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Dr. Shailendra Lalwani

HOD & Senior Surgeon -
Liver Transplantation And Hepato-Pancraetic Biliary Surgery

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Type of Liver Transplantation

What Are The Different Types Of Liver Transplant?

There are various types of liver transplant depending upon the source of the liver to be transplanted. Following are the different types of liver transplantation:

Living donor liver transplant: Living donor liver transplantation is the process in which a healthy person donates a portion of his liver for the patient whose liver is completely damaged. This type of transplantation uses the feature of liver regeneration. The remaining liver gets regenerated in the donor while the transplanted liver portion grows into a complete liver in the recipient. The liver is divided into various segments and grafting of a segment is done depending upon the requirement of the patient. Such type of liver transplant reduces waiting time, flexibility in the schedule of surgery and increase the survival rate. Research indicates that people who have a liver from a living donor have a high survival rate as compared to people who get the liver from a deceased donor.

Deceased donor liver transplant: It is the most common liver transplant process. In this type of transplantation, the liver to be transplanted comes from a deceased donor. The donor may either have cardiac death or brain death. Strict guidelines are followed to certify a patient as brain dead. Braindead patients do not have any brain function but the other organs including liver are in good condition. Sometimes the patient has low brain function and is not fulfilling the criteria of brain death, however, with the consent of the relatives, the life support system of such patients can be removed. In such a case, the death is not considered as brain death rather a cardiac death. Livers obtained from the cardiac death patients are at increased risk of organ dysfunction, biliary complications, and thrombosis of the hepatic artery.

Split liver transplantation: Split liver transplantation involves splitting the liver obtained from a deceased donor to two patients requiring liver transplantation. Split liver transplantation increases the number of cadaveric grafts.

Who Can Donate A Liver?

A healthy person can donate a liver. A comprehensive evaluation of the health of a living donor is conducted before certify him as a donor. The donor should be a good match for the patient to reduce the risk of rejection. The living donor should not have any underlying medical condition. He should avoid smoking 1-2 months before surgery to limit the complications. Other tests that are performed on the living donor are Ultrasound, X-ray and Electrocardiogram.

What Are The Risks For The Donor?

With the advancement in technology, donating a liver is safe. However, it is major surgery and like other major surgeries, it has some inherent risks. The donor may have a risk of bleeding, infection, clotting, allergic reactions and complications in nearby organs. The living donor has increased risk of hernia or bile leakage. In very rare cases, the liver stops functioning normally.

In Which Patients Liver Transplant Cannot Be Done?

Whether liver transplantation should be done in the patient is decided by the transplant surgeons. Following are some of the conditions in which living transplant is no recommended:

  • Severe, irreversible advanced stage medical illness such as cancer
  • Severe, systemic and uncontrollable infection
  • A person who has active substance abuse or is at higher and unacceptable risk of substance abuse. The substance abuse may be of alcohol or drug
  • Severe and advanced psychiatric condition
  • Patient having the history of non-compliance to strict medical regimen
  • Severe pulmonary hypertension