Post-Operative Period

Procedure of liver transplant in a Recipient
In the recipient, the surgical procedure involves removing the entire diseased liver. The new liver (either from a deceased donor or living donor) is kept perfused with a preservative solution and is then attached in the cavity left behind on removing the old liver. The blood vessels and the bile duct of the new liver are then connected with the recipient vessels and ducts.

Recovery period after liver transplantation in the intensive care unit and nursing unit in the hospital?
In the initial 1 week following transplant, the patient requires care in intensive care unit. The patients have round the clock nursing and doctor supervision. Regular blood tests and Doppler ultrasound (sonography) evaluation of the liver is carried out on a daily basis. On the first night of surgery, they are usually on the ventilator (support for respiration), and usually are extubated (removal of the ventilator) on the next morning, if all the parameters are favorable. The patients are on bed rest for the first 2 days and are allowed to be ambulated (walk) from the third day onwards. Those patients who are having an uneventful recovery are usually shifted to step down HDU (High Dependency Unit) by the fourth or the fifth day). If any complications are suspected then the ICU stay may get prolonged. For the first few days the family members are not allowed to come into the ICU to meet the patients as this may increase the chance of infections. The family members can however talk to the patient on phone and can view him or her on a screen through a camera attached in the patient’s room.

Potential complications during and after a transplant
Complications following liver transplant can be divided into early and late. Early complications can include kidney dysfunction, heart problems, infections, organ rejection and technical complications such as blockage of blood vessels or bile leaks. The incidence of these complications is quite low but nevertheless one needs to be prepared for these complications and their remedies. There are set protocols to deal with every complication, though the main emphasis remains on preventing these complications from occurring in the first place.Late complications include bile duct strictures, viral infections such as CMV, organ rejection, and recurrence of old disease or recidivism (going back to alcohol consumption). Patient needs to be on a regular follow up with monthly blood tests which are analyzed through emails, and a 6 monthly out patient visit for the first year and an yearly visit there after. This allows timely detection of any alteration of the normal postoperative course and it helps in taking appropriate corrective measures in time.

Recover Time from Liver Transplantation
Recovery after liver transplantation depends in part on how ill the patient was prior to surgery. Most patients need to count on spending a few days in the hospital in the intensive care unit and another few days on the ward; on an average the patent stays in the hospital for approximately 2-3 weeks in an uncomplicated post operative course and is in a dis-chargeable condition.

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Why liver transplant ?

Liver Transplant is needed when a person develops either acute (sudden) or chronic liver failure. Liver transplant is a life saving procedure in this setting.
Acute liver failure (ALF) happens suddenly. It may be caused by various reasons. In India, acute viral infection from Hepatitis A and E are the commonest cause, though it may also occur from drug induced liver damage (DILI), with acetaminophen being the leading cause
Chronic liver failure, also called end-stage liver disease, is a slower process, which progresses over months, years, or decades. Most often, chronic liver failure is the result of cirrhosis, a condition in which the liver cells progressively get destroyed and are replaced with scar tissue through out the liver.