A liver transplant is needed when the liver's function is reduced to the point that the life of the patient is threatened.
Compared to whites, those with African-American, Asian, Pacific Islander, or Hispanic descent are three times more likely to suffer from end-stage renal disease (ESRD). Both children and adults can suffer from liver failure and require a transplant.
Patients with advanced heart and lung disease, who are human immunodeficiency virus (HIV) positive, and who abuse drugs and alcohol are poor candidates for liver transplantation. Their ability to survive the surgery and the difficult recovery period, as well as their long-term prognosis, is hindered by their conditions.
Once a donor liver has been located and the patient is in the operating room and under general anesthesia, the patient's heart and blood pressure are monitored. A long cut is made alongside of the ribs; sometimes, an upwards cut may also be made. When the liver is removed, four blood vessels that connect the liver to the rest of the body are cut and clamped shut. After getting the donor liver ready, the transplant surgeon connects these vessels to the donor vessels. A connection is made from the bile duct (a tube that drains the bile from the liver) of the donor liver to the bile duct of the liver of the patient's bile duct. In some cases, a small piece of the intestine is connected to the new donor bile duct. This connection is called Roux-en-Y. The operation usually takes between six and eight hours; another two hours is spent preparing the patient for surgery. Therefore, a patient will likely be in the operating room for eight to 10 hours.
The United Network for Organ Sharing (UNOS) data indicates that patients in need of organ transplants outnumber available organs three to one.
J. Ricker Polsdorfer M.D., Crystal H. Kaczkowski M.Sc., The Gale Group Inc., Gale, Detroit,