Liver Transplantation

A liver transplant is a surgical procedure that removes a liver that no longer functions properly (liver failure) and replaces it with a healthy liver from a deceased donor or a portion of a healthy liver from a living donor.

Your liver is your largest internal organ and performs several critical functions, including:

• Processing nutrients, medications and hormones.
• Producing bile, which helps the body absorb fats, cholesterol and fat-soluble vitamins.
• Making proteins that help the blood clot.
• Removing bacteria and toxins from the blood
• Preventing infection and regulating immune responses..

Liver transplant is usually reserved as a treatment option for people who have significant complications due to end-stage chronic liver disease. Liver transplant may also be a treatment option in rare cases of sudden failure of a previously healthy liver.
The number of people waiting for a liver transplant greatly exceeds the number of available deceased-donor livers.
Living-donor liver transplant is an alternative to waiting for a deceased-donor liver to become available. Living-donor liver transplant is possible because the human liver regenerates and returns to its normal size shortly after surgical removal of part of the organ.
In 2017, about 8,000 liver transplants were performed in the U.S. among both adults and children. Of those, about 360 involved livers from living donors. At the same time, approximately 11,500 people were registered on the waiting list for a liver transplant.

Risks

Complications of the procedure

Liver transplant surgery carries a risk of significant complications. There are risks associated with the procedure itself as well as with the drugs necessary to prevent rejection of the donor liver after the transplant.

Risks associated with the procedure include:

• Bile duct complications, including bile duct leaks or shrinking of the bile ducts
• Bleeding
• Blood clots
• Failure of donated liver
• Infection
• Rejection of donated liver
• Mental confusion or seizures

Anti-rejection medication side effects

After a liver transplant, you'll take medications for the rest of your life to help prevent your body from rejecting the donated liver. These anti-rejection medications can cause a variety of side effects, including:

• Bone thinning
• Diabetes
• Diarrhea
• Headaches
• High blood pressure
• High cholesterol

How you prepare

Choosing a transplant center

If your doctor recommends a liver transplant, you may be referred to a transplant center. You're also free to select a transplant center on your own or choose a center from your insurance company's list of preferred providers.

When you're considering transplant centers, you may want to:

• Learn about the number and type of transplants the center performs each year.
• Ask about the transplant center's liver transplant survival rates.
• Compare transplant center statistics through the database maintained by the Scientific Registry of Transplant Recipients.
• Understand the costs that will be incurred before, during and after your transplant. Costs will include tests, organ procurement, surgery, hospital stays, and transportation to and from the center for the procedure and follow-up appointments.
• Consider additional services provided by the transplant center, such as coordinating support groups, assisting with travel arrangements, helping with local housing for your recovery period and offering referrals to other resources.
• Assess the center's commitment to keeping up with the latest transplant technology and techniques, which indicates that the program is growing.