Liver Transplantation
Liver transplantation is the only option for people whose liver can no longer function. A complete liver can be obtained only from a person who has died, but a living donor can provide a part of the liver. A donated liver can be stored for 8 to 15 hours, sometimes up to 24 hours. Some people die while waiting for a compatible liver to become available.
About 80% of liver transplant recipients survive for at least 1 year. Most recipients are people whose liver was destroyed by primary biliary cirrhosis, hepatitis, or use of a drug toxic to the liver (such as high doses of acetaminophen). People whose liver has been destroyed by alcoholism can receive a transplant if they stop drinking. In people who have primary biliary cirrhosis, liver transplantation is often lifesaving. In people who have liver cancer, liver transplantation is rarely successful. The cancer usually returns in the transplanted liver or elsewhere. Fewer than 20% of recipients who have liver cancer survive for even 1 year. In people who have viral hepatitis, the virus tends to infect the transplanted liver.
The damaged liver is removed through an incision in the abdomen. Then the donated liver is put in place and connected to the recipient's blood vessels and bile ducts. Usually, blood transfusions are required. Typically, the operation lasts 4½ hours or more, and the hospital stay is 7 to 12 days.
Liver transplants are rejected somewhat less vigorously than transplants of other organs, such as the kidney and heart. Nonetheless, immunosuppressants must be taken after transplantation. If the recipient develops an enlarged liver, nausea, pain, fever, jaundice, or abnormal liver function (detected by blood tests), doctors may perform a biopsy using a needle. Biopsy results help doctors determine whether the liver is being rejected and whether immunosuppressant therapy should be adjusted.
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