Why is Liver Transplant needed?

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.

In India the common reasons for end stage liver disease include chronic hepatitis B and C infection and long-standing alcohol abuse.

Many other liver diseases also cause cirrhosis, including autoimmune hepatitis, diseases that affect the bile ducts, which are the tubes that carry bile from the liver to the gallbladder and small intestine and include biliary atresia, Alagille syndrome, primary biliary cirrhosis, and primary sclerosing cholangitis.

Other causes include:

Hemochromatosis, a genetic condition in which iron builds up in the liver, Wilson’s disease, a genetic condition in which copper builds up in the liver, nonalcoholic steatohepatitis, or NASH, a disease caused by fat and inflammation in the liver

In children, biliary atresia is the most common cause of liver failure and the need for a liver transplant. Biliary atresia is a disease in newborns in which the bile ducts are absent, damaged, or blocked. As a result, toxic bile builds up in the liver, resulting in cirrhosis.

Other reasons for liver transplantation include cancers originating in the liver such as hepatocellular carcinoma, hepatoblastoma, and cholangiocarcinomas.

How do I assess just how bad is my disease?

End stage liver disease is a progressive disease and has different stages. There are different scoring systems through which one can evaluate the stage of disease and Liver Transplant needed. The common scoring systems used are the Child- Pugh-Turcotte scoring system and the MELD scoring system. Different parameters such as bilirubin, prothrombin time, serum albumin level etc. are required to assess the disease severity

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    A few facts about liver transplantation

    • Only cure for advanced stages of cirrhosis
    • Can be done by donation from a brain dead person or by taking a partial liver from a close living relative with matching blood group
    • Close relative with unmatched blood group (ABO incompatible) can also donate under certain additional criteria
    • Done in time, it carries more than 90% success rate
    • Close follow up and coordination with the medical team is essential after transplant
    • Life can be normal, energetic and productive after transplant