage the liver over a span of 20 to 30 years. These are NAFLD (non-alcoholic fatty liver disease), Alcoholic Liver disease, Hepatitis C and Hepatitis B. Unfortunately, these are slow progressive diseases which may initially show normal liver function.
Seeing liver specialists and detecting these early may prevent the disease from progressing and to be kept at bay for many years. Vaccines for Hepatitis C and B as well as long-term treatment for fatty liver is a must. Only 5 percent of all people with cirrhosis will require transplant and its possible to keep these diseases at under control for several years. Prevention is key.
2. Acute liver failure
The second is Acute Liver Failure (ALF) which accounts for around 10 percent of liver transplants and is a disease that affects young patients who have no existing liver disease. Sudden liver failure develops due to Hepatitis A & E or due to side effects of medication. This kind of failure is life threatening just in a few days. Only 5 percent of patients will require liver transplantation and recognizing this disease and its severity is crucial to a successful transplant.
3. Liver cancer
The third category of patients benefitting from liver transplants are those suffering from liver cancer. You’d surprised to know that liver cancer has a cure, and that is a liver transplant. It accounts for around 10 percent of liver transplants. Not everyone with liver cancer can get a transplant and there are certain criteria that need to be met for the transplant to be offered. However, once it’s done patents are free of cancer.
With respect to Acute Liver Failure and Liver cancer, the survival rate is for people is a few months, but with transplant these patients can expect a normal life quality of life and life expectancy. Children that undergo transplants have achieved normal growth and life expectancy.
Risks of liver transplant
A liver transplant surgery is a long operation lasting 8-12 hours with about 10% risk to the recipients. The level of risks depends on how sick they are at the time of transplant. Each case is different. However, it is important to remember that the risk of mortality because of the various liver disease are much higher and a successful transplant will drastically increase life-expectancy and quality of life. Patients require life-long immunosuppression medicines after transplant, which will be managed by their doctors.
Anyone considering being a donor to their loved one should be in very good physical and mental health and meet strict medical criteria. To prepare for a liver donation, recipients might have to make a few adjustments to their way of life. These changes incorporate staying away from recreational medications, tobacco, and liquor.
The donation must be purely voluntarily, and the transplant is only approved once the donor clears the requirements, which will include being interviewed by a committee who will determine whether they are willing and fit for transplant. The donor undergoes a 6–8-hour operation. With standardization and experience, the risks are low at 0.3 percent. Pain and discomfort in the incision can be controlled with medications.
Typically, a liver donor spends approximately seven days in the hospital and will have an additional six to eight weeks of recovery time. Donors who are from out of town (should plan on spending an extra two to three weeks in town after they are discharged from the hospital.
There will be a scar which will be lifelong, however with new techniques of doing a liver transplant such as robotic and laparoscopic not only will the scarring be less, but also the pain associated with it. It’s important to go to a good transplant center with experienced doctors. The happiness at having saved someone they love and care about is the greatest benefit of a living donor. Post-transplant both donors and recipients should take good care of their health, avoid unnecessary medications, alcohol, tobacco and maintain a very healthy diet.