Decompensated Liver Disease: Liver Transplantation is the Best Option, Not the Last Option

  • Charles Panackel Integrated liver care (ILC), Aster Medcity, Kochi
  • Naveen Ganjoo Integrated liver care (ILC), Aster Medcity, Kochi
  • Rehan Saif Integrated liver care (ILC), Aster Medcity, Kochi
  • Mathew Jacob Integrated liver care (ILC), Aster Medcity, Kochi
Keywords: End stage liver disease, Early referral, MELD score, Better immunosuppression, Cirrhosis Liver, Liver Transplantation, Hepatocellular Carcinoma, Acute liver failure, Metabolic liver diseases

Abstract

The incidence of end stage liver disease and liver transplantation is on the rise in Kerala. All practicing doctors should have an insight into the indications, contraindications, évaluation leading to and complications following liver transplantation. Liver transplantation is now an accepted modality of treatment in end stage liver disease and hepatocellular carcinoma. With potent immunosuppression and newer surgical techniques the 5 year survival rate following liver transplantation is above 75%. It is higher than that for surgeries for most gastro-intestinal cancers. The process to reach liver transplantation starts with early referral to the transplant centre, where extensive investigations performed. Once the patient is accepted into the waiting list, then prioritization for the transplant relies on the MELD score as well as matching the blood group and patient size. Immunosuppression after transplant requires a balance between prevention of graft rejection and minimization of the side effects of immunosuppressive drugs. Lifelong after-care is crucial for long-term graft and patient survival after liver transplantation.

Author Biographies

Charles Panackel, Integrated liver care (ILC), Aster Medcity, Kochi

Consultant in Hepatology and liver transplantation

Naveen Ganjoo, Integrated liver care (ILC), Aster Medcity, Kochi

Consultant in Hepatology and liver transplantation

Rehan Saif, Integrated liver care (ILC), Aster Medcity, Kochi

Consultant in Hepatopancreato biliary and Multiorgan transplantation surgery

Mathew Jacob, Integrated liver care (ILC), Aster Medcity, Kochi

Consultant in Hepatopancreato biliary and Multi-organ transplantation surgery

Published
2016-03-30
Section
Original Research