Liver transplant is surgery to replace a diseased liver with a healthy liver.
The donated liver may be from:
The donor liver is transported in a cooled salt-water (saline) solution that preserves the organ for up to 8 hours. The necessary tests can then be done to match the donor with the recipient.
The new liver is removed from the donor through a surgical cut in the upper abdomen. It is placed into the patient who needs the liver (called the recipient), and attached to the blood vessels and bile ducts. The operation may take up to 12 hours. The recipient will often need a large amount of blood through a transfusion.
A healthy liver performs more than 400 jobs each day, including:
The most common reason for a liver transplant in children is biliary atresia.
The most common reason for a liver transplant in adults is cirrhosis. Cirrhosis is scarring of the liver that prevents the liver from working well. It can worsen to liver failure. The most common causes of cirrhosis are:
Other illnesses that may cause cirrhosis and liver failure include:
Liver transplant surgery is often not recommended for patients who have:
Risks for any anesthesia are:
Risks for any surgery are:
Liver transplant surgery and management after surgery carry major risks. There is an increased risk of infection because you must take medications that suppress the immune system to prevent transplant rejection. Signs of infection include:
Your doctor will refer you to a transplant center. The transplant team will want to make sure that you are a good candidate for a liver transplant. You will make a few visits over several weeks or months. You will need to have blood drawn and x-rays taken.
If you are the one getting the new liver, the following tests will be done before the procedure:
You will want to look at one or more transplant centers to determine which is best for you:
If the transplant team thinks you are a good candidate for a liver transplant, you will be put on a national waiting list.
While you are waiting for a liver, follow these steps:
If you received a donated liver, you will likely need to stay in the hospital for a week or longer. After that, you will need to be closely followed up by a doctor for the rest of your life. You will have regular blood tests after the transplant.
The recovery period is about 6 - 12 months. Your transplant team may ask you to stay close to the hospital for the first 3 months. You will need to have regular check-ups, with blood tests and x-rays for many years.
People who receive a liver transplant may reject the new organ. This means that their immune system sees the new liver as a foreign substance and tries to destroy it.
To avoid rejection, almost all transplant recipients must take medicines that suppress their immune response for the rest of their lives. This is called immunosuppressive therapy. Although the treatment helps prevent organ rejection, it also puts people at a higher risk for infection and cancer.
If you take immunosuppressive medicine, you need to be regularly screened for cancer. The medicines may also cause high blood pressure and high cholesterol, and increase the risks for diabetes.
A successful transplant requires close follow-up with your doctor. You must always take your medicine as directed.
Hepatic transplant; Transplant - liver
Keefe EB. Hepatic failure and liver transplantation. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 157.
Martin P, Rosen HR. Liver transplantation. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier;2010:chap 95.
Updated by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.
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