Could tuberculosis, non-alcoholic fatty liver disease or hepatitis mean a liver transplant is necessary? How do you evaluate a donor to be the right person when you finally find a match? What are the insurance repercussions for a living donor?
A liver transplant is crucial in a condition where liver fails to carry out its functions normally. Also known as hepatic transplantation, where a surgery is carry out to remove the part of a liver or the entire liver. A donor living or deceased with the best match is tested and used for the transplant surgery.
Liver transplant is the desperate remedy for chronic liver diseases with long term complications and for sudden onset of liver diseases failing at regular functioning of removal of toxins, filtering the blood, etc.
How donor is found
A Hepatobiliary surgeon recommends a surgery only when the liver is at end stage and doesn’t respond to other remedies. Conditions such as cirrhosis, hepatitis C, high consumption of alcohol, Non-alcoholic fatty liver diseases are some which if progresses, requires a liver transplantation.
The doctor and the extended team will evaluate the patient’s liver and if transplant is necessary. Some of the factors are severity of the condition, other medical condition of the patient, physical and mental condition of the patient, other chronic conditions such as tuberculosis or HIV, if present, and success rate of the transplant, whether it is be beneficial to the patient.
After the evaluation, a patient is put on waitlist for an appropriate donor to get the best match. The positioning on the list depends on the Model End-stage Liver Disease (MELD) score. The score is based on creatinine level and INR of the blood. Those with higher score are sicker and are positioned on the top.
As a donor, the evaluation list is as follows-
Physical and mental health of the donor- an active human being with appropriate weight can be right choice. With physical health, psychological situation of the donor is also taken into account. The donor are put under lot of screening for physical and mental checkup.
Emotional situation- a living donor is asked questions so that they are future ready for situation which might change the current situation. If the surgery doesn’t succeed, what are the next steps? As a donor where does that leaves you? A living donor are doing every bit of good deeds, but donors are put through lot of screening, as to find the ideal match.
Financial condition- most of the medications and surgical procedures are covered under health insurance. Before thinking for donation of any part of your body (while alive), always check with you insurance company.
Medical consultation- before taking any positive steps towards a good deed, always consult your family doctor/physician. A doctor will follow you through every step and guide you and let you know, if you are eligible as a living donor.
Risk and complications
After the evaluation, surgery is carried out; only if the donor and patient are a good match. As discussed, the surgery is done in two ways- a part of the liver is replaced and other entails replacing the entire liver from a living or deceased donor.
A complete bed rest for three months to a year is recommended, with regular doctor follow-up.
The highest possibility of the transplant is a liver transplant failure. The patient’s body doesn’t accept the new organ, causing a liver failure or a severe risk of infection.
Following are the risks which can occur to donor or patient, if the transplant fails-
- Bleeding and blood clots- blood loss during surgery is considered. Appropriate medications are given.
- Side effects of the medications- Immunosuppressant are prescribed, so that the patient’s body accepts the new liver.
- Bile leakage- If this happens, a tube is inserted in the liver.
- Infection-Site of the surgery, is a common place for the infection.