A living liver donor surgery involves taking a part of a healthy person’s liver, around 60% or more, and using this liver to replace the damaged liver of a patient.
The liver has the ability to regrow over a period of time. In the following weeks after the surgery, both the donor and patients are intended to grow back the normal size of the liver. The first liver transplant was done around the 1990s, and it seemed like an impossible thing back then. Although today the transplantation science has come a long way, there aren’t many organs in the body that actually have the capacity to regrow. The liver, having this unique ability, have transformed the operative insights to a great extent. These make liver transplant surgery a very crucial and life-saving.
But there is one downside to this. For instance, for a patient with kidney disease undergoing dialysis, till the time a person is not suitable to undergo a kidney transplant, dialysis acts as a bridge to keep the patient healthy. There are no alternative therapies for liver failure, making liver transplant urgent surgery required. This is why the liver transplant candidates are prioritized by the severity of the liver disease and the extent of the damage. This is called a MELD score – Model for End-Stage Liver Disease score. The system aims to reduce the death rate due to the waiting lists.
But overall, the demand for organs still far exceeds supply – resulting in more than 14,000 people in the United States waiting for a liver to undergo the transplant. Without a timely and suitable match, the critically ill people are dying from their disease. The biggest reason behind this is the fact that a very less number of individuals come up to opt for a donation. There are not enough numbers of deceased donors who qualify for an organ donation. Most hospitals run campaigns to promote and bring in more and more people to opt for organ donations. This results in a far better outcome for diseased patients.
The facts one should be aware of while understanding liver transplants are
Most donors know their recipient:
For liver transplants in India, it is a mandatory requirement that the donor and the recipient have to be relatives. Otherwise, in most of the countries, given that this surgery needs a speed of decision, the living liver donor typically has close ties to the patient. Both the sides have to undergo a variety of compatibility tests. One biggest issue while deciding between donors is – if there is a body size difference, this results in an inadequate liver availability for the recipient.
Living donations save time:
Living donations are intended to help the diseased patient and help in avoiding the time wasted in waiting for a deceased donor. This means that when it comes to a living donor, a timely transplant can save a life before the patient’s condition deteriorates any further. It is a blessing to have a living donor available.
Live liver donations are not done as frequently:
Living liver donation was first attempted in the children in the 1980s. Adult transplants came into experimentation much later. Even after so much progress, the live liver transplants only account for around 5% of the total transplants that are happening, the reason being that the people are frightened. There are also a lot of disqualifications seen. The donor might have help issues, making them a bad candidate to help in the donation.
Risks affect both recipient and donor:
Studies have concluded that the long-term outcomes are as good for living-donor recipients, but there are some unique challenges that are faced. Because a part of the liver needs to extracted, the transplantation process is more complicated than it seems. The doctors have to understand the amount of liver to be left and the amount of new liver to be implanted.
Risk factors are also there to the donor, such as bleeding and thereby needing a blood transfusion. The mortality rate for the donor, on the other hand, is as low as 1 in 10,000 making it a rather safe surgery for the donor.
Recovery time is significant:
A living donor who is donating a kidney may need to stay in the hospital for a few days to week, while people who donate liver stay in the hospital for twice this time. This is a major operation and requires a significant time has for the donor to recover completely. It takes about six weeks for the donor and the patient to reach their normal liver size after a successful surgery.
Patients bounce back:
In both cases, a living donor or deceased donor, the surgery has a good success rate. Studies have shown that in 12 weeks of time after the surgery, significant improvements have been seen in the recipients, such as new and better muscle mass, and more confident looking gait.