Liver Transplant
Cirrhosis is end stage damage to liver. It means from the soft smooth liver like a sponge, it has become hard and irregular like a bark of a tree. Once an individual develops cirrhosis of liver, the process is irreversible. The disease progresses gradually over a period. Initially if we find the cause of cirrhosis, we can treat and stabilize the liver for a prolonged period. Eventually however, different complications set in. Initially these complications are manageable with medications and dietary restrictions. However, as the disease worsens, complications persist or recur and that is when doctors’advice you to undergo liver transplant.
Most common causes of cirrhosis in adults in India
- Alcohol
- Fatty Liver
- Hepatitis B
- Hepatitis C
- Drug Induced Liver Injury
- Autoimmune Hepatitis
- Wilson’s Disease
The treating Hepatologist will look for these causes once you are diagnosed with cirrhosis. For Alcohol related cirrhosis, stopping alcohol is of paramount importance. For attyliver related cirrhosis, weight loss is stressed upon. Hepatitis B, Hepatitis C, Autoimmune Hepatitis and Wilson’s disease, there are specific drugs which your doctor will start. Stopping complementary and alternative medicines as well as all herbal products is recommended.
Complications of cirrhosis
Complications develop 2-5 years after development of cirrhosis. There is no fixed sequence of development of all these complications and not all patients will have all of these. There are nearly 500 functions of liver and liver damage worsens, different functions are affected differently. The complications are broadly divided into following
| Portal Hypertension – Complications developing because the blood flow through the hardened liver is hampered, and blood flow is reversed. | Ascites (Fluid accumulation in tummy)
Edema feet (Swelling of feet) Low Platelets (Splenomegaly) Hematemesis (Blood Vomitus) Malena (Black Stools) Kidney Injury (Rise in creatinine, fall in urine output) |
| Liver Cell Failure – These complications develop as liver fails to produce necessary substances or clear toxins from the body
|
Jaundice (Yellow eyes, yellow urine)
Coagulopathy (Increased Bleeding tendencies) Hypoalbuminemia (Fall in Albumin level) Encephalopathy (Altered mental state) Sarcopenia (Loss of muscle mass) Sepsis (Infections as liver fails to clear infectious agents) |
The complications that are caused by portal hypertension can be initially managed and controlled by medicines and endoscopy. These would give you some time to prepare for transplant. Once they develop, you should start asking your #Hepatologist about transplant. Also start reading about it. You Need to decide on the centre where you will approach once the liver functions start worsening.Get finances sorted. If possible, inquire within the family if someone will come forward to donate.
The other complications are caused by liver cell failure. Once you develop these, it is the right time to get a transplant. You should be now in a transplant centre. Although with good medical care, we can still delay for few weeks, but it should not be delayed much as you may cross the transplant window and may not remain transplantable in future.
Acute on chronic Liver Failure
This happens very often. After development of cirrhosis, you may still be living normally on only few medicines. However, any insult to liver which can be anything from a routine viral infection, alcohol, drugs, painkillers, herbal supplements, alternative medicines, infections, clogging of blood supply to liver and liver cancer. This is an urgency as it can rapidly progress to multi organ failure and patients do not make it to transplant.The target should be to avoid any such insults to liver and even if it develops, to transplant before multi organ failure sets in.
A line diagram below indicates how liver function deteriorates over time
Liver Transplant in Ahmedabad
The year 2019 has seen one of the major changes in the transplantation scenario in Gujarat. There was the establishment of SOTTO in January this year. After the enforcement of SOTTO guidelines, the Liver transplant program is likely to get much more streamlined. The organ distribution process is going to be much more transparent and predictable.
Liver Transplant is now an established mode of treatment for end stage liver disease with success rate around 90% in most of the centers. Patients from Gujarat are traveling outside the state to get their liver transplant done. During that time, they not only end up paying a high cost for the transplant but to stay there for two to three months is a burden mentally, emotionally and financially. Liver Transplant services are already established and fully functional in Ahmedabad. There is number of transplant centers providing liver transplant services by one of the most eminent liver specialists in the country. There are few centers where there is in house transplant team and the doctors are accessible every day of the month. You can not only get cadaver based transplant at all of these centers but also living related liver transplants can be carried out. Patients are likely to get benefit out of these and they would not have to travel out to other states in the country. The cost of the transplant for the family would then be nearly halved considering cost of staying and transplant.
Patients who are suffering from end stage liver disease, cirrhosis with repeated complications like recurrent ascites, persistent swelling of their feet, development of recurrent bleeding or encephalopathy or requiring multiple admissions should consult one of the transplant centers at the earliest. Unlike kidney failure, where one can survive with dialysis for years, for liver disease one has a small window to get transplanted. It is advisable that such patients should contact their liver specialist at the earliest and get worked up for liver transplant.
Why choose us for Liver Transplant
If you need a liver transplant, you’ll want to get the best care possible. Many people choose a center close to their home because it is convenient and familiar. However, this is not always the best option. The success of a liver transplant depends on the expert hands of an experienced surgeon heavily. Apollo hospital Ahmedabad is the best hospital for your liver transplant because it –
- Has treated patients with your specific condition in the past.
- Offers Pre- and post-transplant services are comprehensive and of high quality.
- Has excellent outcomes in liver transplantation
- Takes your insurance
- It has a transplant team that makes you feel at ease and thoroughly answers all of your questions.
Apollo Hospitals Ahmedabad offers the best multidisciplinary team under one roof, consisting of experienced surgeons, immunologists, laboratory services, transplant pharmacy, nutrition, patient education, financial support, and more all in one place.