How to Get Ready for a Liver Transplant
Liver problems are at a huge increase at the moment in many countries of the world. A liver transplant is a major operation that takes between six and eighteen hours depending on the complexity, condition and needs of the patient. Before a liver transplant, the patient goes through a lot of tests, scans, assessments and is also provided comprehensive information about the entire process which includes post-transplant care.
To read more about liver transplants, please follow the link below. It explains in detail, what a liver transplant is, why it is done, how it is done, the different types of transplants, the complexities involved and criteria required for liver transplants.
Getting prepared for the transplant:
Getting ready for a liver transplant can be a difficult process to go through and it involves specialists from various fields and professionals from different disciplines. The entire team may comprise of the social worker(if the patient has one), the psychiatrist who helps to deal with anxiety and other emotional issues, the liver specialist also called a hepatologist, the transplant surgeons, the nurse who specialises in liver transplants also called a transplant coordinator, dieticians, the anaesthesiologist, intensive care physicians, etc.
There are various tests that are involved and have to be completed before having a liver transplant. The patient will have to bring in all materials in support of his/her medical history, especially the ones related to the liver, so that the liver specialist can complete a pre-evaluation and proceed to the evaluation process.
These tests can take a very long time and can be very tiring. So it is best to bring someone with you, like a family member or close friend to help with understanding and coping with all the information that will be given to you.
Assessment for suitability for transplantation:
During the assessment process many tests are performed and these are supervised by a transplant hepatologist. Some of the tests that are performed include
- CT scan that uses x-rays to help identify the size and shape of the liver
- An electrocardiogram to diagnose or record the heart cycle
- Ultrasound to determine the status of the blood vessels in the liver
- Pulmonary function studies to study the status and health of the lungs
- Blood tests to identify the blood type, check its biochemical status, check its capability to help the liver function, check the clotting ability
- Tests for viruses like AIDS and hepatitis
- Finally general health examination to evaluate the patient’s overall health
Psychological evaluations are also performed to find out if the patient is ready for the transplant and is aware of all the risks involved in the transplant. Based on these results, if any issues are identified, more tests and scans are taken. In case of a female patient, pap tests, mammogram and other gynaecological tests are done. Patients are also checked to see if they are healthy enough for a transplant.
In cases where support workers or social workers are involved;
- They assess the patient to see if they have friends or relatives to care for them after the transplant.
- Counselling will be held regarding financial matters where costs of the transplant and costs for care after transplant are discussed.
- Counselling is also done for emotional issues as these can have a huge impact during the recovery process.
- Patients who had their liver damage or failure due to alcohol or drug intakes are sent for addiction counselling sessions to help them quit.
There are panels and committees at the transplant centres that assess each client based on all the evaluations and tests and check to see if a liver transplant is the best option for treatment. Decisions are made based on all these tests, assessments and evaluations.
Five Most Common Questions Liver Transplant Patients Ask
Waiting process before transplant:
Patients are placed on a waiting list according to their medical condition, blood type and body size. Patients are scored based on the seriousness of the liver disease and the scores are based on three blood tests (creatinine, bilirubin and INR). This score is called Model for End-Stage Liver Disease (MELD) score and ranges from 6 to 40. Patients with the highest score get liver transplant first.
The time for wait will depend on the availability of a suitable liver from a donor. It could be from days to months. Sometimes a matching donor liver might not become available. All these information are provided to the clients while they are on the waiting list.
Patients who are on the waiting list for a liver will be treated by a doctor, to help with the complications and help the patient feel as much comfortable as possible. MELD scores are constantly updated depending on the improvements or deterioration in health so that the position on the waiting list gets updated.
Living Donor Liver Transplant | Q&A
There are cases where a patient will have a living donor who is willing to donate part of their liver. These types of transplants have a higher success rate and the results are good. The percentage of this happening is very low. The donor could be a family member or a friend who is willing to donate part of their liver.
In these cases, this option is discussed with the transplant team and the donor is evaluated for evidence of any liver disease, infections, viruses, cancer, alcohol or drug abuse, etc. They also undergo a psychological test to see if the donor is comfortable with the decision. If the donor screens through then the blood type and body size are checked to see if they match with the recipient, and if they do, the patients are taken in for liver transplant surgery on a planned date.
In this process the surgeons first operate the donor and remove a portion of the liver for transplant. Then the patient is operated, the diseased liver is removed by disconnecting the blood vessels and bile ducts and the donor’s liver is placed inside. The blood vessels and bile ducts are connected to the new liver. The transplanted liver and the donor’s liver regenerate quickly in a few weeks’ time.
All patients have close links with the nurse who will be the transplant coordinator and will also be caring for them. Clinics will be held by a surgeon who will explain the transplant process and will gain the patient’s consent for the operation. The patients will be briefed about what happens after the transplant process, what can be expected, the recovery times and any complications that can be expected. They are given chances to ask any questions that they have. The consent form has to be read thoroughly and any doubts or questions should be clarified with the surgeon.
Pre-transplantation medications and other information:
Patients will be given pre-transplantation medications that help with clearing toxins, removing excess fluids from the body, preventing ulcers, lowering high blood pressure, lowering high cholesterol and reducing chances of internal bleeding.
If the liver is from a living donor, the operations are planned and the patient is asked to fast for eight hours before the operation. In case of a deceased donor, the patient will be expected to fast as soon as they are notified of the availability of the liver. Sedatives are given prior to the operation, to help the patient relax. There can be other preparations that may be required of individual patients according to their conditions and situations.
Tell Me a Story: Liver Transplant Patient Becomes a Determined Medical
The information below is what the patients will be aware of, even before the transplant, so that they are ready for the recovery process too.
- Usually the patient can be expected to stay in intensive care for a few days where they will be monitored by doctors and nurses for any complications and for the working of the new liver.
- After this the patient is expected to stay in the hospital for a week or two depending on the health and progress.
- Schedules are designed for the patient after the transplant for regular check-ups.
- Blood tests and other tests are done frequently during the early days after transplant, to keep check on the patient’s health and functioning of the liver.
- A lot of medicines are prescribed to be taken after the transplant that helps with reducing risks and complications and some drugs called immunosuppressants are taken life-long to prevent the immune system from attacking the new liver.
- The time for recovery can be between six months to a year, and this depends on each individual’s situation, health etc.
- Some people may be able to resume work and normal activities a few months after the surgery.
- Successful transplant and survival rates depend on each individual situation and different criteria. Many people have had liver transplants and are leading a normal life.
The contents of this hub are for general information only and should not be used as an alternative or substitute for medical advice from your own doctor or other health care professionals. Always consult your GP or health professional if you are concerned about your health in any way.
Thank you for reading and please do correct me if there are any mistakes or errors in the information provided here.
This hub is written to create awareness in people regarding health care and organ donation and is in no way written to create worries or anxieties in anyone.