Liver Transplantation
Cirrhosis is end stage damage to liver. It means from the soft smooth liver like a sponge, it has become hard and irregular like a bark of a tree. Once an individual develops cirrhosis of liver, the process is irreversible. The disease progresses gradually over a period. Initially if we find the cause of cirrhosis, we can treat and stabilize the liver for a prolonged period. Eventually however, different complications set in. Initially these complications are manageable with medications and dietary restrictions. However, as the disease worsens, complications persist or recur and that is when doctors’advice you to undergo liver transplant.
Most common causes of cirrhosis in adults in India
- Alcohol
- Fatty Liver
- Hepatitis B
- Hepatitis C
- Drug Induced Liver Injury
- Autoimmune Hepatitis
- Wilson’s Disease
The treating Hepatologist will look for these causes once you are diagnosed with cirrhosis. For Alcohol related cirrhosis, stopping alcohol is of paramount importance. For attyliver related cirrhosis, weight loss is stressed upon. Hepatitis B, Hepatitis C, Autoimmune Hepatitis and Wilson’s disease, there are specific drugs which your doctor will start. Stopping complementary and alternative medicines as well as all herbal products is recommended.
Complications of cirrhosis
Complications develop 2-5 years after development of cirrhosis. There is no fixed sequence of development of all these complications and not all patients will have all of these. There are nearly 500 functions of liver and liver damage worsens, different functions are affected differently. The complications are broadly divided into following
| Portal Hypertension – Complications developing because the blood flow through the hardened liver is hampered, and blood flow is reversed. | Ascites (Fluid accumulation in tummy)
Edema feet (Swelling of feet) Low Platelets (Splenomegaly) Hematemesis (Blood Vomitus) Malena (Black Stools) Kidney Injury (Rise in creatinine, fall in urine output) |
| Liver Cell Failure – These complications develop as
liver fails to produce necessary
substances or clear toxins from the body
|
Jaundice (Yellow eyes, yellow urine)
Coagulopathy (Increased Bleeding tendencies) Hypoalbuminemia (Fall in Albumin level) Encephalopathy (Altered mental state) Sarcopenia (Loss of muscle mass) Sepsis (Infections as liver fails to clear infectious agents) |
Liver Transplant in Ahmedabad
The year 2019 has seen one of the major changes in the transplantation scenario in Gujarat. There was the establishment of SOTTO in January this year. After the enforcement of SOTTO guidelines, the Liver transplant program is likely to get much more streamlined. The organ distribution process is going to be much more transparent and predictable.
Liver Transplant is now an established mode of treatment for end stage liver disease with success rate around 90% in most of the centers. Patients from Gujarat are traveling outside the state to get their liver transplant done. During that time, they not only end up paying a high cost for the transplant but to stay there for two to three months is a burden mentally, emotionally and financially. Liver Transplant services are already established and fully functional in Ahmedabad. There is number of transplant centers providing liver transplant services by one of the most eminent liver specialists in the country. There are few centers where there is in house transplant team and the doctors are accessible every day of the month. You can not only get cadaver based transplant at all of these centers but also living related liver transplants can be carried out. Patients are likely to get benefit out of these and they would not have to travel out to other states in the country. The cost of the transplant for the family would then be nearly halved considering cost of staying and transplant.
Patients who are suffering from end stage liver disease, cirrhosis with repeated complications like recurrent ascites, persistent swelling of their feet, development of recurrent bleeding or encephalopathy or requiring multiple admissions should consult one of the transplant centers at the earliest. Unlike kidney failure, where one can survive with dialysis for years, for liver disease one has a small window to get transplanted. It is advisable that such patients should contact their at the earliest and get worked up for liver transplant.