World Liver Day 2018: 6 FAQs on liver transplant answered by an expert

Till about a decade ago, transplants were rare and their success was considered to be a miracle. But with advanced technologies, there are more successful liver transplants these days.

By: Debjani Arora | | Updated: April 19, 2018 11:10 am

World Liver Day is observed on April 19

A liver transplant is a medical procedure where a diseased liver is replaced either by a part or whole liver of a healthy person or a donor. This procedure is usually suggested to people whose liver functions have deteriorated beyond repair. The liver ceases to function either due to liver failure, cirrhosis or other health conditions that could lead to the same. It is an important organ of the body which helps in metabolism and synthesis of various proteins and enzymes. If this crucial organ stops functioning this could affect one’s health and well-being in more than one way. The body might not be able to metabolise food – carbohydrate and fats, various drugs, remove toxins, etc. So, you can just think of the dangers and the damages one is susceptible to if the liver fails to function at its optimum. Here are five signs of non-alcoholic fatty liver disease that you should know.

What makes it difficult to pick up the signs of liver damage or failure is that they aren’t obvious in their interpretations but ambiguous. The most common signs of liver damage or failure are loss of appetite, nausea, yellowing of eyes, abdominal pain and swelling, swelling of the feet, etc. These signs are so generic that one fails to recognise the problems and reaches out for help when the damages incurred are irreparable. If the liver is partially functional, medications are given to keep the healthy parts functioning and prevent further deterioration. But if the damages are grave a transplant is suggested. Till about a decade ago, transplants were rare and even its success was considered to be close to a miracle. But with advanced technologies and state-of-art facilities in most hospitals, we hear more success stories of liver transplant these days. However, many people still have their questions regarding the same. So, we got talking to Dr Arvinder Singh Soin, Chairman Institute of Liver Transplantation and Regenerative Medicine, Medanta – The Medicity to know more about liver transplant.

When is a liver transplant ‘successful’?

A liver transplant is a major operation which shows promising results in today’s times. A liver transplant is considered successful when the patient operated is given a discharge to go home without developing any complication of the surgery like an infection in the incision area, resistance to drugs given post-operation, internal bleeding or show symptoms of rejection of the organ. These are a few complications that can develop post a transplant, but if care is taken and the surgeon is well-experienced chances of these complications are less. So, when a patient doesn’t develop any obvious complications, we can say that the transplant is successful. Here are four risk factors of non-alcoholic fatty liver disease.

What is the rate of success of a liver transplant?

This depends on a lot of factors – the hospital you choose, the doctor who performs the surgery, the patient’s immediate health status the quality of the cells transplanted, etc. The current liver transplant success rate at Medanta is 95% – which is among the highest in the world.

When a transplant is not an option for people with the end-stage liver disease, how is it treated?

There are a lot of cases where people suffering from end-stage liver diseases are not able to get treated or undergo a transplant. Especially, for people with advanced liver cancer, where cancer has spread beyond the liver into other organs or in case of liver failure, where the general condition of the patient is unsuitable, or their other body parts such as kidneys, heart and lungs are functioning sub-optimally which means they are weak and might not be able to withstand the trauma and stress of a major surgery. In such cases, preventive medications and palliative care is best suggested.

Who can donate? How does one ‘find’ a suitable donor?

A suitable live liver donor is usually a close relative or spouse, 18-55 years of age, not obese and widely with matching blood groups. Here is a success story of a mother-son partial liver transplant.

What are the new treatment options and surgeries available to treat liver diseases and ensure smooth transplant?

While Hepatitis B, Hepatitis C is easily cured with effective drugs in the early stages, they often progress to decompensated cirrhosis and liver cancer later. Giving up alcohol can often control alcoholic fatty liver and even early cirrhosis. Non-alcoholic fatty liver disease or NAFLD is now the commonest liver disease. Besides controlling lifestyle, diabetes and hypercholesterolemia, are also factors that can induce NAFLD. However, there are new classes of drugs called FXR agonists that can reverse NAFLD and even early cirrhosis.

As medications go – there are strong anti-viral drugs for Hepatitis C (sofosbuvir, velpatasvir) and hepatitis B (entecavir, tenofovir) that also works.

What is the current situation of liver transplants in India and how can this be improved?

There are around 50,000 new cases of liver cancer and 2,50,000 cases of liver failure every year in India. Of which 15-20 percent of these can be saved by timely transplants. However, only 1600 liver transplants are done in India annually, largely due to problems with donor availability/suitability and cost reasons.

Improving donation rates after brain death could make it easy. Motivate more live donors by spreading awareness about keyhole, minimally invasive donor surgeries (done at Medanta) and the fact that live donation is totally safe – they go back to entirely normal physical, mental, emotional and sexual life after donation.

How much is organ transplant a part of medical tourism in India?

Medical tourism with organ donation is well developed in India. While 80 percent of all liver transplants at Medanta are for domestic and 20 percent for foreign patients, these figures at some other private hospitals are 50/50. One thing needs to be clarified – no Indian donors donate to foreigners.

Image source: Shutterstock

Published: April 19, 2018 10:28 am | Updated:April 19, 2018 11:10 am

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