Living donor-liver-transplantation-india

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Institute of Liver, Pancreas Diseases & Organ Transplantation Know the facts... Liver Transplantation What happens during the operation? What are the potential complications of surgery? An upper abdominal incision, in the shape of an inverted 'L' is made to expose the liver. The liver anatomy is re-checked, and an X-Ray of the bile ducts obtained (cholangiogram) to ensure patient safety. The donor's liver is split into two parts. One part is removed for the transplant. The wound is then closed with suture or staples. Donors stay in the hospital from 4 to 7 days after surgery, longer if problems occur. The first night after surgery is usually spent in the intensive care unit (ICU). The next day, the patient may be moved to the general surgical floor where nurses have experience caring for liver donors. The nurses will encourage one to get out of bed and sit in a chair the day after surgery and to walk as soon as able. As with any major surgery, there are risks. There is a 10 to 25% chance a donor could have complications from the surgery. A donor may develop some problems during or right after the operation; they might also experience problems later. Surgical problems include bleeding, infection, bile leaks, or damage to the bile tree (the ducts that run through the liver). Other risks can come from anesthesia and general surgery. Living Donor (Modified from the American Society of Transplantation information brochure) You may also want to talk to a donor who has already gone through the surgery and can talk about his or her experiences. You may be in hospital for a week, if all is well. It takes about 4 weeks to recover from surgery. Most donors recover fully after the operation and can do normal activities within a few months after the surgery. The liver team will tell you when it is safe to return to normal life. How long does recovery take? Global Hospitals 6-1-1070/1to4, Lakdi-ka-pul, Hyderabad - 500 004. Ph: +91 40 2324 4444 (10 lines) Aware Global Hospitals Sagar Road, L.B.Nagar, Hyderabad - 500 035, Ph: +91 40 2411 11 Hyderabad | Chennai | Bengaluru | Mumbai Emergency: 040 2324 4444 Specialties: n n n n n Liver Diseases Neurosciences Medical Gastroenterology Therapeutic Endoscopy Bariatric Surgery n n n n n Hepatobiliary Surgery Oncology Critical Care Minimal Access Surgery And other services n n n n n Cardiac Sciences Multiorgan Transplantation Surgical Gastroenterology Endocrinology Pancreatology www.globalhospitalsindia.com Prof. Mohammed Rela, MBBS, MS, FRCS (Edinburgh) Head of Multi-organ Transplantation and HPB Surgery Global Hospitals Group THE HYDERABAD TEAM Dr. Dharmesh Kapoor (Transplant Hepatologist) Dr. Balbir Singh (Transplant and HPB Surgeon)

Transcript of Living donor-liver-transplantation-india

Institute of Liver, Pancreas Diseases& Organ Transplantation

Know the facts...

Liver Transplantation

What happens during the operation?

What are the potential complications of surgery?

An upper abdominal incision, in the shape of an

inverted 'L' is made to expose the liver. The liver

anatomy is re-checked, and an X-Ray of the bile ducts

obtained (cholangiogram) to ensure patient safety. The

donor's liver is split into two parts. One part is removed

for the transplant. The wound is then closed with suture

or staples.

Donors stay in the hospital from 4 to 7 days after

surgery, longer if problems occur. The first night after

surgery is usually spent in the intensive care unit (ICU).

The next day, the patient may be moved to the general

surgical floor where nurses have experience caring for

liver donors. The nurses will encourage one to get out of

bed and sit in a chair the day after surgery and to walk

as soon as able.

As with any major surgery, there are risks. There is a 10

to 25% chance a donor could have complications from

the surgery. A donor may develop some problems

during or right after the operation; they might also

experience problems later. Surgical problems include

bleeding, infection, bile leaks, or damage to the bile tree

(the ducts that run through the liver). Other risks can

come from anesthesia and general surgery.

Living Donor

(Modified from the American Society of Transplantation information brochure)

You may also want to talk to a donor who has already

gone through the surgery and can talk about his or her

experiences.

You may be in hospital for a week, if all is well. It takes

about 4 weeks to recover from surgery. Most donors

recover fully after the operation and can do normal

activities within a few months after the surgery. The liver

team will tell you when it is safe to return to normal life.

How long does recovery take?

Global Hospitals6-1-1070/1to4, Lakdi-ka-pul,Hyderabad - 500 004.Ph: +91 40 2324 4444 (10 lines)

Aware Global HospitalsSagar Road, L.B.Nagar,Hyderabad - 500 035,Ph: +91 40 2411 11

Hyderabad | Chennai | Bengaluru | Mumbai

Emergency: 040 2324 4444

Specialties:

n

n

n

n

n

Liver Diseases Neurosciences Medical Gastroenterology Therapeutic Endoscopy Bariatric Surgery

n

n

n

n

n

Hepatobiliary SurgeryOncology Critical Care Minimal Access Surgery

And other services

n

n

n

n

n

Cardiac Sciences Multiorgan Transplantation Surgical Gastroenterology Endocrinology Pancreatology

www.globalhospitalsindia.com

Prof. Mohammed Rela, MBBS, MS, FRCS (Edinburgh)Head of Multi-organ Transplantation and HPB SurgeryGlobal Hospitals Group

THE HYDERABAD TEAMDr. Dharmesh Kapoor (Transplant Hepatologist)Dr. Balbir Singh (Transplant and HPB Surgeon)

Why Living Donor Liver Transplantation?

What are the advantages of a live organ donation?

By knowing facts about liver transplants, you can make

an informed decision about being a donor.

Approximately 20,000 patients need liver transplants in

India every year, yet less than 600 patients actually

receive a transplant.

Many adult patients

cannot survive the

wai t t imes for a

deceased-donor liver.

Because there is a

long waiting list for

t h o s e n e e d i n g

transplants, 1 out of 4

patients who need a new liver will die before one

becomes available. When considering facts about liver

transplants, remember that the liver is one of the few

organs that will grow back if a portion of it is removed.

� Living donor liver transplantation is now an

accepted method, used more commonly because

of the severe lack of livers from recently deceased

donors.

� The live donor procedure also allows greater

flexibility for the patient because the procedure may

be done for people who are in the lower stages of

liver disease.

� A living-donor transplant means a patient can have

a transplant before their liver failure gets worse. It

means a shorter wait time for a liver.

� Because the surgery can be planned in advance,

the chance for a successful transplant is better.

� The quality of the liver may be better, because living

donors are usually young, healthy adults who have

gone through a complete medical evaluation.

� With a living-donor transplant, the preservation time

(the time when the liver is outside the body) is

shorter.

· The donor may be a family member, such as a

parent, sister, brother, or adult child. The donor can

also be a husband or wife.

· It is against the law for people to sell their body parts.

In general, liver donors must:

• Be at least 18 years old

• Be in good health with no major medical or mental

illnesses

• Be a non-smoker for at least 4 to 6 weeks before

surgery

• Be able to understand and follow instructions before

and after surgery

• Have a compatible blood type

• Have an emotional tie with the recipient

• Not have a selfish motive for donating

• Have a similar body size

• Be able to go through certain medical tests like

blood work, radiology studies, and a liver biopsy

• A person should feel no pressure to donate part of

his or her liver; nor should any money be given or

received.

Who can donate?What are the tests needed for evaluation of a living

donor?

People who want to donate their liver go through a

complete medical exam to make sure their liver is

healthy and that it is safe for them to donate. Safety is

important for both the donor and the recipient

Medical evaluation is done

a) To make sure the donor does not have any health

problems, like diabetes or heart conditions, that

could increase the risks of problems during and

after the surgery.

b) To make sure the donor liver that is the right size for

the recipient.

The general tests performed as part of the evaluation

include:

Physical examination. A complete physical

examination is performed as part of the evaluation.

Did you Know?The Liver is the only organ that can regenerate itself

Blood tests

• Donor's blood type (it should match the recipient's

blood type.)

• Liver and kidney function tests

• Red cell, white cell, and platelet counts

• The donor is also tested for viruses such as hepatitis

B, hepatitis C, and HIV

Ultrasound/MRI/CAT scan. These tests are done to

get images of the liver to make sure the donor's bile

ducts, arteries, and veins are the right fit for the intended

recipient. These tests also measure the volumes of the

liver that will go to the recipient, and make sure that it is

adequate. Additionally, they are used to assess the

piece of the liver that will remain in the donor to ensure

that it is sufficient..

Chest X-ray and EKG. These are standard tests done

before any major operation to check for lung or heart

problems.

Consultation. Every donor will meet with a medical

physician for a complete assessment. All donors will

also have a comprehensive psychosocial assessment

to talk about their reasons for donating a liver and to

make sure they are in a stable mental condition for the

surgery.