Liver transplantation is a surgical procedure performed to replace a damaged liver with a healthy one obtained from either a recently deceased donor or a living donor. The liver, when divided, can regenerate to its full size in both the patient’s and the living donor’s bodies.
Liver Transplantation Process
1. Evaluation and Listing:
- The patient undergoes a comprehensive medical evaluation to assess their suitability for transplantation.
- The patient is listed based on factors like blood test results, creatinine levels, and clotting factors.
2. Finding a Match:
- Matching is crucial for a successful transplant. Blood type compatibility and other factors are considered.
- The donor can be a living donor or a deceased donor.
3. Pre-transplant Preparations:
- Various medical tests are conducted, including blood tests, urine analysis, and imaging.
- The patient may be placed on the waiting list after meeting the minimum criteria.
Living and Deceased Donors
Living Donor:
- The liver is usually divided, and the remaining portion regrows in both the donor and recipient.
- Donors undergo a thorough evaluation to ensure physical and mental suitability.
- The procedure involves removing a portion of the liver from the living donor.
Deceased Donor:
- The entire liver is obtained from a deceased donor, typically someone who has recently passed away.
- Deceased donor transplantation involves a more complex surgical procedure.
Conditions Treated with Liver Transplantation
Liver transplantation is a life-saving option for conditions such as:
- Acute or chronic liver failure.
- Primary liver cancer.
Criteria for Liver Transplantation in Egypt
For Patients:
- Evidence of liver failure or primary liver cancer.
- Overall good health and suitability for surgery and recovery.
- Treatment of any other medical conditions.
For Donors:
- Voluntary decision without external pressure.
- Preferably between 18 and 55 years old.
- Blood type compatibility with the recipient.
- Good health, free from serious diseases.
Preparation and Tests
Before the transplant, the living donor undergoes a thorough medical evaluation, including:
- Blood tests.
- Urine sample analysis.
- Chest X-rays (for women over 40).
- Colonoscopy (for donors over 50).
- Echocardiogram and electrocardiogram.
- Other radiological tests.
Exclusions for Liver Transplantation
Several factors may exclude a person from the transplant process, such as:
- Active infections like viral hepatitis.
- Presence of malignant tumors.
- Severe heart conditions or irregular blood pressure.
- Extensive liver damage.
- Severe depression or psychological disorders.
- Substance abuse.
Follow-up and Preparation of Liver Transplant Patients
Before undergoing a liver transplant, the success of the procedure is assessed. Patients with chronic conditions that may impact the success, such as advanced liver cancer, acute heart issues, or liver cirrhosis due to alcohol addiction, may be excluded as candidates for liver transplantation. The patient’s ability to recover post-transplant is also evaluated.
Once a patient is selected for a liver transplant, they are placed on the waiting list. Patients are categorized based on blood tests, including creatinine levels and clotting factors. The higher the patient’s ranking on the list, the greater their need for transplantation.
Upon finding a match for a liver transplant patient, the surgical process is swiftly coordinated. The donor liver, whether from a living or deceased donor, is utilized based on the recipients’ needs. Typically, children receive the smaller left side of the donor liver.
Steps and Duration of Liver Transplantation
Liver transplantation is a significant procedure lasting between 6 to 12 hours. For such procedures, surgeons install a set of tubes into the body to perform specific functions when unconscious. These tubes remain in place for several days after surgery and include:
- Intravenous catheter in the arms or hands for fluid and medication delivery.
- Catheter in the neck or thigh vein for blood pressure monitoring and blood sampling.
- Tube passing through the mouth into the trachea connected to a mechanical ventilation device, mechanically expanding the lungs to ensure continuous breathing during surgery.
- Tubes in the abdomen to drain blood and fluids around the liver.
- Nasogastric tube inserted through the nose into the stomach for draining gastric secretions, remaining in place for a few days until intestinal function returns to normal.
- Catheter in the bladder for urine drainage.
To commence the procedure, surgeons make a long incision in the abdomen to access the liver. The liver is carefully disconnected, and blood vessels and bile ducts are tied off. Subsequently, the new liver is implanted and connected to the blood vessels and bile ducts.
Follow-up and Postoperative Care
After the transplant, the patient remains in intensive care for monitoring. Tubes for various functions are placed temporarily. The medical team takes blood samples to check the new liver’s function. Once stable, the patient moves to recovery, gradually reintroducing fluids and solid foods.
Best Liver Transplant Doctor in Egypt
Dr. Mohamed Al Boraie, a hepatology and gastroenterology consultant, is recognized as the best liver transplant doctor in Egypt. He is affiliated with esteemed medical organizations and actively participates in scientific conferences. For consultations on liver transplantation or liver-related issues, schedule an appointment with Dr. Mohamed Al Boraie.