Liver transplant is required for patients if the liver is damaged, and there are two conditions that have to me met for liver transplant to be necessary. One, that the damage is such that it cannot be reversed. So, there is no chance of any repair, no chance of any healing of the liver and the liver has been damaged to such an extent that it has to be replaced. Second, other important thing is that the liver failure or the symptoms because of this liver damage, have to be so severe that the medical management is not effective in controlling these symptoms. Subsequently, the complications of liver failure will be life threatening to the patient.
So, these are two conditions, one is irreversibility. The other one is severity. So, once these two conditions are met, we will advise the patient for transplant. Now, medically there are different ways of measuring it. There are different scores. And based on those we advise a patient for transplant. Majority of the transplants that we do here, will be done for patients who have chronic liver disease or liver cirrhosis. So liver cirrhosis is the indication for doing transplants in around 95% of the cases that we do. These patients are the ones in whom liver has been damaged over a longer period of time. And they are the ones who will need a transplant over the next few weeks to few months. There are few patients (5% of the transplants that we do) who have acute liver failure. Acute liver failure means that the liver was fine and a suddenly there was a big injury to the liver in form of some medicines, some poisons some infections like viral hepatitis. And, then because of this severe damage, the liver has completely stopped working. These are the patients in whom transplants will be required on a very urgent basis. Sometimes they have not more than a few days (two or three days) to undergo a transplant. But then these cases are less frequent.
– Dr Manish C Varma
Professor and Head
Liver Transplant and HPB Surgery
Apollo Hospital, Jublihills, Hyderabad.
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