LIVER TRANSPLANT PROCESS AT DUHS

  • At Liver Transplant & Hepatopancreatobiliary Surgery Unit, DUHS,doctors from various specialties work as a team to develop the most appropriate plan of care for you.
  • They follow you before, during and, most importantly, after your liver transplant, to ensure the best possible results and quality of care.
  1. BeforeYour Transplant
    • A team of doctors trained in liver transplantation and other areas evaluate you to determine whether a liver transplant may be safe and beneficial for you. Your evaluation may last few days to a week and include:
    • History &Physical examination
    • Blood tests, including blood and tissue type analysis
    • Serological studies for tumor markers
    • Blood, urine, sputum cultures etc.
    • Imaging studies, including X-rays, Doppler Ultrasound,CT scan, MRCP etc.
    • Consultations with pulmonologist, cardiologist, nephrologist, psychiatrist, physiotherapist, Anesthetist, Dentist etc. for fitness
    • Doctors, your transplant coordinator and others will discuss with you what to expect after a liver transplant, including taking medications, lifestyle changes and other changes.
    • They will also discuss with you the risks and benefits of transplant surgery.
    • If the transplant team determines you are a candidate for a liver transplant, your will be considered for living-donor liver transplantation.
    • The potential donor will also undergo evaluation including blood tests, CT Scan, MRI scan, liver biopsy, psychiatrist evaluation and assessment by various specialists including cardiologist, pulmonologists, nephrologist and anesthetists. Depending on the clinical situation, the investigations can take few days to a week.
    • The case will be than evaluated by Transplant Evaluation Committee for approval.
    • The family registration certificate (FRC) will be required for the confirmation of close blood relation between liver donor and the recipient from NADRA.
    • The papers have to be submitted to the Human Organ Transplant Authority (HOTA) for clearance.
    • Only after this formality the liver transplant takes place.
  2. Transplant Surgery
    • The liver transplant operation last from 8 to 10 hours.
    • First the diseased liver is removed from the patient (Explantation).
    • The donor operation is going on at the same time to remove the partial liver graft (Donor Hepatectomy).
    • The donor liver graft will be than attached to the recipient. (Implantation)
    • During implantation, Firstly hepatic veins were anastomosed (outflow), then portal vein & the hepatic artery (Inflow) and finally the bile duct anastomosis will be done.
  3. After Your Transplant
    • After the operation, the recipient and the donor (Living donor) will be treated in the Intensive care Unit.
    • The duration of stay in the ICU depends on the rapidity of recovery of the donor and the recipient.
    • The recipient (patient) stays for 5-7 days in ICU and 2-4 weeks in the hospital.
    • In the hospital, the recipient will slowly start eating again. He/She will start with clear liquids, and then switch to solid food as the new liver starts to work.
    • During this period you will start to learn how to take care of yourself and use your medicines to protect your new liver after you go home.
    • The donor stays for 2-3 days in ICU and 7-10 days in the ward.
    • Both donor &recipients will be followed in the post-transplant Clinics initially monthly than once or twice the year, depending on the patient condition.
    • The recipient will need to take immunosuppressive medications daily for life to keep the body from rejecting donor liver.
    • Most patients are ready to return to work or school within three months after the transplant.