The liver can be transplanted either from the living-donor or from the deceased donor. Liver transplant surgery includes the transplantation of a part of the liver from the donor to the donee who has a damaged liver and does not function well. Living-donor liver transplant is more common especially among children as the number of liver donee are more than the available deceased donors of the liver.

Living liver donors are the alternative for the donee waiting for a liver transplant from a deceased person. The remaining liver of the living donor, after the transplant, regenerates itself and reoccurs to its usual capacity and volume within a few months post the surgery. The donated part of the liver to the donee also regenerates and restores to its normal functioning.

Most often, the living-donor of the liver is a close relative or friend. Everyone or anyone cannot donate a liver but only those can who have the matching liver depending on age, organ size, blood type, and other health and medical factors. Both the donor and the donee have to go through a thorough medical examination before the transplant to know the potential outcome and risk involved.

Procedure-
For the transplant, the donor is first operated and the required part of his/her liver is removed. The donee s damaged liver part is then replaced by the healthy liver part of the donor. Both the donor s and the donee s operated liver is then attached with the bile duct and the blood vessels. Both the patients are kept under observation for some days for the medical team to know if they are having any health issue due to the transplant. The operated liver regenerates itself within certain months and starts functioning normally.

Precautions for the Donor-
Although the donor can go back to normal life routine a few months after the transplant there are a number of precautions that should be taken into account to avoid any health issue or liver damage.
  Avoid smoking.
  Avoid consumption of alcohol.
  Eat on time or do not starve or overeat.
  Avoid having heavy meals.
  Avoid heavy exercise or weight lifting or physical work.

Take Away-
Liver transplant is a surgery conducted to remove the damaged or injured liver of the patient with the healthy liver of the donor. The donor of the liver can either be deceased or living depending upon the availability of the donor and the severity of the donee.

Various lab tests and examinations are conducted on the donor and the donee to confirm their match and assess potential complications before the transplant. The donor is usually someone close to the patient or the donee whose liver has been matched depending upon various factors. As the liver regenerates within a few months, the donor can lead a normal life after the transplant.

Know How To Choose A Liver Donor For Liver Transplant! 

Liver transplant in the only curative option available for patient who develop cirrhosis of liver due to any cause ( Chronic Hepatitis B , Chronic Hepatitis C, Alcoholic Cirrhosis, NASH etc). Once patient has been diagnosed with cirrhosis it can not be reversed with any non-surgical treatment . Over a period of time patient may develop worsening in liver function resulting in complications of cirrhosis (bloody vomitus, black stools, jaundice , altered sensorium, renal dysfunction, abdominal swelling etc) labeled as  decompensated cirrhosis . These patients require Liver transplant at the earliest and should be reffered to a liver transplant centre immediately. Ideally all patient diagnosed with cirrhosis should be under the follow-up of a gastroenterologist/Hepatologist. The source of graft liver can be from two sources namely from a deceased brain-dead donor or a Living-related donor and termed respectively as DDLT ( Deceased donor liver transplant) and LDLT ( Living Donor Liver Transplant) . However both DDLT and LDLT have nearly 90% success rate and both the procedures have their own benefits and lacunaes. Also the decision to go for DDLT and LDLT may vary for any particular patient. 

Before the Liver transplant 

All recipient and Living donor go thorough evaluation before the transplant process that includes blood investigations, Imaging studies, Cardiac and pulmonary fitness tests, multidisciplinary consultation before the clearance for liver transplant is achieved. The healthcare provider will explain the entire procedure. The healthcare provider is also supposed to answer all your questions. You would be needed to sign a consent form that allows the doctor to do the surgery. Eating food is not allowed at least 8 hours before the surgery. If you cannot stay relaxed before the surgery, a sedative will be given. 

After the Liver Tranplsant 
The recipient surgery lasts for anywhere between 12-16 hrs and donor surgery for 8-12 hrs. After the surgical procedure is complete, you will be taken to the intensive care unit (ICU)and will be closely watched for several days. 

Immediately After the Surgery 
You will most likely have a tube in your throat. This is so that you can breathe with the help of a machine (a ventilator) until you can breathe on your own. The ventilator tube will be removed on next morning when all parameters are found to be satisfactory. All parameters are monitored by round the clock critical care doctors and staff for a few days. The recipient has to stay in the hospital for three weeks and the donor is discharged in one week. 

Blood samples will be collected on a regular basis to check the functioning of the new liver. Antibiotics will be infused via IV channels to prevent you from infections. The area where the operation was done should always be kept clean after you have reached home. Any stitches or surgical sutures will be removed at a follow-up visit.

Complications that may arise 
Blocked blood vessels to the new liver, bleeding, an infection, leakage of bile or blocked bile ducts, or the new liver not working for a short time right after surgery are a few complications that may arise. Not to aggravate the condition, in the case of a complication, it is imperative to visit your doctor.

Liver Transplant - What To Expect Before & After The Procedure?

The liver is the second largest organ in the human body. Everything that is consumed goes through the liver and gets metabolized. Generally the liver consists of fat accumulation, in the range of 2%, but when it reaches close to 10%, the condition is termed as fatty liver. Progression of fatty liver can lead to cirrhosis and eventually liver failure. The liver has an amazing ability to regenerate itself if a part of it is damaged. 

However, if the damage is cumulative, then the repair becomes difficult. Another point to note is that the liver can be resected in parts to ensure that the non-affected liver continues to be available to take care of the metabolism.

Causes: There are two main types of fatty liver:

Alcoholic fatty liver: This is the most common type and is seen in heavy drinkers.
Non-alcoholic steatohepatitis (NASH): The causes for this type are not clear, but obesity, diabetes, and hyperlipidemia are some causes for NASH.
Symptoms: Fatty liver develops over years, and the symptoms are both vague and appear randomly. These can be attributed to any general illness, and so diagnosis is often delayed.

Unexplained weight loss
Jaundice
Loss of appetite
General malaise
Dull pain in the right upper quadrant of the abdomen
Overall physical weakness
Ascites or fluid accumulation in the abdomen
Increased tendency to bleed
Abnormal liver enzyme levels
Diagnosis: If suspected of fatty liver, the following are done to confirm the diagnosis.

Blood tests to check for liver enzyme levels.
Imaging studies including x-ray, CT and/or MRI scan
Biopsy to confirm the diagnosis
Treatment: Fatty liver is a completely reversible condition. If a person with alcoholic fatty liver quits drinking for about 8 to 10 weeks, the damage can be totally reversed.

If there is no history of alcoholism but obesity, then switching to a non-fatty diet with lots of fresh fruits and vegetables, multigrain, dairy products, etc., can help in controlling fat accumulation and use the stored fat. Increasing the levels of physical activity also helps in burning stored fat.

As noted, the liver is capable of self-repair and self-regeneration, so if further triggers are stopped, it can heal itself.

If fatty liver is not controlled, it can develop into cirrhosis and liver failure. If it reaches liver failure, then survival rates and prognosis look very gloomy.

Prevention: Fatty liver disease can be prevented by controlling alcohol intake, adopting a healthy lifestyle, eating non-fatty and non-sugary products, and maintaining an active and healthy lifestyle.

Monitor health periodically to check on liver function, diabetes, and cholesterol levels.

Fatty Liver - All You Need To Know!

In healthy individuals, the liver contains little or no fat. In overweight or obese people, gradual fat accumulation leads to significant liver disease. Interestingly, these individuals may be consuming minimal to no alcohol. So, alcohol, which is the main cause for liver damage, does not have a significant role to play.

The non-alcoholic fatty liver disease (NAFLD) has 4 significant stages as outlined below. It is a chronically progressive disease and may take years to reach the final stages of cirrhosis and fibrosis.

1. Simple fatty liver (steatosis): This is usually identified when diagnostic tests are done for some other suspected conditions. There are usually no symptoms obvious in this stage, other than the buildup of fat in the liver.

2. Non-alcoholic steatohepatitis (NASH): The second stage where the liver is inflamed to a greater extent due to fat accumulation.

3. Fibrosis: The next degree of inflammation where blood vessels may be narrowed leading to scarring in the liver with impaired liver functions.

4. Cirrhosis: This is the most severe stage that occurs due to years of cumulative inflammation. The liver shrinks in size, is scarred, and liver functions are markedly impaired and can also result in liver cancer.

Risk factors for NAFLD: The exact reason why a person develops NAFLD is not established, but some of the risk factors include

1. Obesity, with more weight concentrated around the abdomen

2. Type 2 diabetes

3. High blood pressure

4. High cholesterol levels

5. Age greater than 50

6. Smoking

Symptoms: This will depend on the stage in which it is identified. While there are no symptoms in the early stages, in some people there could be a dull, aching below the ribs, unexplained weight loss, weakness, and extreme tiredness. As it progresses to cirrhosis, there could be jaundice, fluid accumulation in the abdomen and feet, and itching of the skin.

Management: While there is no treatment aimed at curing the disease per se, there are ways to manage the symptoms, as noted below.

1. Weight loss: Reducing excess accumulated fat will help reverse symptoms and prevent further progression of the disease. A BMI of 18 to 26 is considered optimal.

2. Dietary changes: Modify your diet to a carbohydrates and protein rich and reduced fats and sugars. Increasing fiber through fruits and vegetables is highly recommended.

3. Exercise: Whatever your choice of workout, it will do wonders for NAFLD. Keep a target of an hour or two of moderate to intense exercise per day to reduce weight.

4. Smoking: This is another risk factor and can also help prevent other effects of NAFLD such as diabetes and heart disease.

NAFLD is highly controllable with these changes and other damages can be reversed too.

What is Nonalcoholic Fatty Liver Disease (NAFLD)?

Fatty liver or steatosis refers to the condition in which excess fat gets accumulated in the liver causing the liver to dysfunction. Some percentage of fat in the liver is normal but if it gets beyond the figure of 5 to 10 percent, then it is surely a cause of concern. Such a condition warrants treatment and if fatty liver is not treated on time, it can lead to liver cirrhosis or cancer. Therefore, the signs and symptoms of fatty liver should be taken seriously.

Some of the common symptoms of fatty liver include pain in the abdomen, loss of weight, swelling in the foot, jaundice, and inflammation of the liver. Anyone who suffers from these symptoms is likely to suffer from fatty liver. But the good news is that it can be treated. There are medicines in Ayurveda, homeopathy, and allopathy for fatty liver and if one talks about Ayurveda, it treats fatty liver with a holistic approach.

1. Fatty liver and Pitta Imbalance: Ayurveda works on the principles of managing vata, pitta, and kapha   the three physical energies present in the human body. It believes that when there is any imbalance in these energies, dosha (disease) affects the body. According to Ayurveda, pitta is related to the metabolic system of the human body, which governs ingestion, digestion, and excretion. The liver, being a part of the metabolic system, is further related to pitta and this is why, when the pitta gets aggravated, the liver becomes diseased and starts to dysfunction. Ayurveda says that pitta imbalance is responsible for fatty liver. In fact, the liver is known as pitta in Ayurveda. It says that when toxins begin to build up in the liver, the liver has to work extra and this causes inflammation, ultimately leading to liver problems. So, Ayurveda tries to correct this imbalance through herbal medicines and detoxification treatment procedures.



2. Ayurveda dos and don ts: Ayurveda is a holistic science and therefore, it does not focus on suppressing the symptoms, similar to what allopathy does. It is also free from side effects and gives a permanent relief. But the patient undergoing Ayurvedic treatment has to be mindful of their lifestyle and eating habits. In case of fatty liver, Ayurveda prohibits alcohol, smoking, and spicy and oily food. So, the patient should avoid these foods. These food items should not be taken by the patient during the treatment duration. Otherwise, the effect of the medicines will get nullified. Anyone who goes for Ayurvedic treatment should remember that diet and lifestyle is a part of the treatment process and both go hand in hand.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Ayurveda for Fatty Liver - Must Know Information!

Cirrhosis of the liver is a chronic and progressive condition in which the liver gets damaged and healthy liver tissue is replaced with scar tissue, ultimately causing dysfunction of the liver. Liver damage obstructs the circulation to the liver and also hinders the processing of nutrients, hormones, drugs, toxins as well as the production of proteins and other substances made by the liver. Liver cirrhosis is caused due to hepatitis C, fatty liver, alcohol abuse, viral infections, inherited diseases, and as a toxic reaction to drugs and environmental waste products. The modern management of this condition involves diet modification, reduction in salt intake, total abstinence from alcohol, and avoiding all the causative factors of this condition.

Cirrhosis of liver causes multiple symptoms in the body including fluid collection in the abdomen, bleeding varices in the stomach, chronic heart failure, damage to the central nervous system, and various metabolic disorders in the body. Advanced cirrhosis of liver is ultimately fatal.

Ayurvedic Treatment

It is therefore of prime importance to commence treatment at the earliest possible. It is of utmost importance to treat the known cause of the condition. Ayurvedic herbal medicines have a definite action on the hepatic cells and can effectively treat inflammation within the liver. Ayurvedic medicines can also treat infection as well as metabolic dysfunction of the liver, and protect it from the toxic effects of drugs and environmental wastes. Ayurvedic medicines can therefore be effectively used to treat all the known causes of liver cirrhosis.
Liver damage causes healthy cells to be replaced with scar tissue. This is preceded by a process of inflammation, swellingand gradual death of the liver cells. Early institution of Ayurvedic treatment can help dramatically reduce inflammation and swelling and thereby preserve the liver cells and prevent unnecessary damage. Even in the early phase of scar deposition. Ayurvedic herbal medicines can help remove scar tissue, minimize permanent liver damage, and help regenerate damaged or near-dead cells Ayurvedic herbal medicines, therefore, form a comprehensive treatment therapy for liver cirrhosis.
The other symptoms resulting from liver cirrhosis such as ascites, esophageal varices, congestive cardiac failure and metabolic disorders start improving automatically when the obstruction in the liver is treated and removed. However, Ayurvedic medicines can treat these symptoms independently too, if these are observed to be severe in the affected individual and require urgent medical care. Improved functioning of the liver also helps to improve the overall metabolism and nutrition of the body and metabolize toxic substances within the body. Prompt and aggressive Ayurvedic treatment, therefore, helps comprehensively treat liver cirrhosis and significantly reduce morbidity and mortality resulting from this disease.
Cirrhosis can also adversely affect the central nervous system and cause psychotic symptoms and permanent nerve damage. Prompt treatment with Ayurvedic herbal medicines also helps to preserve the brain function and treat the associated symptoms. If required, brain damage can be treated separately with herbal medicines which strengthen the nervous system and help rejuvenate nerve cells. Medicines which act on the nervous system also help improve confidence and self-control and are therefore equally useful in helping the affected individual abstain completely from alcohol, which is a known and predominant cause of cirrhosis.
Depending upon the severity of the condition, most individuals affected with cirrhosis require regular and aggressive Ayurvedic herbal treatment for periods ranging from six to eighteen months, in order to obtain significant benefit and a possible complete cure from the condition. Ayurvedic treatment thus has a definite role to play in the management and treatment of cirrhosis.

Cirrhosis Liver - Ayurvedic Remedies That Can Help!

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