Health Articles

Knowledge

“Liver Transplant” Another avenue for treating end-stage liver disease

RAPEEPUN KALAYAVINAI,M.D.

Introduction:


In contemporary medical terminology, acute liver disease can be evolved into liver failure, or in the case of end-stage chronic liver disease, cirrhosis. While general symptom recovery is achievable in many cases, complications persist, posing a significant risk of mortality. This article aims to enhance your comprehension of liver transplantation indications and concepts, presenting information in a question-and-answer format.


Indications for Liver Transplantation:


When considering a liver transplant, certain criteria are crucial for surgery treatment. These include:


  • Quality of life assessment
  • Severity of liver disease (measured by the Child-Pugh score)
  • Disease-specific criteria determining the appropriateness of transplantation

The overarching principle is to reserve liver replacement as a last option, only for cases which no alternative treatments are available. It should be pursued in patients with a genuine hope for complete recovery. Factors indicating urgency include:


  • Child-Pugh score is greater than or equal to 7
  • 1 year survival rate below 90 % without transplantation
  • History of ascites-related infections
  • Severe hepatic encephalopathy grade II in acute liver failure patients


Liver Diseases Treated by Transplantation:


Liver transplants are commonly employed for various diseases, with notable percentages attributed to:


  • Chronic hepatitis C or B (28%)
  • Alcohol-induced liver disease (16%)

Other indications encompass liver failure from diverse causes, including infections, fatty liver in pregnant women, cryptogenic hepatitis, liver cancer, iron or copper liver disease, inherited liver disease, and hepatic stenosis.



Contraindications for Liver Transplant:


Certain conditions may have contraindicated liver transplantation, though exceptions can be considered. Absolute contraindications include:


  • Ongoing heavy alcohol drinking and drug consumption
  • HIV/AIDS diagnosis
  • Non-hepatic cancer
  • Biliary tract infection
  • End-stage lung or heart disease


Emergency Liver Transplantation:


In life-threatening situations, emergency liver transplantation may be necessary. Indications include:


  • Hepatorenal disease leading to kidney failure
  • Recurrent ascites-associated infections
  • Albumin protein below 2.5 g/dL
  • Prothrombin time exceeding 5 seconds
  • Bilirubin levels over 5 mg/dL
  • Poor quality of life in cholestatic patients


Assessing the Need for Liver Transplantation in Cirrhosis:


For individuals with cirrhosis, certain factors indicate a higher likelihood of mortality, prompting consideration for transplantation. These factors include kidney failure, mental alterations, respiratory problems, age over 60, and blood clotting problems.



Conclusion :


While liver transplantation remains a viable treatment for end-stage liver disease, careful patient selection is crucial. Studies have shown promising long-term survival rates, emphasizing the importance of timely intervention before complications arise. Early transplantation, when patients are still relatively well, offers a more favorable outcome, reducing the risk of mortality compared to delayed interventions.


Related Articles (10)

View All

Ovarian Cysts: A Hidden Threat Every Woman Should Know

These days, who would have thought that “ovarian cysts” would become a silent danger women need to be aware of? What’s even more concerning is that ovarian cysts often present no clear warning signs. Many women may be unaware that they have an ovarian cyst until they experience severe symptoms such as intense menstrual cramps, irregular periods, abdominal bloating, noticeable lumps in the pelvic area, or severe pain during intercourse. If left untreated, this condition can potentially be life-threatening. Unveiling the Secrets of Ovarian Cysts with a Specialist Professor Emeritus Dr. Sangchai Preutthipan, a specialist in reproductive medicine and laparoscopic surgery from Praram 9 Hospital, explains that the “ovaries” are small, thumb-sized organs responsible for producing eggs each month. With each ovulation, a fluid-filled sac forms around the egg. Sometimes, these sacs don’t dissolve as they should, leading to cyst formation. There are several types of ovarian cysts, including those caused by ovarian dysfunction, tumor-related cysts, endometriosis cysts (also known as chocolate cysts), cysts resembling other body tissues, and even cancerous cysts. Dr. Sangchai further notes that women of reproductive age up until menopause are at risk for ovarian cysts. Around 30-35% of women develop cysts due to ovarian dysfunction, while 20% develop tumor-related or chocolate cysts. Approximately 15% may have cysts that resemble other tissue types, and 1-5% are diagnosed with cancerous cysts. Each type of cyst carries different health risks.

Read More

Copyright © 2024 All Rights Reserved | Praram 9 Hospital