Deceased Donor Liver Transplant - Procedure and Recovery
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Rs 2200000------ To ------
Deceased Donor Liver Transplantation (DDLT) is a surgical procedure in which an unhealthy or diseased liver (that no longer functions normally) is replaced with a healthy liver from the deceased donor. This is also medically referred to as Cadaver Liver Transplantation.
A deceased donor liver transplant is nowadays a routine procedure for the treatment of terminal liver failure and often represents the only chance of a cure. The procedure usually takes 5 to 6 hours to complete depending on the patient's age and other medical conditions. The procedure has a high success rate.
|Surgery Name||Deceased Donor Liver Transplant|
|Alternative Name||Cadaver Liver Transplantation|
|Disease Treated||Acute liver failure, Chronic liver disease, Cirrhosis, Primary liver cancer|
|Benefits of the Surgery||Choice of treatment when living donors are not available, Improved quality of life|
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What is Deceased Donor Liver Transplant?
A Deceased Donor Liver Transplantation involves surgically replacing an unhealthy or diseased liver (that no longer functions normally) with a healthy liver from the deceased donor. This is also medically referred to as Cadaver Liver Transplantation. The liver is donated from a deceased donor either after brain death or circulatory death.
- Donation after Brain Death (DBD) donors: Approximately 75 out of 100 livers donated by deceased donors are from the donors whose brain stops working and are declared brain dead.
- Donation after Circulatory Death (DCD) donors: Approximately 25 out of 100 livers donated by deceased donors are from the donors whose heart stops working and are declared circulatory dead. This type is a newer process of liver transplantation
Anatomy and Physiology of the Liver
The liver is the largest internal organ in the upper right quadrant of the abdominal cavity, above the stomach and beneath the diaphragm. The weight of the liver is about 1.4 kg and is reddish-brown in appearance. The liver comprises two lobes which are further subdivided into 1000 small lobes. These small lobes are associated with small ducts. Different small ducts connect with a large duct known as the common hepatic duct. The hepatic duct carries the bile synthesised by the liver to the gall bladder and intestine.
The liver performs over 500 vital functions. Some of the essential functions of the liver include:
- Bile synthesis
- Synthesis of plasma proteins and cholesterol
- Storing of glycogen
- Regulating serum amino acid levels
- Helps in blood clotting
Conditions treated with Deceased Donor Liver Transplantation
A deceased donor liver transplant is nowadays a routine procedure for the treatment of terminal liver failure and often represents the only chance of a cure. When a living donor is unavailable, a deceased donor liver transplant is the only option. Some of the medical conditions treated by deceased donor liver transplant are:
- Acute liver failure
- Chronic liver disease
- Primary liver cancer
Who needs Deceased Donor Liver Transplantation?
An individual requires a liver transplant when his/her liver stops working properly. It is recommended when an individual has an end-stage liver disease that cannot be treated longer and need a replacement only. A deceased donor liver transplant is needed in the following cases:
- Liver failure
- Liver cirrhosis
- Acute hepatitis necrosis ( cells in the liver die due to infection and reaction to chemicals or toxins)
- Viral hepatitis (mainly caused by hepatitis B and C)
- Metabolic diseases
- Primary liver cancer
- Autoimmune hepatitis (body immune system attacks the liver cells)
- Biliary atresia (a rare disease of the liver and bile duct that occurs in newborns)
How is Deceased Donor Liver Transplantation performed?
The deceased donor liver transplantation is a life-saving and successful procedure for patients with end-stage liver disease. The procedure takes about 5 to 6 hours to complete depending on the patient's age, his/her medical condition and other medical complications. The procedure is done under general anaesthesia to keep the patient comfortable. A hepatologist along with other professional medical staff performs this procedure. The following steps are involved in the procedure:
- At first, the patient will be made to lie on the back on the operation table, and an anaesthesiologist induces a nerve block and/or general anaesthesia.
- Once the patient sedates due to the effect of the anaesthesia, the doctor will insert a tube into the lungs.
- A thin tube called a Foley catheter will also be inserted into the urethra. It helps in urine excretion during surgery.
- The skin at the operation site will be cleaned using a sterile antiseptic solution.
- An incision will be made under the ribs on both sides of the abdomen. A laparoscope and other surgical instruments are administered through the incisions.
- The surgeon carefully and precisely separates the donor liver from the nearby tissues and organs.
- The surgeon removes the damaged liver, the doctor clamps the arteries and veins to stop the blood flow.
- Then, the deceased donor's liver is carefully attached to blood vessels to initiate blood flow.
- The surgeon will then attach the bile ducts to the newly transplanted liver and check for any bleeding.
- Later, the incisions are closed with the help of stitches and staples.
- Finally, the sterile bandage will be applied to the incision site to prevent swelling and infection.
What to expect before and on the day of Deceased Donor Liver Transplantation?
Deceased donor liver transplantation generally requires the patient to stay in the hospital for a few days, depending on his or her health condition. To prepare for the day of surgery, the patient must consider the following things:
Before Deceased Donor Liver Transplantation
- The recipient will be notified about the availability of the liver from the deceased.
- The patient will undergo various tests to determine eligibility for undergoing liver transplant surgery.
- The recipient must inform the doctor/surgeon about all the medicines, including herbal medications and health supplements that they consume.
- The doctor may advise the recipient to stop taking medicines like aspirin, warfarin, and other medications that make the blood thinner and make it hard to clot.
- The recipient will be advised not to eat anything before the surgery post midnight on the day of the surgery.
- If any medicines are prescribed, the recipient may take them with a small sip of water.
On the day of Deceased Donor Liver Transplantation
- The recipient should:
- Follow all the instructions provided by the doctor.
- Leave all the valuables at home.
- Try to reach the hospital before the time of the surgery.
- Fill out a consent form before the surgery on reaching the hospital.
- Wear loose-fitting, comfortable clothes.
- Change into a surgical gown and cap before surgery.
- The doctor will insert an IV in the arm of the patient and then he/she will be taken to the surgery room.
- All the vital signs of the recipient will be checked before shifting to the operation theatre.
- Once the surgery starts, the family of the patient will be informed, and the healthcare providers will update them at regular intervals about the patient’s condition.
- Once the surgery is performed, the recipient will be taken to a recovery room. Here the recipient will be monitored until their health condition becomes stable.
What to expect after Deceased Donor Liver Transplantation?
The following things can be expected after the deceased donor liver transplantation procedure:
The recovery process at the hospital
- After the transplant, the patient will be shifted to the intensive care unit, where medical staff will monitor the patient's vitals and recovery process.
- Various tubes will be installed in the body after the surgery:
- IV lines in the arm or the neck to give the fluids and medications.
- Tubes in the stomach and the abdominal cavity to drain fluids.
- A catheter in the bladder to drain urine.
- Over time, these tubes will be removed.
- The doctor and nurse will monitor the condition to check for the signs of any complications.
- Once the condition is stable, the patient will be discharged from the hospital. The doctor will prescribe medications on the day of discharge.
Recovery process/expectation after hospital discharge
- Instructions provided by the doctor must follow at home.
- Proper hygiene should be maintained always. Hand washing after meeting strangers should be practised, and a separate towel should be available for the patient.
- The patient should wear a mask in the first three months following the surgery while going to the crowded area.
- A normal diet can be started as soon as the doctor recommends. Diet rich in protein should be consumed.
- Plenty of water should be consumed by the donor and the recipient.
- The dressing on the surgical area must be kept in place till the follow-up visit. It may get wet while taking a bath, but it is best to keep it dry if possible.
- The doctor may also recommend some regular exercise to the patients.
- Lifting anything heavier than five lbs. for the first six weeks after the surgery is unsafe.
- All the medications prescribed by the doctor must be consumed regularly as per the dosage.
- The recipient should visit the doctor for regular checkups.
First follow-up appointment
- The first follow-up with the doctor will generally be scheduled about one or two weeks from the day of the discharge.
- The patient will have regular, frequent follow up with the doctor for the first six weeks after the liver transplant.
- The doctor will monitor the condition and perform some exams, including blood tests, to monitor liver function. It is also to check for the rejection of the new liver transplant and infection.
- The patient will be on a specific diet for the first few weeks. He/she should also avoid drinking alcohol and smoking after the transplant.
- The doctor might also change the medication or advise the patient to continue with the previous medication for some more time, depending on the condition and recovery of the surgical area.
Benefits of Deceased Donor Liver Transplantation
Deceased donor liver transplantation is the most common type of liver transplant procedure. The benefits of this procedure include:
- Better quality of life with a healthy liver.
- It is a choice of treatment when living donors are not available.
- Can transplant as a whole liver.
Risks and complications of Deceased Donor Liver Transplantation
Like any other surgery, the deceased donor liver transplantation also has some potential risks and complications, such as:
- High fever, chills, or flu-like symptoms
- Rejection of the newly transplanted liver
- Infection in the transplanted liver
- Pale stool and dark-coloured urine
- Yellow skin or eyes (jaundice-like symptoms)
- Swelling in the tummy and toes
- Redness and inflammation in the body
- Reaction to anaesthesia
- Leakage of the bile or blocked bile ducts
- Infection or pus at the site of operation
- Itchy skin
When is consultation with the doctor needed?
A patient should contact the doctor as soon as possible if he/she observes any risks or complications. Risks and complications associated with the liver transplant are:
- If there is any infection at the site of the incision.
- Persistent high fever. This may be a sign of rejection.
- Bleeding from the site of the incision.
- Formation of blood clots.
- Bile leakage: It is a rare complication. It occurs in very few cases; most of them resolve independently and do not require any treatment.
Risks of delayed Deceased Donor Liver Transplantation
Research has found that delaying a deceased donor liver transplantation can lead to:
- Complications of liver failure include fluid accumulation in the brain, accumulation of toxins and bleeding disorders that can worsen the complications.
- Progression of chronic liver failure leads to an increased risk of death or permanent debility.
- Can be life-threatening for the patient.
Cost of Deceased Donor Liver Transplantation
The cost of deceased donor liver transplantation ranges from ₹15,00,000 to ₹25,00,000. The cost varies based on the following factors:
- Age of the patient
- Type of the procedure done
- Technique and equipment used
- The medical condition of the patient
- The type of hospital facility availed - individual room or shared.
|Procedure Name||Cost Value|
|Deceased Donor Liver Transplantation||₹15,00,000 to ₹25,00,000|
FAQs for Deceased Donor Liver Transplant
What are the myths versus facts about deceased donor liver transplant?
- Myth: For a deceased person, it is not necessary to get registered to donate the liver.
Fact: No, a deceased person who is declared brain dead or circulatory dead needs to be registered to the transplant centre for any organ donation.
What is a deceased donor liver transplantation?
A deceased donor liver transplantation involves surgically replacing an unhealthy or diseased liver (that no longer functions normally) with a healthy liver from the deceased donor.
What is the approximate duration of deceased donor liver transplantation?
A deceased donor liver transplantation usually takes about 5 to 6 hours to complete depending on the recipient's age, medical condition and other medical complications.
How long after death can a liver be donated?
A liver should be donated to a recipient within 24 hours after the death of an individual.
What are the types of deceased donor liver transplant?
The liver is donated by a deceased donor either after the brain (Donation after Brain Death (DBD) donors) or circulatory death (Donation after Circulatory Death (DCD) donors).
What are the advantages of deceased donor liver transplant?
A deceased donor liver transplant is the most common type of liver transplant procedure. The benefits of this procedure include better quality of life with a healthy liver, it is a choice of treatment when living donors are not available, and transplantation of the whole liver can be done.
What are the risks associated with the deceased donor liver transplantation?
The risks associated with a deceased donor liver transplantation are high fever, chills, or flu-like symptoms, rejection of the newly transplanted liver, infection in the transplanted liver, vomiting, diarrhoea, pale stool and dark-coloured urine, and yellow skin or eyes (jaundice-like symptoms).
For how long a patient have to stay at the hospital after the deceased donor liver transplant?
On average, the patient must stay at the hospital for 5 to 10 days. The days may also extend depending on the recovery time and the medical condition of the patient after the surgery.
What is the success rate of the deceased donor liver transplantation?
A deceased donor liver transplantation is a successful procedure. The success rate is about 85%.
What is the recovery time for a deceased liver donor transplant?
Full recovery of a deceased liver donor transplant takes an average of 3 to 6 months depending on the age and the health condition. If a donor has undergone laparoscopic surgery, then the recovery time will be shorter, and the wounds will heal faster.
How painful is the deceased donor liver transplantation?
The deceased donor liver transplant procedure is performed under general anaesthesia to keep the patient comfortable. Post-surgery, the patient may feel mild pain in the abdominal region for which the doctors will prescribe painkillers.
What is the cost of deceased donor liver transplantation?
The cost of a deceased donor liver transplantation procedure starts from ₹15,00,000 and goes up to ₹25,00,000.
Why does the cost of deceased donor liver transplantation procedure vary for different patients?
The cost of a deceased donor liver transplantation procedure differs due to factors including the patient’s age, the type of procedure done, techniques and equipment used, the type of hospital, and the admission room that a patient opts for.
Does insurance cover deceased donor liver transplantation?
Yes, all health insurance plans cover deceased donor liver transplantation. Paperwork is facilitated by our team on your behalf ensuring smooth approval and a cashless facility. Contact HexaHealth for a simple cashless and hassle-free experience.
Which patient should wait for a cadaver liver transplant?
A patient must wait for a cadaver liver donation when they do not have a living family member whose blood group and liver size match theirs.
Updated on : 25 July 2023
HexaHealth Care Team
HexaHealth Care Team brings you medical content covering many important conditions, procedures falling under different medical specialities. The content published is thoroughly reviewed by our panel of qualified doctors for its accuracy and relevance.
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