Transplant surgery in Thailand
If all other options of retaining the normal working of a liver fails, the doctor will ask for a liver transplant and replaces the damaged liver with a healthy one.
When Is a Liver Transplant Needed?
Acute Liver failure can occur anytime because of major infection or complications from certain medications. It could also occur due to slow deterioration of a chronic condition.
The reasons of the transplant include the following complications:-
-Alcohol induced cirrhosis
- Primary Hyperoxaluria type I
-Primary Biliary Cirrhosis
-Primary Sclerosing Cholangitis
-Drug induced liver failure
-Acute/fulminant liver failure
Source of Liver Donor:
This donor liver is removed from a person who is already diagnosed as brain dead and the person’s family is willing to donate the organ for transplantation. People who are lucky to get cadaver donors need to wait and waiting time varies with the availability of the donor liver.
Living donor can be a family member (generally parents, siblings, child or someone emotionally close to the patient) to donate part of their liver for transplantation. The donor is thoroughly evaluated by the team to make sure that there would not be any complications to the donor or recipient.
Living or cadaver donor whatever the type is the liver of a healthy adult donor is transplanted into the patient’s body. The patient’s non-active liver remains the same until the auxiliary piece regenerates and assumes function. The diseased liver may then be replaced. This technique is rarely used these days. The average success rate of a liver transplant at one and five years is 90 percent and 75 percent respectively.
Evaluation before the Liver Transplant.
Monitoring with the donor and Doctors.
Before the transplant consultation is needed. One meets with members of the transplant team to review past medical history and to ascertain appropriate medical treatment.
Transplant & Hepatobiliary Surgeons:
Hematologists are trained in the field of transplantation. They will take care of patient’s medical needs during the transplant period.
Nurses who assist in the evaluation, education and post-operative follow-up. They may provide support to the patient and his/her family in dealing with stress associated with chronic illness and transplantation.
- Blood Tests to confirm your blood type
- Evaluate serum chemistries
- Hematology, coagulation, hepatitis screens
- Viral studies.
- Chest X-ray, determines whether the patient’s lungs and lower respiratory tract are healthy or not. Liver and other abdominal organs and blood vessels is being examined by Ultrasound.
-Computerized Tomography gives a computer image which shows the size and shape of the liver and major blood vessels.
-MRI (Magnetic Resonance Imaging) is for more detailed picture of the abdominal organs and their blood vessels.
- Endoscopy is for a scope to look at the esophagus and stomach and assess for ulcers, inflammation or varices.
The Transplant Team requires the patient to undergo a cardiac workup to make sure his/her heart is strong enough to withstand during the treatment. ECG ensures how well the heart is beating. Echocardiogram examines the sound waves to look at the heart and the pressure in its vessels. Stress Test examines heart’s response towards the exercise. There are a few different types of stress tests. Some of them require walking on a treadmill and some give the medicine to make the heart think it’s exercising. Cardiac Angiogram, if your stress test is abnormal. Dye is injected into your arteries to help identify any abnormalities or blockages in your heart vessels.
Liver transplant surgery Pulmonary Evaluation
If the patient was a smoker or has a lung disease it may need the following tests:
Pulmonary function tests: It assesses the lung capacity and function to determine blood's ability to carry oxygen.
Arterial blood gas: It tests the carbon dioxide and oxygen level. For which the blood must be drawn from an artery.
The Transplant Surgery
One needs to take an admission to the hospital during the transplant and get prepared for surgery.
Patient and his family is being informed by a physician from the transplant team to come over the hospital once the liver is available. If there is any sort of infection then the transplant needs to be postponed immediately. But if the team thinks to take it forward to the operating room the patient is being admitted that instant. A team of surgeons will be monitoring the surgery to remove the organ from the donor’s body. In some of the cases they can even find something which bars them not to perform the transplant as the organ is not suitable for the patient. In that case the surgery needs to be postponed. In most of the cases the organ is good in condition as loads of other tests are being done before one goes to the operation theater.
Living Donor Transplantation:
This is a much planned operation, hence the both of the donor and the recipient need to undergo presurgical Tests before the transplant, these test include Blood tests, Chest X-Ray, EKG and so many other ones. The donor needs to be admitted to the hospital atleast 7 days before the surgery. Once the necessary procedures are completed surgeons may contact the family of the patient. The patient may be attached to a cardiac monitor, intravenous lines, tubes, and drains in the Intensive Care Unit When the condition of the patient stabilizes he/she is being transferred to the regular rooms. The average length of the total process is like two to three weeks.
Life after a Liver Transplant
The first thing one has to keep in mind after operation is the tendency to infection. Before one leave the hospital the team would let the patient and his/her family knows how and which are the areas to take care of. Most of the patients get back to their normal life within three months of the transplant. The goal of the total team is to provide best possible assistance an guidance to the patient.