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Second Opinion Liver Transplant in India

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Second Opinion in Liver Transplant Surgery IS OF PARAMOUNT IMPORTANCE. It can be a difference between end stage liver failure and a second life. In todays scenario, live donor liver transplant is gaining popularity.

Who Needs a Liver transplant?

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Liver transplantation surgically replaces a failing or diseased liver with one that is normal and healthy. At this time, transplantation is the only cure for liver insufficiency or liver failure because no device or machine reliably performs all of the functions of the liver. Some diseases in children also warrants a liver transplant.People who require liver transplants typically have one of the following conditions.

ACUTE LIVER FAILURE

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Acute liver failure, also known as fulminant hepatic failure, occurs when a previously healthy liver suffers massive injury resulting in clinical signs and symptoms of liver insufficiency. Any number of things can lead to acute liver failure but the most common causes are acetaminophen overdose, viral infections, ingestion of a toxin such as poisonous mushrooms, or an idiosyncratic drug reaction.

The hallmark of this condition is the development of confusion (encephalopathy) within eight weeks after the onset of yellowing of the skin (jaundice). Confusion occurs because toxins typically metabolized by the liver accumulate. Unlike patients with chronic liver disease, who can survive weeks to months to years while awaiting liver transplantation, patients with acute liver failure may die within days if not transplanted.

CHRONIC LIVER FAILURE

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The liver has a remarkable ability to repair itself in response to injury. Nevertheless, repeated injury and repair, typically over many years and even decades, scars the liver permanently. The end stage of scarring is termed cirrhosis and corresponds to the point where the liver can no longer repair itself. Once a person has cirrhosis, he or she may begin to show signs of inadequate liver function. This is termed “decompensated liver disease.” Although medications can decrease the symptoms caused by the liver failure, liver transplantation represents the only permanent cure.

Viral Hepatitis

Alcoholic Liver Disease

Metabolic Liver Disease

Autoimmune Liver Disease

Genetic Liver Disease

Vascular Liver Disease

Hepatocellular Carcinoma

What happens during a liver transplant?

Liver transplant surgery requires a hospital stay. Procedures may vary depending on your condition and your provider’s practices.

Generally, a liver transplant follows this process:

1. You will be asked to remove your clothing and given a gown to wear.
2. An IV (intravenous) line will be started in your arm or hand. Other tubes (catheters) will be put in your neck and wrist. Or they may be put under your collarbone or in the area between your belly and your thigh (the groin).These are used to check your heart and blood pressure, and to get blood samples.
3. You will be placed on your back on the operating table.
4. If there is too much hair at the surgical site, it may be clipped off.
5. A catheter will be put into your bladder to drain urine.
6. After you are sedated, the anesthesiologist will insert a tube into your lungs. This is so that your breathing can be helped with a machine (a ventilator). The anesthesiologist will keep checking your heart rate, blood pressure, breathing, and blood oxygen level during the surgery.
7. The skin over the surgical site will be cleaned with a sterile (antiseptic) solution.
8. The doctor will make a cut (incision) just under the ribs on both sides of your belly. The incision will extend straight up for a short distance over the breast bone.
9. The doctor will carefully separate the diseased liver from the nearby organs and structures.
10. The attached arteries and veins will be clamped to stop blood flow into the diseased liver.
11. Different surgery methods may be used to remove the diseased liver and implant the donor liver. The method used will depend on your specific case.
12. The diseased liver will be removed after it has been cut off from the blood vessels.
13. Your surgeon will check the donor liver before implanting it in your body.
14. The donor liver will be attached to your blood vessels. Blood flow to your new liver will be started. The surgeon will check for any bleeding where you have stitches.
15. The new liver will be attached to your bile ducts.
16. The incision will be closed with stitches or surgical staples.
17. A drain may be placed in the incision site to reduce swelling.
18. A sterile bandage or dressing will be applied.

The transplant evaluation process

If your provider thinks you may be a good candidate for a liver transplant, he or she will refer you to a transplant center for evaluation. Transplant centers are located in certain hospitals throughout the U.S.

You will have a variety of tests done by the transplant center team. They will decide whether to place your name on a national transplant waiting list. The transplant center team will include:

• A transplant surgeon
• A transplant provider specializing in treating the liver (a hepatologist)
• Transplant nurses
• A social worker
• A psychiatrist or psychologist
• Other team members such as a dietitian, or an anesthesiologist

The transplant evaluation process includes:

• Psychological and social evaluation . Many different issues are assessed. They include stress, financial concerns, and whether you will have support from family or friends after your surgery.
• Blood tests . These tests are done to help find a good donor match and assess your priority on the waiting list. They can also help improve the chances that your body won’t reject the donor liver.
• Diagnostic tests . Tests may be done to check your liver and your general health. These tests may include X-rays, ultrasounds, a liver biopsy, heart and lung tests, colonoscopy, and dental exams. Women may also have a Pap test, gynecology exam, and a mammogram.

The transplant center team will review all of your information. Each transplant center has rules about who can have a liver transplant.

You may not be able to have a transplant if you:

• Have a current or chronic infection that can’t be treated
• Have metastatic cancer. This is cancer that has spread from its main location to 1 or more other parts of the body.
• Have severe heart problems or other health problems
• Have a serious condition besides liver disease that would not get better after a transplant
• Are not able to follow a treatment plan
• Drink too much alcohol

When is SECOND OPINION IN LIVER TRANSPLANT important ?

1. ^{second opinion in LIVER TRANSPLANT in India is important when your doctor doesn’t have the required surgical super specialist knowledge for your condition.}
2. ^{second opinion in LIVER TRANSPLANT in India – is important when different surgeons have given you different recommendations and you are not able to take a call.}
3. ^{second opinion in LIVER TRANSPLANT in India – is important when you haven’t received a clear cut diagnosis or treatment recommendation.}
4. ^{second opinion in LIVER TRANSPLANT in India is important when your doctor has recommended a major surgical procedure .}
5. ^{second opinion in LIVER TRANSPLANT in India is important when you feel you have incomplete information about your planned treatment.}
6. ^{second opinion in LIVER TRANSPLANT in India is important when the suggested treatment promises no significant improvement to your condition.}
7. ^{second opinion in LIVER TRANSPLANT in India is important when you want to find out if there are other treatment options you can pursue.}

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