| Organ Transplantation FAQ's Patient Videos Patient Manuals Links Patient Thank You's Seeking Transplants? |
|
Heart Lung Kidney Liver Pancreas Small Bowel Living Donor |
The Multi Organ Transplant Program of the Toronto General Hospital performs approximately 100 liver transplants per year. Indications There are many causes of end-stage liver disease. Patients under consideration for liver transplant present with a variety of liver diseases. Although the liver can regenerate to a certain degree, once the disease process becomes too extensive, liver transplantation becomes the only treatment option. The following list outlines four types of liver diseases that may be referred for liver transplantation. 1. Diseases affecting liver cells
2. Diseases producing changes in liver structure
3. Diseases affecting the blood supply to the liver
4. Disease affecting the blood supply from the liver
Assessment Pre-transplant evaluation consists of a variety of medical tests and interviews with members of the transplant team. This process is essential in determining a patient's suitability for liver transplant. During the evaluation process the potential candidates and their family will be provided with information to assist them in making informed decisions about the operation and post-operative period. The patient and their family are encouraged to ask questions of the team members and meet the candidates awaiting transplant as well as those having received a liver transplant if possible. The workup process typically involves the following tests, but may require additional testing if other health issues are of concern:
The Transplant Team Members who consult on kidney transplant evaluation are:
Waiting List There are presently over 225 patients on the waiting list for liver transplant within our program. The waiting period for a donor varies in length because the donor pool is limited and the selection criteria for a matching donor are strict. Patients can expect to wait up to 24 months, but most patients are transplanted within 6-18 months. Surgery Liver transplant surgery may take from 4 to 6 hours. The operation consists of complete removal of the diseased liver, and the attachment of the new donor liver. The patient's gall bladder will also be removed. There are five major anastomoses necessary to connect the new liver into the recipient. Four attachments are at the site of the major blood vessels:
The fifth anastomosis is at the site of the bile duct. There is a 10-15% chance that patients may require cardiopulmonary bypass to maintain hemodynamic stability. Recovery Liver transplant recipients can expect to be in the hospital for approximately 2-3 weeks after surgery. After the transplant procedure, patients are usually ventilated and monitored hemodynamically in the intensive care unit. Once stabilized and extubated, patients are then transferred to the Multi Organ Transplant Unit. Patient care following transplantation focuses on:
Discharge & Follow-up Discharge planning begins well in advance and patients meet with a social worker during their initial assessment to addressing these issues early. The program's Patient Resource Coordinator assists in assessing patients' readiness for discharge and ensuring patient teaching is complete. Patients will return to the Ambulatory Care regularly after the initial postoperative period, with the frequency of clinic visits reduced as the patient's condition permits. During clinic appointments, patients are seen by their Transplant Coordinator, and Transplant Physician. Communication with the patient's family physician and other specialists is an important component of follow-up care. Patients keep in contact with their transplant team through our patient voicemail system, Easy Call. The Multi Organ Transplant Program's team approach ensures that patients receive comprehensive follow-up care after transplantation and throughout their lives post-transplant.
|
