Liver Transplant (Living Related Donor) in Pakistan

A liver transplant surgery from a living donor is usually scheduled in advance. 

The surgeons will first operate on the donor. The surgery is done under general anesthesia, a portion of the donor's liver is removed through an incision in the abdomen. Both the left and right lobe of the liver can be used for donation. The specific part of the liver donated depends on the donor liver’s size and the recipient’s needs. Around 40% to 70% of the donor’s liver is removed for transplantation. 

Once the donor's liver is ready, the surgeons will perform the liver transplant on you (the recipient). During this surgery, an anesthesiologist will give you a general anesthetic. After you are anesthetized, the surgeons will create an incision under the ribs on both sides of your belly and separate the diseased liver from the nearby organs and structures to carefully remove it. Then, the donated liver portion will be placed in your body by connecting the bile ducts and blood vessels to the new liver. The final step is closing the incision with stitches or surgical staples.

After a living related donor liver transplant, you should expect to spend 5 to 10 days in the hospital. Expect to stay in Pakistan for at least a month after you are discharged from the hospital as you need to attend follow-up checkups. Your liver transplant team will design a checkup schedule for you. Laboratory blood tests are typically obtained twice a week after transplantation and will be reduced gradually. You must attend all of the follow-up checkups and blood tests because your doctor needs to check your condition.

The recovery period depends on the severity of your condition before your liver transplant surgery. In general, the full recovery time until you feel fully healed after your liver transplant surgery can take around six months or more. However, you should be able to return to some of your normal activities, including work (office job) within 2 to 4 months following your surgery. Simple activities of daily living may be resumed within a few weeks.

• You will take medication for the rest of your life – the medications are called immunosuppressant (anti-rejection medicines), which works by keeping your immune system from attacking your new liver. They are used to help the transplanted liver survive in your body.

• You will take other medications – you may need other types of medications to help reduce the risk of other complications.

• Avoid crowds or anyone who has an infection – anti-rejection medicines affect your immune system, increasing your risk of infections. Therefore, you need to avoid contact with anyone who has an infection or crowds for the first few months.

• Eat a well-balanced diet –to help you recover and keep your new liver healthy. A dietitian from your transplant team will discuss your nutrition and diet needs. In general, your diet should be low in fat, salt, cholesterol, and sugar. You also need to avoid alcohol.

• Exercise regularly – walk as much as you can soon after your transplant. Then, start to incorporate more physical activity into your daily life. Make sure to check in with your transplant team before starting an exercise routine.

The success rate of the liver transplant depends on your specific situation. In general, around 75% of people who have a liver transplant live for at least five years. People who receive a liver from a living related donor usually have longer survival rates than those who receive a deceased donor liver. Also, people who have a living related donor liver transplant seem to experience fewer medical problems.

The risks and side effects associated with liver transplant include rejection of the donated liver, bleeding, bile duct complications, failure of donated liver, infection, mental confusion, seizures, and recurrence of liver disease in the transplanted liver.

There are currently no alternatives to a liver transplant. However, the alternative to living related donor liver transplant is to wait for a deceased donor liver or an altruistic donation to become available. Make sure to discuss with your doctor the best option for your case.