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Living donor liver transplant is the procedure where a portion of the liver of a living donor is transplanted to one whose liver is damaged and beyond recovery. 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) .
In case of DDLT , the recipient name is registered in the NOTTO list , and whenever a suitable brain-dead donor is available the recipients are transplanted according to their position on NOTTO list. DDLT involves a longer waiting time before a deceased donor may become available which can be anywhere between a month to years . The recipient runs a risk of developing a fatal complications during the waiting period. In LDLT ( Living donor liver transplant) the graft liver is procured from a living donor who is related to recipient and agrees to donate a portion of his liver. After careful pre-operative evaluation of prospective donor nearly 60-70% of liver of donor is removed and transplanted into the recipient.
Due to the unique ability of human liver to regrow, within 6-12 weeks nearly 100% of previous liver volume is achieved. LDLT enjoys the benefits of a elective surgery done without any waiting time and delay. 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.
Factor that makes living donors potent enough to donate part of their liver:
- As the liver is composed of two lobes , right and left lobe. Also the liver has an unique ability to regenerate.
- The donor’s right lobe preferably transplanted in and adult recipient and left lobe is transplanted in pediatric age group .. When the portion of the liver is in place in the recipient’s abdominal cavity, the transplanted liver generates supplementary liver tissue adequate for decent functioning.
- The donor liver regrows to nearly 90% of its original volume in 6 weeks and nearly 100 % in three months. Morever liver functions tests revert to completely normal even before complete regeneration happens.
The knowledge, essential for the living liver donors:
- The living donor transplant method is a lifesaver, but there are some concerns. The donor should have an excellent health record and should be free from cancer, pulmonary hypertension, congestive heart failure, or any other chronic diseases.
- The donor’s liver must be healthy and large enough so that it works correctly after the right lobe is removed. The operation may take many hours, and both the recipient and the donor must rest in the ICU overnight.
- The donor can be discharged by the end of one week and can resume normal household and office work by end of second week.
Patient is advised to avoid abdominal straining for three months but after that he or she can resume absolutely normal life style. Living donor liver transplants have an advantage that they can be performed in elective setting when the patient and donor are well-optimized, eliminates the waiting time, donor liver has been well evaluated and can be performed quickly in advanced or decompensated patients. In case you have a concern or query you can always consult an expert & get answers to your questions!
My brother have cbd stones in gallbladder already stent is placed in abdomen. Please suggest me is why stent placed and how many days he will carry and also suggest what is the treatment for that.
What is MRCP. Any side effects for female who had gone through a cesarean delivery 45 days back. Any effects to breast feeding baby.
Celiac disease is a serious genetic autoimmune disease with over 300 symptoms, and most people manifest with a combination of them. It is caused by intolerance to gluten, which is a protein found in wheat, rye, barley, and other cereals. Gluten is usually present in the small intestine, and in patients with celiac disease, the lining of the small intestine gets attacked. Consequently, a number of organs and/or body systems are affected, making it extremely difficult to pointedly say that a person has celiac disease.
These symptoms cover almost all systems of the body including reproductive to digestive, cardiovascular to endocrine, respiratory to neuromuscular, and even affect the bones, and the teeth. Another major variation also is the age at which celiac disease becomes symptomatic. While some show symptoms quite early in their childhood, some others show symptoms later in their life, and some may not manifest with any symptoms all through their life.
Talking of the oral/dental symptoms, there are two main causes for concern one involving the soft tissues and the other involving the teeth. Let us look at the two in a little more detail.
Similar to the canker sores or the usual mouth ulcers, celiac disease also cause whitish sores. Unlike the canker sores which appear on the lips, the celiac mouth sores are common on the insides of the cheek, gums, lips, palate, and sometimes even the tongue. The appearance is very similar to that of aphthous ulcers, which have a whitish or grayish margin. They appear at random with no specific reason. The soft tissue lining of the digestive system is present from the stomach or intestine all the way to the mouth, and therefore these ulcers are seen. These can be quite discomforting and interfere with nutrition. Topical creams and/or gels can be applied to treat them. If celiac disease is diagnosed by then, abstaining from a gluten-free diet will help relieve the symptoms. Else, they may continue to recur and symptomatic treatment would be required.
The second oral symptom of celiac disease is the presence of visible defects of discoloration in the enamel. There are usually white, brown or yellow spots, usually discolored on the incisors and molars (front and back teeth). The bad news with the tooth issue is that these do not go away once a gluten-free diet is adopted. Depending on the severity, these may require tooth whitening treatments ranging from bleaching to veneers to full crowns.
The next time you have a group of symptoms, with the above two oral symptoms, contact your doctor and have a detailed discussion. It does not take much effort to diagnose and treat celiac disease.
Bladder prolapse is a condition wherein a woman’s vaginal wall ceases to adequately support the urinary bladder. The front wall of the vagina gives support to the bladder under normal circumstances but when this wall weakens, it allows the bladder to droop and become prolapsed. This can lead to a wide range of medical problems such as urinary difficulties, stress incontinence (leakage of urine while coughing or sneezing), pain and discomfort, etc.
Prolapsed bladders are generally associated with menopause. Also known as cystoceles or fallen bladders, they are categorized into four different types depending on the extent to which the bladder has prolapsed.
Grade 1: This is the mild stage wherein a small portion of the bladder droops into the vagina.
Grade 2: This is the moderate stage in which the bladder droops far enough to reach the opening of the vagina.
Grade 3: This is when the condition becomes severe and the bladder protrudes from the body through the opening of the vagina.
Grade 4: This occurs when the bladder has completely prolapsed. The entire bladder protrudes outside the vagina and is normally associated with other forms of pelvic organ prolapse such as uterine prolapse (the sagging of the uterus from its normal spot) and rectocele (prolapse of the wall between the vagina and the rectum).
What are the causes of prolapsed bladders?
Following are the factors that lead to the condition of prolapsed bladders:
- Menopause: The vaginal walls are known to become weak upon the onset of menopause. This occurs because the body inhibits the production of oestrogen, the hormone that renders strength to the muscles of the vagina. As a result, the bladder is no longer supported by the vagina.
- Childbirth: The process of childbirth puts a tremendous amount of stress on the vagina and often leads to deterioration of the muscles of the vaginal wall. This in turn leads to the condition of prolapsed bladder.
- Straining: Anything that puts strain on the walls of the vagina can lead to this condition. This includes lifting heavy objects, chronic constipation, obesity, excessive coughing and sneezing or any other factor that damages the pelvic floor.
What are the symptoms of a prolapsed bladder?
Symptoms of a prolapsed bladder vary from case to case, depending on the category and extent of the condition. Some of the most commonly experienced symptoms of the condition are as follows:
Tissue sticking out of the vagina (that may be tender and/or bleeding)
- Frequent urge to urinate
- Urinary incontinence (unwanted leakage of urine)
- Pain during urination
- Pain during sex
- Frequent urinary tract and bladder infections
- Pain in the vagina, pelvis, lower abdomen or lower back
- Incomplete urination
In case you have a concern or query you can always consult an expert & get answers to your questions!