Our Summary

This research paper looks at liver transplants in Kazakhstan, where over 1,000 people have severe liver disease and their only treatment option is a liver transplant. The study analyzed patients who received a liver transplant between February 2013 and December 2014.

Seven patients received transplants during this period. Three of these were from deceased donors, with an average age of 52, and their main reason for needing a transplant was uncontrolled high blood pressure in the liver due to an autoimmune disease. The median age of the deceased donors was 45. The patients stayed in intensive care for over five days and required inotropic support (medicines that help the heart work more effectively) for over three days. The average time the liver was kept cold (to preserve it during transport) was over six hours. Unfortunately, one patient died in the first week after surgery due to a blood clot in the liver’s main artery.

The remaining three patients received their transplants from living donors, with an average age of 47. Their liver disease was due to hepatitis virus (one with Hepatitis C and two with Hepatitis B and D). The average time the liver was kept cold was less than half an hour. Sadly, one patient died shortly after surgery due to heavy bleeding.

The researchers concluded that their experience was too limited to properly assess how often complications occur or survival rates; the longest patient follow-up they had was just over two years. However, they didn’t see any cases of the body rejecting the new liver. They also found that survival rates were the same regardless of whether the liver came from a living or deceased donor, even though the livers from deceased donors were not in perfect condition. The study highlights the importance of timely diagnosis of surgical complications, as these were the cause of all the deaths in their patient group.

FAQs

  1. What is the main reason for liver transplants in Kazakhstan?
  2. What were the common causes of mortality in the liver transplant patients in the study?
  3. How did the survival rates compare between living and deceased donor recipients in the study?

Doctor’s Tip

One helpful tip a doctor might tell a patient about liver transplant is to closely follow post-transplant care instructions, including taking medications as prescribed, attending follow-up appointments, and maintaining a healthy lifestyle to support the new liver. It is also important to be aware of potential complications and to seek medical attention if any concerning symptoms arise.

Suitable For

Patients who are typically recommended for liver transplant include those with end-stage liver disease, uncontrolled portal hypertension, autoimmune liver disease, hepatitis virus-related liver disease, and those who have failed other medical treatments. These patients may have high Model for End-Stage Liver Disease scores and may require intensive care unit stay, inotropic support, and may have prolonged ischemic times during the transplant procedure. Patients may receive either a deceased donor liver transplant or a living donor liver transplant, depending on their individual medical condition and availability of donors. It is important for timely diagnosis and management of surgical complications post-transplant to improve patient outcomes.

Timeline

Before liver transplant:

  1. Diagnosis of end-stage liver disease
  2. Evaluation by a transplant team to determine eligibility for transplant
  3. Placement on the transplant waiting list
  4. Waiting for a suitable donor (either deceased or living)
  5. Preoperative testing and preparation for surgery

After liver transplant:

  1. Surgery to remove the diseased liver and replace it with a healthy donor liver
  2. Postoperative recovery in the intensive care unit
  3. Monitoring for complications such as rejection or infection
  4. Long-term follow-up care and medication management to prevent rejection
  5. Rehabilitation to regain strength and function
  6. Ongoing monitoring of liver function and overall health
  7. Possible need for additional surgeries or treatments due to complications.

What to Ask Your Doctor

Some questions a patient should ask their doctor about liver transplant include:

  1. What is the success rate of liver transplant in your center?
  2. What are the risks and potential complications associated with liver transplant surgery?
  3. How long is the typical recovery period after a liver transplant?
  4. Will I need to take immunosuppressant medications for the rest of my life after the transplant?
  5. How will I be monitored for rejection of the transplanted liver?
  6. What lifestyle changes will I need to make after the transplant?
  7. How often will I need follow-up appointments after the transplant?
  8. Are there any support groups or resources available for liver transplant recipients?
  9. What criteria do you use to determine if I am a suitable candidate for a liver transplant?
  10. How long is the average wait time for a liver transplant in your center?

Reference

Authors: Sultanaliev T, Zhexembayev A, Mukazhanov A, Zharkymbekov B, Kuttymuratov G, Spatayev Z, Ibrayev B, Yesmembetov K, Ashimkhanova A, Asykbayev M. Journal: Exp Clin Transplant. 2015 Nov;13 Suppl 3:120-2. doi: 10.6002/ect.tdtd2015.P66. PMID: 26640930