If you or someone you know are considering a liver transplant, it is important that you completely understand the benefits, risks, and limitations of transplantation so you can make an informed decision.
Your success as a liver transplant recipient depends in part on your understanding of what to expect before, during, and after your transplant surgery.
The Healthy Liver
The liver is the largest solid organ in the body, weighing about three (3) pounds in the adult. It is located primarily on the right side of the body between the diaphragm and the bottom of the rib cage. The blood vessels that carry blood to the liver are the large portal vein and the smaller hepatic artery. The blood vessels that carry blood away from the liver are the hepatic veins. The liver performs several important functions, a few of which are:
- Metabolism (breakdown) of nutrients from food for use by the body.
- Manufacture of proteins necessary for blood clotting and restoring body protein, which your body continually breaks down.
- Metabolism of drugs and hormones.
- Manufacture of a protein called albumin, which helps the body keep blood volume and blood pressure normal.
- Manufacture of bile, which helps the body digest fats.
- All of these important liver functions are decreased or lost when the liver is irreversibly damaged from disease. Just as you cannot live without your other vital organs, you cannot live without your liver. Your liver is a vital organ, necessary to sustain life.
The Failing Liver
Cirrhosis is a chronic, progressive disease in which the functions of the liver are gradually lost as normal liver tissue is replaced by scar tissue. Common causes of cirrhosis in the adult are chronic hepatitis, sclerosing cholangitis, primary biliary cirrhosis, hepatic vein thrombosis, chronic alcohol abuse, and cryptogenic or unknown causes.
Damage to the liver occurs from a virus, a poison, or disease. As part of the healing process, scar tissue forms and replaces normal liver cells and tissue. As liver function is gradually lost, some or all of these signs of liver disease may appear:
- Jaundice (yellow coloring of the skin and eyes)
- Dark, tea-colored urine
- Clay-colored stools
- Weight loss and muscle wasting
- Tendency to bruise and bleed easily
- Ascites (fluid in the abdomen)
- Decreased energy and fatigue
- Mental confusion which may progress to coma
- Vomiting blood or passing blood in the stools
- Edema or swelling of your legs or other parts of your body
Risks of Liver Transplant
Liver transplantation has been a life-saving surgery for many individuals. Currently, the survival at 5 years after transplant is about 70-85%. Success is largely due to advances in drug therapy (immunosuppression) and surgical technique. Long-term survivors of liver transplantation can lead active and productive lives. However, there are significant risks associated with the surgery and the chronic use of immunosuppressive drugs. A member of the liver transplant team will discuss them with you individually.