When Should a Patient Be Recommended for Liver Transplantation?

Dr.Saurabh Singhal, 2 mins read

The liver is one of the most vital organs in the body. It helps in digestion, removes toxins, stores energy, and supports immunity. When the liver becomes severely damaged and can no longer perform its functions, doctors may recommend a liver transplantation. This is a major surgery where the diseased liver is replaced with a healthy one from a donor.

When is a Liver Transplant Needed?

Liver transplantation is considered only when all other treatments fail to keep the liver working. A patient may be recommended for liver transplant in the following conditions:

1. End-Stage Liver Disease (Cirrhosis)

Cirrhosis is the most common reason for a liver transplant. It occurs when healthy liver tissue is replaced by scar tissue, usually due to long-term damage. The main causes of cirrhosis are chronic hepatitis B or C infection, excessive alcohol use, non-alcoholic fatty liver disease, or autoimmune liver diseases, among many other diseases.

2. Liver Cancer

There are certain types of liver cancer, especially hepatocellular carcinoma, which may require transplantation if the cancer has not spread outside the liver. A liver transplant option is considered when surgery to remove the tumor is not possible.

3. Acute Liver Failure

Sometimes, the liver stops working suddenly due to infections (most commly hepatitis A, hepatitis E, dengue, fever etc.), drug reactions (such as an overdose of paracetamol), or toxins. In such emergencies, transplantation may be the only life-saving option, if the medical management fails.

4. Genetic or Metabolic Liver Diseases

Conditions like Wilson’s disease (copper buildup in the body), hemochromatosis (iron overload), or certain enzyme deficiencies can damage the liver severely. When these diseases cause liver failure, a transplant may be recommended.

How Do Doctors Decide for Need of Liver Transplant?

Complete evaluation of patients with liver cirrhosis includes a detailed history of examination by a liver specialist followed by blood tests and CT and MRI scans. Doctor would objectively assess using MELD (Model for end stage liver disease) score and CTP (Child-Turcotte-Pugh) score. High scores patients are in urgent need for liver transplant and are given priority.  Other factors include overall health of the patients, presence of other medical conditions and availability of a suitable donor.

Which Patients are Not Eligible For a Liver Transplant?

A transplant is not suitable for everyone. Those who are not eligible are patients with uncontrolled infections, severe heart or lung disease, widespread cancer, or those who are unable to stop alcohol or drug abuse. 

Takeaway!

Liver transplantation is usually recommended when the liver is so damaged that survival without a new liver is impossible. It is a life-saving procedure but also requires lifelong medical care and healthy living after surgery. If you or a loved one has chronic liver disease, consulting a liver specialist early can help in better planning and timely decision-making.