Who needs to seek help for Liver Disease?
Patients with diagnosed or suspected liver disease, liver cancer or liver failure can get benefited by consultation with our interdisciplinary team of specialists in liver disease.
Liver diseases are usually complex in nature and need co-ordination between multiple allied specialists. By bringing together a set of specialists needed for care of such patients, Liver clinic aims to provide comprehensive liver care under one roof.
• Specialist evaluation and consultation with multi-disciplinary team consisting of
– HPB surgeon
– Liver transplant anesthesia and intensive care specialist
• Liver transplant coordinator
• Onsite laboratory service
• Liver Elastography
• Day care unit – for convenient administration of treatments that require short hospital stays for a few hours and for procedures such as paracentesis, endoscopy and biopsy.
What is Liver Failure?
As the name implies, livers can fail to function to their full capacity due to variety of reasons. Loss of liver function results in life threatening complications such as deep jaundice, bleeding, coma, accumulation of fluid in abdomen. Broadly, liver failure can be classified into acute (developing over short period of time) and chronic (developing over long period of time. Advance stages of liver failure need liver transplantation as a definitive treatment. However, liver transplantation is not always feasible or available to such patients. Such patients need medical management for optimization of their clinical conditions. Sometimes, liver failure is reversible and patients can avoid transplantation.
Types of Services & Treatment Provided
• Dedicated liver intensive care unit
• Therapeutic plasma exchange
• Continuous renal replacement therapy
• 24-hour Blood Bank with apheresis facility
• Advanced laboratory and microbiology (infection control) support
• Round the clock dialysis and CRRT support
Who needs a Liver Transplant?
Liver transplantation is often only curative treatment for patients with end-stage liver disease, certain types of liver cancers and inherited metabolic liver diseases. Liver transplant surgery is not recommended for patients who apart from serious liver disease also have: advance heart, lung, or kidney disease; type 1 diabetes and other life threatening diseases.
Types of Liver Transplants Offered
There are two major types of liver transplantation based on the source of donated liver. Liver transplantation using organ procured from brain-dead donor is known as deceased donor liver transplantation (DDLT). Similarly, liver transplantation done partial liver graft from the living donor is called living donor liver transplantation (LDLT).
Deceased donor Liver Transplant
Globally, most liver transplantations use livers from deceased donors. In this procedure, the liver usually comes from a donor who has irreversible severe brain damage incompatible with life. Massive strokes and head-injuries are common causes of such major brain damage. Healthy livers from these donors are harvested after consent. Donated liver is then transplanted in patients were various types of liver disease.
To receive a DDLT, patients are required to register with government agency regulating organ donations and transplantation activity. Unfortunately, there is a massive shortfall in organ donation compared to people waiting for transplantation. This means that people have to go on a waiting-list before they get transplantation. Sometimes, considerable length of time passes before a matched deceased donor liver becomes available.
Living donor Liver Transplantation:
In LDLT, as the name implies organ comes from a living donor. Commonly, such donor is either spouse of other close family member. A part of liver from an otherwise healthy individual having compatible blood group is removed and transplanted into the recipient. Because the liver can regenerate, the liver portion remaining in the donor, and the liver graft in recipient can grow to normal capacity.
Split Liver Transplantation:
A split-liver transplant is a procedure in which a deceased donor’s liver is divided and used for two recipients. Thus, this procedure can provide liver to two patients, usually but not always a child and an adult.
Auxiliary Liver Transplantation:
It is a surgery where donor liver is transplanted without removing patient’s own liver. After a period of time when native liver regains its function, immunosuppressants can be stopped and transplanted liver shrinks
Domino Liver Transplantation:
A domino transplant involves transplanting a living or deceased donor liver into one recipient, and using that recipient’s original liver for transplantation into another recipient. The first patient’s liver is “dominoed” into the second patient. The first patient’s liver in a domino procedure typically would have a genetic disorder. This disorder will not impact the functioning of the liver in the second transplant recipient.
Swap Liver Transplantation
Swap transplantation is applied in patients without blood group compatible donors. People who want to donate part of their liver but do not have compatible blood groups can enquire with transplant center if any other donor-recipient pair has similar issue. Sometimes between the two pairs who are facing the same problem the donor and the recipient can be switched to receive same blood group organ.
We at Kamineni Hospitals, routinely perform liver transplantation in both pediatric and adult recipients. Our focus is on using innovative surgical techniques and implementing latest advances in immunosuppressive drugs to deliver quality patient care.