What does your liver do?
Your liver is one of the largest organs in your body, consisting of two main sections, or lobes. The left lobe makes up about 40% of the liver, and the right lobe makes up about 60%. The liver receives a double supply of blood: blood rich in oxygen comes from the heart through the hepatic artery, and blood with newly absorbed nutrients comes from the stomach and intestines through the portal vein.
Your liver plays an important role in many vital life processes, including:
- Breaking down food into the chemicals our bodies need
- Producing bile fluid (necessary for digestion)
- Controlling blood sugar levels
- Storing vitamins, minerals, and sugar
- Maintaining hormone balance
- Removing toxins from the bloodstream
What happens when your liver is not working the way it should?
If your doctor has said that there is a problem with your liver, it is probably because a disease is affecting the way your liver is working. This may mean that your body is not:
- Making the necessary proteins to control blood clotting
- Filtering toxic substances that you eat, drink, or absorb
- Storing vitamins, minerals, and sugars that give you energy and protect you from infection
- Removing waste products properly
- Producing bile to help you digest food
Why might you need a liver transplant?
There are many diseases that can injure the liver. If the damage is life-threatening, then a liver transplant must be considered.
Diseases of the liver that may be treated
with a liver transplant include:
- Hepatitis A, B, and C (Hepatitis B and C remain in the body after a liver transplant. These viruses may come back and act up once again, even with a transplanted liver)
- Cirrhosis (scarring of the liver due to alcohol use and other causes)
- Primary biliary cirrhosis
- Primary sclerosing cholangitis
- Certain types of liver cancer
- Autoimmune liver disease
- Acute liver failure
Types of liver transplants
According to the Organ Procurement and Transplantation Network, the national 1-year survival rate for patients who received a liver transplant from 1997 to 2004 was 86% for patients who received a liver from a deceased donor and 90% for those who received a liver from a living donor. As with all surgical procedures, there are also risks associated with liver transplants. These risks are discussed below.
There are three possible liver transplant procedures that you may want to discuss with your transplant team so that you can decide which option may be right for you:
- Living donor liver transplant
- Deceased donor liver transplant
- Split-liver transplant
Living donor liver transplant
A living donor liver transplant involves removing a portion of a healthy liver from a living donor and transferring it into the body of a waiting recipient. Since the liver is able to make new cells, a part of a donor’s healthy liver can be removed and put into another person’s body. In the recipient, the transplanted liver part grows to the size needed to support life. The remaining part of the donor’s liver also grows.
Living donors can be:
- Aunts and uncles
- Adult children
There is also a possibility that a non-related donor may be found. Relatives make the most successful donors because their blood and tissues are usually similar to yours.
If a living donor liver transplant is a possibility, your transplant center may have a list of requirements for the potential donor. This list of requirements may include:
- Being of a certain age
- Ability to pass all physical and psychological tests
- Having a compatible blood type with normal kidney and liver function
- Liver volume and structure verified by computerized tomography (CT)
Not everyone who needs a liver transplant is a candidate for a living donor transplant. A patient may be too sick for part of a donated healthy liver to support his or her stage of disease. In this case, the patient would require a whole liver, which would come from a deceased donor.
There is always a risk of complications after a liver transplant. These may include:
- Rejection of the transplanted liver
- Clotting of a blood vessel
- Narrowing or leaking of bile ducts
- Liver not working properly
- Discomfort (possibly for up to 6 months)
If you have any concerns or questions about these complications or anything else to do with your transplant, talk to your transplant team.
National 1-year survival rates for liver transplant patients according to the Organ Procurement and Transplantation Network, http://optn.transplant.hrsa.gov/converge/latestData/rptStrat.aspx, accessed October 7, 2014.
Before your surgery, your transplant team will discuss the transplant and possible risks with you in detail. Liver transplants typically take up to 12 hours, but this timing may vary. Your surgeon may update your family while the transplant is in progress.
Liver transplants may take up to 12 hours
Before your surgery, your transplant team will discuss the transplant and possible risks with you in detail. Kidney transplants typically take 3 to 4 hours, but this timing may vary. Your surgeon may update your family while the transplant is in progress.
After your transplant:
You may have a hospital stay of 7 to 14 days
You may have a disability period of 2 to 6 months or longer, depending on your health
- Your condition before the transplant often affects your recovery time after the transplant. Your muscles will have been deprived of protein due to liver disease, and they will need time to recover and rebuild
- Physical therapy may be needed to help build up your strength. After a transplant, most patients feel stronger as each day passes, with their transplanted liver doing its job
- Your transplant team is a resource for you and will advise you after your transplant on certain topics, including:
- Taking your medicines
- Checking your health