Improvements in medical technology and surgery techniques have made so much possible. With organ transplants becoming relatively simpler and less risky, many critical health conditions can now be resolved. Liver transplants are one of the most common and patients going through the agony of life-threatening liver diseases now have hope.

What is a Liver Transplant?

When the patient s liver is damaged to the extent that functioning is severely impaired and regeneration is not possible, a liver transplant is advised. In the transplant surgery, the diseased liver is removed and replaced by whole or part of healthy liver from the donor.

Types of Liver Transplants

Based on the type of donor, liver transplant can be classified as deceased donor and live donor transplantation.

Deceased Donor Transplants (DDLT): A "brain dead" person can be a liver donor if they had pledged their organs previously or if their relatives consent for organ donation. The healthy liver can give a new lease of life for an ailing patient.
Live Donor Liver Transplants (LDLT): A blood relative or spouse may donate a part of their liver to the patient (subject to compatibility). As the liver is a regenerative organ, the donor's liver will function normally and the recipient will have a completely new liver. At Kauvery Hospital, a detailed evaluation of the prospective donor is done to ensure that the health risks are minimized and complete recovery is achieved.
Donor Safety

Donor can lead a normal and physically active life with no restrictions. Lifelong medications are not required and women can enjoy pregnancy and motherhood.

Who Needs A Liver Transplant?

A person with end-stage liver disease is a candidate for a liver transplant. The failure can happen over a period of time or be a sudden occurrence, due medical conditions or reactions to drugs (ALF). Following are some of the common reasons for liver failure.
Alcoholism: Long term drinking can lead to end stage liver disease.
Biliary Atresia: Absence of bile ducts since birth.
Chronic viral Hepatitis: (Hepatitis B & C)
Haemochromatosis: An inherited disorder that overwhelms the body with abnormal levels of iron deposits including liver.
Liver Cancer: (Hepatocellular carcinoma) Cirrhosis increases risk of liver cancer. Transplantation early would offer potential cure.
Primary Biliary Cirrhosis: (PBC) An unusual condition with immune mediated destruction of the bile ducts resulting in failure of the liver.
Non Alcoholic SteatoHepatitis (NASH): It is a common cause of liver disease seen in those with metabolic syndrome (Obesity, Diabetes Mellitus, Hypothyroidism and Dyslipidemia with or without Hypertension). Unlike alcoholic or viral hepatitis, it occurs in people with no inherent liver problem.Primary Sclerosing Cholangitis: (PSC) The bile duct gets scarred and narrowed, which blocks bile drainage, ultimately leading to failure of the liver.
Wilson's disease: A very rare inherited disease that causes abnormal levels of copper deposition throughout the body including liver, ultimately causing liver failure.
What does a Liver Transplant Involve?

First stage: Evaluation: A team of specialists will evaluate the patient to determine if transplant is the best option or if any other course of action will be better. This includes review of the patient's medical history and a number of investigations.

If a patient is found to be a suitable candidate to undergo transplant, we proceed to the second stage where his or her name is placed on the waiting list if he or she opts for cadaveric liver transplant.

A scoring system based on medical criteria determines the priority. In general, sicker the patient, greater is the necessity for transplant.

Third stage: Donor becomes available. When a suitable donor has been identified, the patient is contacted and informed about donor's medical condition. If the patient consents, he or she will have to come to the hospital. Some basic tests will be repeated to ensure that the current condition is safe for surgery. Surgeons and anesthetists involved in the transplant will meet the patient and brief him or her about what to expect. Once all the test results are found to be satisfactory, we proceed for surgery.

 The Procedure

While aspects of the surgery vary from patient to patient, the procedure typically takes between 8 to 12 hours to complete. Once the surgery is over, the patient is shifted to the ICU where he or she will stay for 3 to 7 days. At this stage, various tubes are connected to the body to enable it to carry out its natural functions. These are gradually removed as and when deemed appropriate. From the ICU the patient is shifted to a room for 2-3 weeks. In total, patient spends about 3-4 weeks in the hospital while undergoing transplant.

Discharge & Recovery

Once the doctors deem that the patient can return home, he or she is discharged from the hospital.
A follow up schedule is given to the patient so that complete recovery is monitored. Before discharge, patient and family will be trained on how to take medicines and what precautions to take. The number of medications will reduce over time as the recovery progresses.
The pace of recovery depends upon several factors. In general, a patient may be able to resume daily activities by 1 month and resume work by about 3 months after the surgery.

The Liver Transplant Process!

Recovery from a hernia after the surgery will need a time of approximately 2-3 weeks. The time for recovery also depends upon the surgery performed. An open surgery performed through a large incision across the region of a hernia will require a longer hospital stay and a longer time for recovery, whereas, in contrast, a laparoscopic surgery performed with 2-3 small incisions will heal faster and will need a shorter hospitalization.

The recovery process can be speeded up by taking appropriate care, and recovery tips for it are as follows:

Medication should regularly be taken as recommended by the doctor to lessen the symptoms of the surgery. 
Wound care should be taken properly. 
Dressings should be kept clean and dry, and they need to be changed very frequently in order to avoid the infection.
A persistent cough and sneezing need to be treated with the proper medication. 
Keep a pillow nearby. 
Every time while coughing and sneezing hold the pillow over the suture in order to prevent pressure on the sutures. 
Use an abdominal binder of a proper size. It supports the abdominal muscle and maintains abdominal pressure.
Use clothing which is expandable and has elastic waistbands whenever there is swelling. 
Swelling over the incision is a common complication after the surgery. Thus, the incision area should not be closed tightly by wearing tight clothing. 
Wearing expandable cloths will give more comfort and will not cause pain due to pressure. Take a stool softener before and after surgery. 
Constipation should be treated before the surgery and should be avoided after the surgery by using stool softeners. 
Straining for the stools will create pressure over the incision and hernia repair site and will delay the recovery. 
Eat healthy food. The food should be fiber-rich as it will help to improve the bowel movements, and it will avoid the risk of constipation.
Drink plenty of water to avoid constipation and improve the bowel movement.
Do not bend to pick up the things or maintain personal hygiene, i.e., cutting toenails as it will create pressure on the sutures and it may break open.
Avoid lifting of any objects as it will create pressure on sutures and will increase the risk of rupture. After a certain period of time, lift only light items (less than 20 pounds), and always use back muscles and knees. 
Do moderate exercises, such as walking, as it will speed up the recovery. Do not start with heavy exercises. 
Smoking should be avoided after the surgery as it will improve breathing and blood circulation, which will help in the healing process.

Hernia Surgery: Quick Recovery Tips!

A dialysis diet is a special diet that is customized for patients who are or will be starting dialysis within a short period of time. Such a diet is prepared to reduce the waste and fluid levels that keep on accumulating between the dialysis sessions so that the patient remains healthy for the process to be carried out seamlessly.

What can you eat?
Eat foods which are rich in high-quality proteins (poultry, fish, lean meat and egg whites).

What can t you eat?
Eat less of foods which are rich in sodium and phosphorus.

Foods high in Sodium
1. Use minimum salt in preparing the dishes; this helps control BP and probable weight gain that might happen between the dialysis sessions.
2. Make use of spices, herbs and other salt-flavored enhancers.

Meat
1. Patients on dialysis need to include more of high-quality protein foods in their diet. This will help regulate blood protein levels. Eat about 10 ounces of foods rich in high-quality protein every day.
2. 1 egg,   cup of ricotta cheese,   cup of tuna.

Salads/Vegetables

The potassium content of vegetables can be alarming for a patient on dialysis. Eat 3 servings of vegetables that are low in potassium every day. These include broccoli, cauliflower, cabbage, carrots, garlic, cucumber, eggplant, celery, radishes, etc.
Avoid vegetables such as beets, potatoes (in any form- wafers or wedges), winter squash, cooked spinach, pumpkin, asparagus and avocado.
Note:

Although seeds, nuts, peanut butter, lentils, dried beans and peas are rich in protein, they are generally struck off from the diet plan because of their high phosphorus and potassium content.
You can have moderate amounts of grains, bread and cereals.
Try and not have brown bread and other whole grains as they are loaded with phosphorus.
Usually, 5-10 servings of these are considered sufficient for patients on dialysis.
Also, limit intake of milk and other dairy products.
  cup yoghurt or   a cup of milk is considered safe. Also, remember that all varieties of milk- skim, whole and low fat, have the same amount of phosphorus.
All fruits contain some amount of potassium. However, some of them contain more potassium than the others. Limit your intake of fruit juices.
Avoid or limit fruits like: 
Orange juice and oranges
Kiwis
Prune juice and prunes
Dried fruit and raisins
Melons
Bananas

Dialysis - What To Eat & What To Avoid?

Doctors keep learning from research conducted on different types of diseases and their treatments. In the case of lactose tolerance, the conventional wisdom has been that the condition may actually start setting in by the time the baby turns 2 years, but it may not manifest itself till the child reaches adulthood. However, later research has revealed that not only does lactose intolerance occur as one ages, but there are other considerations besides the age of the person, which determine lactose intolerance and its intensity.

Production of Lactase: There is no difference of opinion that the basic cause of this condition is directly related to the production of an enzyme, lactase within the body. This enzyme is produced in the small intestine, and once its production tapers off or stops completely, lactose intolerance surfaces. Lactose intolerance refers to the manner in which the body reacts to the consumption of milk and some foods made with milk. Chemically, milk is described as a combination of one portion galactose and one portion glucose. When milk is consumed, these two are broken down with the help of the lactase enzyme.

Age Does Matter: When researchers started studying cases of lactose intolerance reported at different locations or parts of the world, the patterns that emerged showed a slightly different picture. It is true that the age of the person diagnosed with lactose intolerance does matter. As mentioned, it can start in kids as young as 2 years, but definitely, many symptoms may appear only later in the adolescence period. But some people may develop the condition much later. This means, they might not have faced lactose intolerance to begin with, but as they grow older, their body s ability to produce lactase may dwindle and even disappear and that is when the condition could be noticed and if left untreated, it can become serious too.

Other Factors Relating to Lactose Intolerance: While remaining with the same conviction that age is in important factor in the onset of lactose intolerance, there are other significant indicators which have relation to the genetic composition of the person. For example, in a mixed race population or country such as the US, among whites, the condition may not occur before 5 years of age, while among African-Americans, it occurs by the age of 2 years. Among the Asian population also the occurrence of lactose intolerance is very common, whereas in some European races, the condition is rarely noticed.

How to Manage with the Condition?
It can be easily diagnosed by Lactose Hydrogen breath test (LHBT). If you have already been diagnosed with lactose intolerance, there is not much you can do to improve or induce lactase secretion. The only way is to avoid milk. But there are some products such as butter and some specific types of cheese that can be consumed. Many manufacturers mark the packaging of their products to indicate if they can be consumed by people who are lactose intolerant.

Lactose Intolerance & Age - Understanding The Relation!

Measures to be taken before surgery for fast recovery from Abdominal Surgery.

Ancillary measures

Take regular walks several times daily to prevent blood clots and help the bowels moving.
Avoid climbing the stairs every day, at least for the first ten days. 
Avoid strenuous exercise such as lifting, carrying, pulling, or moving heavy objects (more than 5 pounds) until your surgeon advises as it may open the sutures due to pressure. Avoid lifting anything over a certain weight for at least six weeks after your operation.
Maintaining a good posture will help your wound heal correctly. Use a comfortable pillow while sitting to give rest to the operated site.
Take good sleep and proper rest for a quick recovery as most of the repair and healing occurs during sleep.
Avoid straining with bowel movements by eating a high-fiber diet or taking stool softeners to avoid constipation.
An abdominal binder can also help with the recovery process. These help keep everything in place and can decrease the possibility of a hernia.
A gradual return to work may be advised because sudden resume to work may cause opening of sutures and delay the process of healing.
Use table that easily wheels away from the bed but can also straddle the bed. This will allow you to read, use the computer, and eat without putting any pressure on your stomach or twisting around.
Cough and sneeze carefully by applying pressure to the incision with your hands or a pillow to avoid reopening of the surgical incision.
Improper dressing or not maintaining hygiene during dressing and keeping dressing unchanged for a longer period of time may lead to infection which may cause delayed healing. Thus, in order to prevent this a gentle wash with soap and water is required to avoid infection.
Dietary measures

A protein-rich diet should be consumed in order to hasten wound healing.
Have a liquid diet with lots of vitamins as vitamin C and zinc help with healing. Also, include B12 and Iron   as both aid bone marrow in forming new blood cells.
Intake of Fiber and probiotics help boost the immune system and also keeps your digestive tract moving along.
Have plenty of water-this will help the recovery process and removal of toxins from the body.
Try sitting in the sunlight as it will help with getting some extra Vitamin D.
Keep control over sugar levels if you are diabetic as increased levels of sugar in the blood helps bacteria to grow rapidly. This will further lead to infection and delay the process of healing.

Abdominal Surgery - Recovery Tips!

Coronary artery disease is one of the major killer diseases of the modern society. It is not a solitary problem but brings with it a multitude of issues including obesity, diabetes, stroke, and other metabolic disorders. A thorough understanding of what causes it and how to manage it can help save thousands of lives.

Causes: The circulatory system is mainly made up of the heart and a complex network of arteries and veins. The inner walls of these are lined with smooth muscles, allowing for free flow of blood. Gradually, over a period of time, given the density, the fat from the blood flowing through these vessels settles along the walls of these vessels. This attracts more fat, lipoproteins, and other inflammatory cells and so the process continues. This reduces the diameter of the blood vessels, therefore reducing the amount of blood supply to the target organs. If the target organ is a vital one like the brain or the heart, then it could lead to stroke or heart attacks.

Main causes for coronary artery disease include high blood pressure, high cholesterol, sedentary lifestyle, obesity, smoking, diabetes, and stress. Men are more prone than women, and family history and age puts them at higher risk.

Symptoms: Reduced blood supply to the target organ causes the following symptoms:

Shortness of Breath: A person with coronary artery disease will feel short of breath and tired with most activities, even like walking a few meters.

Chest Pain: A strong pressure sensation on the left side of the chest is an indication of coronary artery disease. Known as angina, it comes with stress and goes away once the stress is removed. It could sometimes radiate to the shoulder, down the arm, or up into the jaw also. These are classical symptoms of angina or heart attack and is considered an emergency. Of note, this is often mistaken for indigestion.

Palpitations: A sensation where you are able to hear your heartbeat.

Nausea and Excessive Sweating: Nausea and excessive sweating are also seen during angina.

Treatment: There are 3 modes to manage this.

Medications:

Aspirin to reduce the viscosity of the blood.

Statin to control the cholesterol levels.

Beta blockers to control hypertension.

Nitroglycerin for temporary relief of angina pain.

Surgical Procedures:  Surgical procedures including balloon angioplasty followed by placement of drug-eluting stents and coronary artery bypass surgery are done to manage more severe cases.

Lifestyle Change: Lifestyle changes including reduced fat consumption, decrease body weight, stop smoking, increased physical exercise, and reducing stress are highly important in preventing further damage.

Once suspected, coronary artery disease can be effectively managed and the extent of damage controlled using the above techniques.

Coronary Artery Disease   Causes, Symptoms, and Treatment

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