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Organ transplantation is one of the most successful advances in modern medicine. For patients with end stage diseases, transplantation most often provides them a chance for survival. Organ transplantation save lives in patients affected by terminal organ failure and improves quality of life.
Organ transplants have shown good result in the last two decades due to improvement in surgical technique, immunosuppression & usually provide excellent long term outcomes in adult and paediatric patients.
A transplant is commonly considered when the liver can no longer function properly. Liver failure can be caused by a chronic medical condition called ‘cirrhosis’ or sudden failure can occur following an infection, a complication from medication or several other reasons.
A liver transplant is required for chronic liver disease as well as acute liver failure. Liver transplant is indicated when a patient’s diseased liver no longer sustains required functions and develops complications.
At Alexis Multispeciality Hospital, our experts carry out both deceased and live donor liver transplants, backed by world-class infrastructure for a quick recovery. We also help patients with comprehensive management of acute liver failure and chronic liver diseases.
End-Stage Liver Disease (ESLD) is used to describe advanced liver disease, liver failure, and decompensated cirrhosis (an advanced stage of cirrhosis).
ESLD develops after an inflammation of the liver, which then leads to fibrosis (scarring), and loss of regular liver function. While the only cure for ESLD is liver transplantation, many patients do not receive one due to waiting times or other health issues that make them too sick to survive the surgery.
ESLD refers to the irreversible decomposition of liver function due to chronic liver disease or acute liver failure. ESLD has several etiologies. Hepatitis B, other viral infections, and excessive alcohol intake are also linked to liver cirrhosis and, eventually, ESLD. Non-alcoholic steatohepatitis is becoming a more common etiology for ESLD because of the expanding population of pre-diabetics and patients with metabolic syndrome.
In this type of liver transplant surgery, the entire healthy liver from a deceased or brain-dead (Cadaver) donor is surgically removed and transplanted into the patient after the diseased liver is removed.
As it is highly unpredictable as to when the liver will become available to the recipient, in most cases of deceased donor liver transplant, the surgery is done in an emergency as soon as the donor becomes available.
Several tests are done and the recipient’s blood group and liver size are matched to the donor’s before the surgery is done.
In the case of the deceased donor, the whole liver is taken out and transplanted. However, in some cases, it may be divided into two portions and used to conduct liver transplants of two patients, usually a child and an adult.
In this type of liver transplant surgery, a patient’s diseased liver is removed and replaced with a portion of the liver from a healthy donor that has to be a suitable first or second-degree family member of the patient. Since the liver can regrow itself to 90-100% of its original size, the parts of the liver in both, the patient and the donor, grow into normal size and shape after the surgery, usually within 2-4 months of surgery.
For patients with compromised kidney function and advanced chronic kidney diseases three treatment options are available- haemodialysis, peritoneal dialysis or a kidney transplant. Depending on the age and the stage of kidney disease, a nephrologist decides the course of treatment. A successful kidney transplant when indicated provides a better quality of life as it prevents long-term issues related to dialysis.
A kidney transplant allows a person whose own kidneys have failed to receive a new kidney from another person. A successful kidney transplant can improve many of the complications of kidney failure. A kidney may come from a living donor or from an individual who has died (deceased donor). A living donor may be someone in your immediate or extended family, or it may be your spouse or a close friend. A deceased donor is someone who has consented to donating his or her organs upon death. In situations where the wishes of the deceased donor are not known, family members may consent to organ donation.
Most people notice that they feel weak, lethargic, and become easily fatigued. Their appetite decreases and tongue has an unusual taste. However, there are other common signs of renal failure which include:
The kidneys are two bean-shaped organs located on each side of the spine, below the rib-cage. The main functions of the kidneys are to filter and remove waste, minerals and fluid from the blood, producing urine. When the kidneys lose their filtering ability, harmful levels of fluid and waster accumulate in the body, raising the blood pressure, resulting in kidney failure. When the kidneys lose about 90% of their ability to function normally, it is called end-stage renal disease (ESRD).
When your kidneys are no longer working properly, there are treatments such as haemodialysis and peritoneal dialysis which can filter the waste products from your body. However, dialysis does not perform many of the other vital functions such as stimulating the production of red blood cells. In this case, only a kidney transplant can work.
Causes of end-stage renal disease (ESRD) include:
A kidney transplant is mostly the preferred treatment for kidney failure, compared to a lifetime on dialysis and is associated with:
However, for certain people with kidney failure, a transplant may be riskier than dialysis. Conditions that may prevent someone from being eligible for kidney transplant include:
Family members are usually the most compatible living kidney donors. In case a compatible living donor is not available, the patient will be placed on a waiting list for a deceased donor kidney. The number of people waiting for a transplant is more than the available deceased donor kidneys hence the waiting time maybe long.
Bone marrow in our bones is responsible for formation of blood cells. In fact, all the blood cells are formed by a subset of bone marrow cells known as “hematopoietic stem cells†or simple “stem cellsâ€. These stem cells have special characteristics i.e. they can renew themselves, and have the capability to develop into any type of blood cells. Nowadays, hematopoietic stem cells can also be obtained from peripheral blood after treatment with certain growth factors or from umbilical cord. Thus, “Hematopoietic stem cell transplantation†is now also referred to as “Bone Marrow Transplantationâ€, wherein the stem cells from bone marrow that produce red blood cells, white blood cells, and platelets are injected into a recipient after a short course of chemotherapy called conditioning. Today, this is a viable option for several disorders and with continued research, success has improved markedly.
The conditions which necessitate a BMT can be broadly classified into 2 groups:
There are two basic types of transplants: Allogeneic and Autologous, depending on who donates the bone marrow or stem cells.
Allogeneic BMT: Donor and Recipient are two separate individuals and transplant is done using the stem cells of donor. It may be
Autologous BMT: Donor and Recipient are same individuals, where transplant is done using patient’s own stem cells. The procedure involves giving high dose chemotherapy to patient in order to remove primary disease. Thereafter, an autologous transplant is conducted to rescue damaged bone marrow. This type of transplant has minimal complication and is preferred for diseases like multiple myeloma/lymphoma.
Undergoing a Bone Marrow Transplant is a five-stage process.