Liver Transplant (cont.)
IN THIS ARTICLE
The search for a donor: Once a person is accepted for transplantation, the search for a suitable donor begins. All people waiting are placed on a central list at UNOS, the national agency involved in finding suitable livers. Local agencies, the Organ Procurement Organizations (OPO), facilitate the identification and procurement of livers for distribution through UNOS. The United States has been divided into regions to try to fairly distribute this scarce resource. Many donors are victims of some sort of trauma and have been declared brain dead. A donor with the right blood type and similar body weight is sought. Rejection occurs when the patient's body attacks the new liver.
Living donors: Avoiding a long wait is possible if a person with liver disease has a living donor who is willing to donate part of his or her liver. This procedure is known as living donor liver transplantation. The donor must have major abdominal surgery to remove the part of the liver that will become the graft (also called a liver allograft, which is the name for the transplanted piece of liver). As techniques in liver surgery have improved, the risk of death in people who donate a part of their liver has dropped to about 1%. The donated liver will be transplanted into the patient. The amount of liver that is donated will be about 50% of the recipient's current liver size. Within 6-8 weeks, both the donated pieces of liver and the remaining part in the donor grow to normal size.
A donor is found: Once a suitable deceased donor liver has been found, the patient is called to the hospital. It is best that the patient carry a beeper as he or she rises on the transplant list, so that they can be contacted and get to the hospital can be done quickly. Donor livers function best if they are transplanted within 8 hours, although they can be used for up to 24 hours. Presurgical studies, including blood tests, urine tests, chest X-rays, and an ECG, are performed. Before surgery, a number of IV lines are started. The patient also receives a dose of steroids-one of the medicines to prevent rejection of the new liver-and a dose of antibiotics to prevent infection. The liver transplantation procedure takes about 6-8 hours. After the transplantation, the patient is admitted to the intensive care unit.
Medically Reviewed by a Doctor on 8/14/2015
Steve Guillen, MD
Martin Black, MD, FRCP
Grace Thomas, MD
Robert M McNamara, MD, FAAEM
Michael D Burg, MD
Francisco Talavera, PharmD, PhD
James Ungar, MD
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