Right behind kidneys, which rank as the most commonly transplanted organ, liver transplants are the second on the list of most in-demand transplants. However, less than 10% of transplantation needs around the world are met – due to a shortage of donors. For example, a quick search for “kidney transplant in Thailand” will show that when it comes to kidney transplant in Thailand, the first surgery of this kind took place in 1972, with other types of transplant coming afterward – first liver failure in 1987. In most cases, the surgery is performed by transplanting the organ from a deceased person. Unlike in the case of kidneys, where patients can buy more time using dialysis, there is no therapy for liver failure.
Liver-related disease stats
2 million deaths occur every year around the world as a result of liver disease – 1 million as a result of a complication from cirrhosis and 1 million as a result of viral hepatitis and hepatocellular carcinoma. In addition, liver cancer is ranked as the 16th most common cause of death in the world, with cirrhosis being listed at number 11. Around the world, 400 million people suffer from diabetes and around 2 billion adults are obese, which puts them at risk for hepatocellular carcinoma as well as fatty liver.
In addition, approximately 2 billion people consume alcohol, and upwards of 75 million get diagnosed with disorders related to alcohol use, being at risk of liver disease associated with alcohol. In the United States alone, alcohol is the second most common cause of liver cirrhosis, while hepatitis C virus infection is listed at number 1.
Liver transplant scenario
Generally, there are two scenarios where an individual might need a liver transplant: in case of acute liver failure, and in case of chronic liver failure. The surgery replaces the diseased or failing liver with a healthy one – this being the only cure, as there is no device available that can perform the functions of a liver.
Acute liver failure is the most dramatic scene in which the liver transplant is performed. Liver failure can be the result of a number of things, with the most common ones being viral infections, ingestion of toxins, acetaminophen overdose, or an idiosyncratic drug reaction. Patients who suffer from acute liver failure could die within days, unlike those who suffer from chronic liver failure, who can survive almost years while they await transplantation.
In the case of chronic liver failure, an individual has a permanently scarred liver as a result of repeated injury. While the liver has the ability to repair itself, this repeated process over the years and decades can leave the liver permanently scarred. This leads to cirrhosis, the liver no longer being able to repair itself. Medication can alleviate the symptoms that come as a result of liver failure, but transplantation is the only cure that is permanent.
The liver can be transplanted from a deceased person or a living donor – with a portion of the donor’s liver being removed and transplanted to a patient. Split-liver transplant is also possible, which is designed to expand the pool of donor organs, by using one liver from a deceased person for two patients. This is possible due to the fact that the liver has the ability to regenerate, which means that a liver that has been split is able to grow and get to normal size.
Advancements have been made in the way livers are stored as well. Organs are generally stored on ice prior to the transplant, however, a hospital in the United Kingdom started using a perfusion machine before the transplantation, in order to keep the liver warm and to pump it with nutrients, blood, and medicine (if necessary).