Liver Transplant: Criteria, Surgery and Recovery, Life After

A liver transplant is a life-saving surgical procedure used to replace a failing or damaged liver with a healthy liver from a donor. It is often the final treatment option for patients with end-stage liver disease or acute liver failure. With advancements in medical technology and surgical expertise, the liver transplant success rate has significantly improved, offering patients a second chance at life.

What Is Liver Transplant?

A liver transplant involves the surgical replacement of a diseased liver with a healthy liver from a living or deceased donor. The liver is a vital organ responsible for detoxification, digestion, and the synthesis of essential proteins. When it fails, it can lead to life-threatening complications.

Types of Liver Transplant

There are several types of liver transplant based on the source of the donor liver:

• Deceased Donor Liver Transplant: The liver is obtained from a donor who has recently passed away but was medically declared brain-dead and consented to organ donation.
• Living Donor Liver Transplant: A portion of a healthy person’s liver (usually a close relative) is transplanted. The liver regenerates in both the donor and recipient.
• Split Liver Transplant: One donor liver is divided and transplanted into two recipients, often one adult and one child.

Each type is chosen based on urgency, compatibility, and availability.

Liver Transplant Criteria

Not everyone with liver disease qualifies for a transplant. Strict liver transplant criteria help ensure that the procedure is beneficial and has a high chance of success.

Common eligibility criteria include:

• Diagnosis of end-stage liver disease (e.g., cirrhosis, liver cancer)
• MELD score (Model for End-Stage Liver Disease) indicating severe liver dysfunction
• No severe heart, lung, or other life-threatening diseases
• Absence of active alcohol or drug abuse
• Commitment to follow medical guidance and post-transplant care

Patients are carefully evaluated by a transplant team that includes hepatologists, surgeons, psychologists, and social workers.

Liver Transplant Donor Criteria

Liver transplant donor criteria differ for living and deceased donors.

Living Donors:

• Age 18–60, generally in excellent health
• Blood group compatibility with the recipient
• No significant medical issues like diabetes, heart disease, or liver disorders

Deceased Donors:

• Brain-dead but otherwise medically stable
• No history of liver disease, infection, or cancer
• Age and organ condition are assessed by the transplant team

The goal is to ensure the best possible outcome for both donor and recipient.

Liver Transplant Procedure Steps

The liver transplant procedure is a complex operation that requires meticulous planning. Here are the general liver transplant procedure steps:

Preoperative Preparation:

• Final evaluations, imaging, and lab tests
• Confirming donor-recipient compatibility

Anaesthesia and Incision:

• General anaesthesia is administered
• An incision is made in the upper abdomen

Removal of Diseased Liver:

The damaged liver is carefully detached from blood vessels and bile ducts

Implantation of Donor Liver:

The donor liver or liver segment is placed and connected to blood vessels and bile ducts

Closure and ICU Recovery:

• The incision is closed
• Patient is transferred to the intensive care unit (ICU) for monitoring

The entire liver transplant surgery may take 6 to 12 hours depending on complications and surgical approach.

Liver Transplant Recovery

Liver transplant recovery requires hospitalisation followed by a long-term follow-up plan:

Hospital Stay:

• ICU monitoring for 3–7 days
• General ward stay for another 1–2 weeks

Medications:

• Immunosuppressants to prevent rejection
• Antibiotics, antivirals, and antifungals
• Regular monitoring of liver function tests

Lifestyle Modifications:

• Healthy diet, regular exercise, and alcohol abstinence
• Avoiding infections and minimising exposure to crowded areas.

Complete recovery can take 3 to 6 months or longer. Long-term success depends on adherence to medical advice and follow-ups.

Liver Transplant Complications

Like any major surgery, liver transplant complications can arise:

• Rejection: The immune system may attack the new liver
• Infection: Due to immunosuppressive medications
• Bleeding and blood clots
• Bile duct complications: Leakage or narrowing
• Recurrence of liver disease

Close monitoring and timely intervention help manage most complications effectively.

Life After Liver Transplant

Life after transplant can be fulfilling, with most patients returning to normal activities. Key considerations:

• Lifelong medication adherence
• Regular blood tests and imaging
• Balanced diet and exercise
• No smoking or alcohol consumption

When to See a Doctor?

Post-transplant, contact your transplant team or doctor immediately if you experience:

• Persistent fever
• Yellowing of the skin or eyes
• Abdominal pain or swelling
• Unusual fatigue or weight loss
• Change in stool or urine colour

If you are seeking guidance on transplant eligibility or aftercare, visit the Best Liver Transplant Hospital in Bangalore, such as SPARSH Hospital. Their team includes some of the Best Liver Transplant Surgeons in Bangalore, known for expertise in both adult and paediatric transplants.

Conclusion

A liver transplant is a transformative procedure for those with advanced liver disease. Understanding the liver transplant procedure, criteria, recovery process, and life after surgery helps patients and families make informed decisions.

Frequently Asked Questions

What is liver transplant?

It’s a surgical procedure to replace a diseased liver with a healthy donor liver.

Who qualifies for a liver transplant?

Patients with end-stage liver disease, liver cancer, or acute liver failure, based on MELD score and medical evaluation.

What is the liver transplant success rate?

Success rates range from 85–90% at 1 year, with many patients living decades after transplant.

How long is liver transplant recovery?

Hospital recovery takes 2–3 weeks, with full recovery spanning 3–6 months.

Are there complications after liver transplant?

Yes, including rejection, infection, and bile duct issues, but most are manageable with timely care.