AN OPTION OF LIFE
By. Dr. Cesar Gonzalez, Transplantologist
Liver Transplantation is considered today a treatment of choice for patients with acute or serious chronic liver disease where other medical treatment alternatives have been exhausted.
The Liver transplant surgery is defined as the replacement of diseased liver without function, for a healthy liver. The most common techniques involves: removing the non-functional liver and putting the new healthy liver in the same place, linking veins, arteries and bile duct, with very fine sutures.
Currently, survival in adult patients is on average 90% after a year of transplantation and is more than 75% 5 years after transplantation. The quality of life dramatically improves in patients after transplantation, so it is almost similar to that of the general population, with good social reintegration.
What is the lifetime of a patient with a transplanted liver? Due to advances in modern medicine and patients care with organ transplant, life can continue for several years. There are reports in medical literature that indicate a possible survival of 20 to 30 years. However, this survival depends on several conditions, including the condition of our body at transplant and the presence or absence of other diseases, and the care that we give to the new liver.
Who are the patients who primarily need a liver transplant? All people diagnosed with some chronic, advanced and irreversible liver disease and to whom their doctor enrolled in the National List of patients waiting for an organ or tissue.
In patients with liver cancer, it is only considered if the tumor is in the liver and is well defined, however, when tumors are metastatic cancers of other organs or cancer is already very advanced, transplantation is not curative so it is not considered.
What are the most common diseases treated with Liver Transplant? Cirrhosis due to chronic viral hepatitis both B and C, alcoholic cirrhosis, liver failure or acute inflammation and obstruction of the bile ducts that go to the liver and biliary primary cirrhosis and sclerosis cholangitis. In children, the most common causes are congenital diseases such as: atresia of the bile ducts (lack of development of bile ducts).
Cirrhosis Hepatitis C Virus
It is the most frequent indication in Mexico and the United States (30 to 40 %), alone or associated with liver cancer (20%), in this group of patients it is important to research and rule out the presence of other viruses such as Human Immunodeficiency
Virus (HIV), hepatitis B virus, as it is necessary not to have alcohol addiction. The main problem transplant teams face is the viral recurrence in the new liver transplant.
Alcohol Cirrhosis (Alcoholic).
It is the second indication in order of frequency, a minimum of 6-month withdrawal is required. The results of transplantation in this group of patients are excellent, with survival of 5 years in more than 75%.
Contraindications for Liver Transplantation:
It is when the patient presents:
- Serious heart or lung disease.
- Tumors outside the liver or metastatic disease.
- Serious systemic infection.
- Active addiction to drugs or alcohol.
- Serious social or psychiatric problems.
- Malignant liver tumors larger than 5 cm.
- Extensive portal vein thrombosis and mesenteric (veins of the liver and intestine).
- Severe cerebral edema.
- Multi-organ failure.