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Liver Transplantation & Billiary Sciences

Overview

Department of Liver Transplantation

A liver in a person’s body is located in the upper right-hand portion of the abdominal cavity, beneath the diaphragm, and on top of the stomach, right kidney, and intestines. Some of the functions that are carried out by the liver include bile production which helps in carrying waste and break down fats in the small intestine during digestion. It helps regulate blood clotting, remove toxins or drugs from the body, maintain hormone balance, produce proteins and enzymes, helps the body in resisting infection by producing immune factors and removing bacteria from the blood.

A liver transplant is an operation that replaces a person’s diseased liver with a healthy liver, either whole or partial liver from a healthy person or a cadaver.

A liver transplant is considered when the liver does not function properly, which could be due to infection or from complications caused by disorders or certain medicines. A liver transplant can be caused due to sudden liver failure due to illicit drug use and sometimes by viral Hepatitis.  Liver transplants are needed by patients who have:

  • Liver cirrhosis-scarring of the liver tissue caused by viral hepatitis or alcoholism or toxins and immunological diseases
  • Liver cancer such as hepatocellular carcinoma (cancer that arises from liver cells called hepatocytes) or cholangiocarcinomas (cancer that starts in the bile ducts)
  • Wilson’s disease-excess copper in the liver
  • Acute (sudden) liver failure
  • Genetic liver disease and
  • autoimmune liver disease

The liver transplant team who will perform the liver transplant surgery will be:

  • Transplant hepatologist
  • Liver transplant surgeon
  • Living-donor liver coordinator
  • Nutritionist/ dietician

Continental Hospitals is the best hospital for liver transplantation in Hyderabad as we have an excellent well-coordinated team of expert doctors who are well versed in carrying out these surgeries.

At Continental Hospitals, our gastroenterologists recommend a patient expecting to undergo a liver transplant to the liver transplant team. They do a thorough evaluation of a patient’s medical and clinical history and review the records to help the patient, who is planning to undergo a liver transplant surgery. They meet the patients and their families and explain the transplantation process in detail to them so that they do not have any doubts in their minds about the different aspects of the surgery. The doctors explain to the patients the different treatments for liver diseases, liver cirrhosis, and other ailments and try to educate them about the importance of liver transplant surgery. In this aspect, Continental Hospitals has the best liver transplant surgeon in Hyderabad, thus making it is the best hospital for liver transplantation in Hyderabad.

Everybody is not eligible for a liver transplant because of factors such as the presence of other life-threatening diseases that will not improve on transplantation, a history of chronic or persistent drug or alcohol abuse that is not successfully treated before transplantation, a history of psychiatric disorders or non-compliance to medical treatments or medications. Continental Hospitals' liver transplant team considers all the factors for deciding whether a patient is eligible for liver transplantation. The multidisciplinary team helps critical patients receive whole or part of a healthy liver for transplantation. This makes Continental Hospitals, the best hospital for liver transplant surgery in Hyderabad.

A patient who has to undergo a liver transplant has to undergo certain tests like blood tests, imaging tests like MRI of the abdomen, CT scan of the abdomen, ultrasound of the abdomen, chest X-ray, other tests like an electrocardiogram, Dobutamine stress echocardiogram (DSE), colonoscopy and similar diagnostic tests. These tests will provide comprehensive data for the transplant team to assess the function of your liver and other body systems to determine if you are a candidate for a transplant.

What are the symptoms of liver cirrhosis or liver failure?

The symptoms of liver cirrhosis are:

  • Fatigue
  • Nausea
  • Weakness
  • Loss of appetite
  • Loss of sex drive

Further complicated symptoms include:

  • Jaundice-yellowing of the skin and eyes due to deposition of bilirubin (product of the breakdown of old cells in the liver) in these tissues
  • Fever
  • Diarrhea
  • Abdominal swelling or bloating
  • Weight gain
  • Swelling in ankles or legs due to fluid retention
  • Difficulty in breathing
  • Itching
  • Bleeding from gums or nose
  • Easy bruising due to impairing blood clotting factors
  • Sensitivity to medications
  • Hemorrhoids- varicose veins in the rectum due to liver congestion
  • Loss of muscle mass
  • Abnormal menstrual periods in women
  • Enlargement of breasts in men

What other liver diseases or the condition warrants a liver transplant?

A person who requires a liver transplant has one of the following liver diseases or conditions:

  • Acute liver disease

It occurs a previously healthy liver suddenly suffers a massive injury-causing liver failure. Several factors influence such sudden liver injuries such as drug (acetaminophen) overdose, viral infections, ingestion of poison and other similar factors. Usually, these patients are the top I priority in liver transplantation as they may die within days without a liver transplant.

  • Viral Hepatitis

Hepatitis B-is a liver infection caused by the hepatitis B virus (HBV). The hepatitis B virus is transmitted when blood, semen, or another body fluid from a person infected with the virus enters a healthy, non-infected body.

Hepatitis C-is a liver infection caused by the hepatitis C virus (HCV). It is a blood-borne virus. People become infected with the hepatitis C virus by sharing needles or other equipment to inject drugs. It is one of the most common indications for a liver transplant.

  • Alcoholic liver disease

Liver failure due to alcohol abuse is one of the most common causes for liver transplantation

  • Metabolic liver disease

Non-alcoholic steatohepatitis (NASH): Deposition of fat within liver cells may result in inflammation that injures and scars the liver. Metabolic conditions like diabetes can aggravate and lead to liver failure.

  • Autoimmune disease

Biliary atresia-absence of bile ducts outside the liver usually occurs in infants

Neonatal sclerosing cholangitis -infection and scarring of the bile ducts in the liver of an infant.

Primary Sclerosing Cholangitis (PSC) -the destruction of bile ducts inside and outside the liver.

Caroli’s disease -an abnormality of the bile ducts within the liver

  • Genetic liver disease

Hemochromatosis: excess iron deposition in the liver

Wilson’s disease: abnormal copper metabolism

Alpha-1 anti-trypsin deficiency: lack of a gene product that limits the activity of trypsin, an enzyme that digests protein. Over time this leads to progressive destruction of the liver and lung.

Glycogen storage disease (type I, III, IV): an inherited metabolic disorder

  • Vascular liver disease

Budd-Chiari syndrome is thrombosis (clotting) of the hepatic veins which leads to poor blood flow through the liver.

  • Liver cancer

Hepatocellular carcinoma -cancer that arises from liver cells called hepatocytes

Cholangiocarcinomas -cancer that starts in the bile ducts

                All the above liver diseases or liver conditions warrant a liver transplant.

Continental Hospitals is the best hospital for liver transplantation in Hyderabad

How is Liver Cirrhosis diagnosed?

Liver cirrhosis is usually asymptomatic until functional deterioration occurs.

  • Physical examination by doctors includes inquiries about the quantity of alcohol consumption by a patient, any risk factors caused by Hepatitis transmission as well as transmission history and family history of the patient. The doctor can diagnose ascites depending upon the amount of fluid in the abdomen.
  • Laboratory tests include liver function tests such as tests involving serum enzymes aspartate transaminase (AST), alanine transaminase (ALT) (test for identifying metabolic or drug-induced hepatic injury), alkaline phosphatase, and γ-glutamyltransferase; total, direct, and indirect serum bilirubin; and serum albumin.

Diagnosis is made via contrast cholangiography that can be supported clinically by positive antimitochondrial antibody (for primary biliary cirrhosis)

  • Radiography tests

Ultrasonography- Abdominal ultrasonography with Doppler helps in diagnosing nodules, irregularity, increased echogenicity and atrophy of liver cirrhosis

       CT and MRI

CT portal phase imaging can be used accurately to demonstrate nodularity and lobar atrophic and hypertrophic changes on the liver due to cirrhosis

MRI helps in distinguishing changes in the appearance of lesions on liver

Liver biopsy is performed via a percutaneous, transjugular, laparoscopic, open operative, or ultrasonography- or CT-guided fine-needle approaches to confirm a diagnosis of cirrhosis of the liver.

What is the treatment for Liver Cirrhosis?

The treatment for liver cirrhosis usually involves medication prescribed by doctors. Doctors advise patients about their alcohol intake and medicines that could have caused cirrhosis or worsening of liver cirrhosis. Treatment most often focuses on managing symptoms and complications. For complicated cirrhosis, the treatment by doctors includes the following:

Portal hypertension– is hypertension (high blood pressure) in the hepatic portal system – made up of the portal vein and its branches that drain from most of the intestine to the liver. Treatment includes lowering the blood pressure in the portal veins by medication and recommendations like reduced salt intake in the diet.

Bacterial infection– treatment by antibiotic

Liver cancer-treatment includes ant-cancer medicines, surgery, radiation therapy and sometimes a liver transplant

Liver failure-it is also called end-stage liver disease when the liver completely stops working and a liver transplant is recommended by the doctors.

Continental Hospitals is the best hospital for the treatment of liver cirrhosis in Hyderabad as we have the best liver transplant surgeon and specialist in Hyderabad to diagnose and treat liver diseases by liver transplantation procedures.

When should I come for a follow up after liver transplantation?

Initially, there will be frequent follow-up visits so that the liver transplant team can monitor if the liver is functioning properly and the healing process is positive. The frequent visits will be 1-2 times a week and then weekly or as suggested by the concerned doctors. During the follow-up, blood tests, consultation with the transplant coordinator, transplant hepatologist and surgeon will take place, along with any additional tests if required.

Continental Hospitals is the best hospital for liver transplantation in Hyderabad as we have excellent positive outcomes of liver transplant surgeries performed by our specialized liver transplant team.

At Continental Hospitals the team of doctors who comprise the Liver transplant team is experts in the field of hepatology, liver transplants, liver diseases and have been part of research teams that have studied the various aspects of liver disease in adults and children. The top teams of doctors have received awards and medals at the top medical institutes around the world and have received specialized training in the latest medical techniques to perform surgery. They have performed several liver transplants with positive outcomes throughout their career. Continental Hospitals is privileged to have some of the best hepatologists and liver transplant surgeons in Hyderabad on board, who has won many accolades and international recognition for their work. Our doctors diagnose patients suffering from liver cirrhosis and liver failure in the early stages itself so that they can advise the patients, their families or caregivers the option of liver transplant surgery at the earliest possible time. Continental Hospitals is considered the best hospital for liver transplant in Hyderabad on account of its wonderful team of doctors leading the Liver transplant team.

Dr John Doe
Dr Ushast Dhir

MBBS, MS(General Surgery),DNB

Consultant

Dr Raghuram Kondala

MD (PGI), DM(G.B. PANT)

Consultant Medical Gastroenterologist

Dr Santosh Kumar Enaganti

MBBS, MD(Int Med), MRCP, CCT Gastro(UK), FRCP

Senior Consultant Medical Gastroenterologist and Hepatologist

Dr John Doe
Dr Prakasam Rangaswamy

MBBS, MS (General Surgery)

Senior Consultant Surgical Gastrology and Laproscopic surgeon

Dr Guru N. Reddy

M.B.B.S, M.D, FACP, FACG, FASGE

Founder, Promoter, Director & Sr. Consultant Medical Gastroenterologist & Hepatologist

Dr Satish Reddy Pullalrevu

MBBS, MS (Gen Surgery)

Senior Consultant General Surgeon

We are with you in your journey to better health

A consultation with our panel of doctors, specialists and surgeons will help you determine what kind of services you may need to help diagnose and treat your condition. If you or someone in your family or friend’s circle are facing any health issues, please get in touch with us, we are here for you.

 

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