Which Category of Patients Need A Liver Transplant?

A liver is the largest organ in the human body, weighing about 1.5 kg and has a significant role in terms of digestion and metabolism. It also helps remove toxins and fight infections. Therefore, when a liver fails, the overall health of an individual is significantly affected. Often a liver transplant is required where the affected liver is removed and a new liver from a donor, either living or deceased, is placed and sutured in place. The success rate, if done early and well, can be close to 80% at three years. Over a period of time, this new liver gets accepted by the body to perform various functions that were done by the original liver.

The people affected by the following diseases could benefit significantly from a liver transplant.

• Chronic liver failure: This is not easily identifiable and the condition develops over a period of time, usually over years. Chronic liver failure is produced by many conditions, the most common being cirrhosis. Due to chronic alcohol abuse, the liver tissue undergoes scarring. This scarred tissue replaces the normal liver tissue and the liver functions are affected. This leads to poor metabolism, indigestion, toxin accumulation, etc. The most typical symptoms include accumulation of fluid in the abdomen and black, tarry stools. Once diagnosed, evaluation is done to find out the MELD score. This determines the severity of cirrhosis and overall prognosis. For most cases of severe cirrhosis, transplant is almost a definitive treatment with 3-year survival rates of close to 75%.
• Nonalcoholic steatohepatitis (NASH): People who are not alcohol abusers, but have a fatty accumulation within the liver, often face a liver failure. This again can require a liver transplant.
• Biliary conditions: The bile ducts transport the bile that is produced in the liver to the stomach. If these are not functioning properly, either due to cirrhosis, blockage, or improper development, then a liver transplant may be required. This is often done in younger patients, less than 15 years old.
• Congenital conditions like hemochromatosis and Wilson’s disease: These are genetic conditions, often identified in children, and require a transplant at a young age. A full liver transplant may not be required in these cases.
• Acute liver failure: This is often a side effect of medications and can onset within a few weeks. This can necessitate a liver transplant as in most of the cases, the patients are young.