A liver transplant is a surgical procedure performed to replace a diseased liver with a healthy liver. The liver is the largest internal organ and has multiple functions necessary for sustaining life. It plays a crucial role in glucose metabolism, filtering blood, detoxifying drugs and alcohol, storing vitamins and producing bile for fat digestion.
When Is Liver Transplant Recommended?
Liver transplantation may be recommended for acute or chronic conditions resulting in irreversible liver failure or end-stage liver disease (ESLD).
End-stage liver disease can result from:
- Biliary atresia
- Metabolic disease
- Liver cancers
- Nonalcoholic steatohepatitis (NASH)
- Autoimmune hepatitis
- Hepatitis B and hepatitis C
- Acute hepatic necrosis
A liver transplantation may not be possible for individuals with metastatic cancer, recurring infection, active drug and alcohol use and severe cardiac or other medical problems.
Starting the Process
The first step in the transplant process is talking with your doctor. Once your doctor has referred you to our liver transplant program, our team can begin working with you.
It is recommended that at this time you have a care partner firmly in place who can provide support, transport you to your clinic visits, and receive the necessary information about your continued care.
Getting on the National Liver Transplant Waitlist
After a comprehensive medical evaluation by our transplant specialists, you will be placed on the national liver transplant waiting list. A donor is matched based on compatible blood type and similarly sized liver. The
United Network for Organ Sharing (UNOS) oversees the allocation of donor organs using the model for end-stage liver disease (MELD), a system that assesses the severity of chronic liver disease by examining renal function, bilirubin and coagulation.
Our surgeons will then determine which organ is best suited for you to achieve the best long-term outcome.
Staying Well for Surgery
It is critical to stay as healthy as possible prior to liver transplant surgery to ensure that transplantation is successful. Our experts will support you in your daily efforts to maintain optimal wellness. A donor liver can become available at any time, day or night. We will help you put a plan in place so you will be able to respond quickly and arrive at the hospital prepared.
Liver Transplant Surgery
The liver transplant experts at UC San Diego Health have extensive skills in deceased donor, split and domino liver transplant procedures. Our team is heavily involved in research and clinical trials to refine and develop new surgical techniques.
Our team performs the following types of liver transplant procedures:
Deceased donor after brain death liver transplant
In this procedure, the liver comes from a donor who is diagnosed as "brain dead" but whose other organs are functioning.
Deceased donor after circulatory death (DCD) liver transplant
In this procedure performed as part of a national clinical trial, the liver comes from a donor whose cardiac circulation and respiratory functions stopped first. The organ is kept viable using a warm perfusion pump.
As part of the HOPE clinical trial, a liver from a donor with human immunodeficiency virus (HIV) is transplanted into an HIV-positive recipient.
Learn more about this groundbreaking procedure.
During this procedure, the deceased donor's liver is divided and used for two transplant recipients. For example, this procedure can provide liver function to two pediatric patients in need of liver transplantation.
This type of transplant uses one donated liver to save two lives by taking a liver from a living or deceased donor and putting it into a recipient, and then using the recipient's original liver and transplanting it in another.
The average operating time for a liver transplantation procedure is four to eight hours. After surgery, you will be monitored carefully to check for signs of rejection. Depending on how healthy you were before transplant, your hospital stay could range from one week to six weeks. During this time, our team will help guide you on continuing care at home, including review of your medications, nutrition (foods that help/hurt recovery) and exercise activities to do (and ones to avoid). Preventing rejection and infection is an important part of the healing process.
Resuming normal activities may take upto a year. Most patients can participate in fairly vigorous physical exercise six to 12 months after successful surgery.
The quality of life usually improves dramatically after liver transplant surgery, and most people go on to lead healthy, normal lives.