People needing liver or heart transplants often need to wait nine or more months. Recipients are assessed for compatibility to the donor (not just blood type, but for six different tissue antigen subtypes as well as general body size – e.g. putting an adult heart into a small child is not possible).
Waiting for a liver transplant
Donor livers are scarce and waiting for a suitable liver may take many months or even several years. During this time, the cancer may continue to grow. As a result, most people have tumour ablation or TACE to control the cancer while they wait for a donor liver to become available.
The waiting period for a deceased donor transplant can range from less than 30 days to more than 5 years. How long you will wait depends on how badly you need a new liver.
Some people may not be suitable for a liver transplant. Some reasons a person may not qualify include: They have other untreatable conditions affecting other organs, such as cancer or severe coronary artery disease.
Organ donation process
There are around 1,800 Australians waitlisted for a transplant and around 14,000 additional people on dialysis – some of whom may need a kidney transplant.
Dr Hodgkinson said it was extremely gratifying to know patient time on the waitlist had been reduced and that five-year survival rates continued to improve in Australia. “Historically, liver transplants have had a 90% survival rate after five years, but now our five-year survival rate has improved to 96%.”
It is a major operation and comes with surgical risks, like bleeding. Infections and bile duct complications are common after a liver transplant. You will need to take strong medicines to suppress your immune system. You may need further surgery to fix any problems.
a serious heart and/or lung condition, such as heart failure or chronic obstructive pulmonary disease (COPD) a serious mental health or behavioural condition that means you would be unlikely to be able to follow the medical recommendations for life after a liver transplant.
If your MELD or PELD score is very high, you will have very high priority for a transplant. MELD scores range from 6 (least sick) to 40 (most sick). PELD scores may range lower or higher than MELD scores. Your score may go up or down over time as your liver disease either worsens or improves.
You may be disqualified from having a liver transplant if you have: Current alcohol or drug abuse problems. Uncontrolled infection that will not go away with a transplant. Metastatic cancer or bile duct cancer.
Liver transplant can have excellent outcomes. Recipients have been known to live a normal life over 30 years after the operation.
While waiting on the list patients are advised to stay as healthy as possible by eating a healthy balanced diet, taking regular exercise, completely avoiding alcohol, not smoking etc. An average waiting time for a liver transplant is 149 days for adults and 86 days for children.
Those who don't recover may die within days. Chronic liver failure is a more gradual process. People can live with cirrhosis for months or years while waiting for a liver transplant, although the need becomes more urgent when complications, such as portal hypertension, begin to develop.
Most people who need a liver transplant suffer from long-term liver disease (cirrhosis) that is advanced and irreversible. Usually you have liver disease for months or years before symptoms occur.
In Australia the most common reason (indication) for alpha-1 liver transplantation is cirrhosis of the liver from a build-up of antitrypsin which is stuck in the liver.
The cost of a liver transplant can vary depending on a person's location, medical charges, healthcare facility, insurance coverage, and other factors. Evidence from 2020 indicates that a liver transplant costs $878,400.
You may not be able to have a transplant if you: Have a current or chronic infection that can't be treated. Have metastatic cancer. This is cancer that has spread from its main location to 1 or more other parts of the body.
People with cirrhosis of the liver have a life expectancy of between two and 12 years. If you have early-stage cirrhosis, treatment and lifestyle changes can help you live longer.
Can I be a living donor? If a liver transplant candidate is eligible to receive from a living donor, then a family member, relative or close friend can be considered for donation.
This informal policy, often called "the 6-month rule," can be traced to the 1980s. The thinking was that six months of abstinence gave a patient's liver time to heal and, thus, avoid a transplant. If that didn't work, the patient would have proven they can stay sober and would not return to drinking after a transplant.
Rejection happens in up to 30 in 100 patients. The risk of rejection is highest in the first 6 months after a transplant. After this time, your body's immune system is less likely to recognise the liver as coming from another person. Chronic rejection happens in 2 in 100 patients.
Therefore, adult living related partial liver transplantation is an excellent treatment for primary biliary cirrhosis.
The structure of the scar tissue has created a risk of rupture within the liver. That can cause internal bleeding and become immediately life-threatening. With respect to stage 4 cirrhosis of the liver life expectancy, roughly 43% of patients survive past 1 year.
A transplanted liver may be more sensitive to damage by chemicals, including alcohol. The transplantation team recommends that recipients avoid overuse of alcoholic beverages after transplantation.
Very common longer-term risks
The most common infections are chest or urine infections. These are usually fairly straightforward to treat with antibiotic tablets. Infections inside the liver transplant itself can be harder to treat.