The waiting time can be very variable from 1 to 12 months depending on your blood group and your waiting list number. While waiting, if you are not available at your usual numbers, you must inform the Transplant Team of your whereabouts at all times so that they can contact you as soon as an organ becomes available.
It is good idea to have a suitcase already packed with essential toiletry and underwear at home so that no time is wasted before you go to the hospital.
When is a Liver Transplant needed?
Liver transplantation is considered when the liver no longer functions adequately (liver failure). A potential cause of liver failure is a sudden (acute) failure from infection or complications from certain medications.
Long-term liver failure is more common and can be a result of the following conditions:
How are candidates for liver transplant determined?
Evaluations by specialists from a variety of fields are needed to determine if transplantation is appropriate. The evaluation includes a review of your medical/surgical/psycho-social history and a variety of tests. Many health care facilities offer an interdisciplinary approach to evaluate and select candidates for liver transplantation.
This interdisciplinary health care team may include the following professionals:
Which tests are required before getting a liver transplant?
You will need to bring all of your previous medical records, X-rays, liver biopsy slides, operative reports and a record of medications to your pre-evaluation. To complement and to update previous tests, some or all of the following diagnostic studies are generally performed during your evaluation. If specific problems are identified, additional tests may be ordered.
When you arrive at the hospital, you will undergo a series of tests. These are a routine part of the preparation for surgery and are designed to discover any infections which may not be immediately obvious. You will have a general physical examination and be asked to give samples of urine and blood. A chest X-ray, and electrocardiogram of your heart will also be made. Finally you will be asked to wash yourself thoroughly with antiseptic soap and the nurse will shave the surgical area.
The transplant surgeon and anaesthetist will meet with you to explain the operation procedure and the risks that may be involved. You will be asked to sign a form consenting to the operation.
The transplant involves a major operation to remove the diseased liver and replace it with a normal donor liver placed in its usual position in the right upper abdomen. While this may sound relatively easy, the surgery is very demanding and can take between six and eighteen hours to complete. At least three surgeons, two anaesthetists, and half a dozen nurses are needed during the operation. The diseased liver must be disconnected from four major blood vessels and the tube that carries bile from the liver to the intestines, known as the bile duct, has to be disconnected from the bowel. The new liver is then put in place, and the major blood vessels and bile duct reattached to complete the operation.
After the operation you will be taken to the intensive care unit and connected to a respirator (breathing machine). If all goes well, the respirator can gradually be phased out over 24-48 hours, although it is not unusual to require the respirator for longer periods of time.
After three to ten days in intensive care, you will probably spend another two to four weeks convalescing in the transplant unit before being allowed to go home. It is important that you try to get up and about as soon possible so that blood circulatory problems can be avoided.
Since the donor liver is foreign to the body, the body mounts an immune response to reject it. This is prevented by certain medicines referred to as immunosuppressive drugs.
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