Transplant
Liver Transplant
The liver is the only organ within the human body that can regenerate itself. We can grow additional liver.
A liver transplant has two (2) possibilities: a cadaver transplant and a live donor liver transplant. Cadaver transplants are difficult to obtain, because usually PLD polycystic liver disease livers do not fail, but they can become life threatening. Our MELD scores do not reach qualifications for a transplant. We must relay on time on the transplant list to move us up.
Some centers are able to achieve two organ transplants from one donated liver. They split the liver with a smaller portion going to a child and the larger to an adult.
The Pros and Cons of a living donor liver transplant.
Live donor liver transplantation (LDLT) is a where a living person donates a portion of liver to another. The feasibility of LDLT was first demonstrated in the United States in 1989. The recipient was a child, who received a segment of his mother's liver. Since that time, LDLT for children has enjoyed wide success and many pediatric programs use this technique. In the pediatric experience, survival of both the recipient and the transplanted liver (graft) at one year is about 90%. Donor complications have been very few. A rising population of adult patients awaiting liver transplantation has led to the application of LDLT for adult patients, and the preliminary results have been very encouraging. Only a handful of centers in this country perform the procedure.
How long will a liver transplant last?
A study of over 2,702 liver transplant recipients in the UK showed that for women a liver transplant lasted 26 years.
Liver transplant performed without the need for blood
World's First Adult-to-Adult Live Donor Liver Transplant Without a Blood Transfusion - June 15, 1999. Some said it could not be done. Others simply refused to attempt it. But Bill Jennings needed a liver transplant and he needed the procedure to be performed without the transfusion of blood or blood products. Neither his end-stage liver disease nor his religious beliefs as a Jehovah's Witness would allow for anything less. Jennings already had a donor lined up: his older brother Scott, who was both able and willing. The problem was finding a doctor who would give Jennings a chance at a normal and healthy life while still respecting his religious convictions.
FDA issued Sirolimus warning
Sirolimus has a warning for liver transplant recipients. Rapamune.
Sildenafil treatment accelerated hepatic regeneration
The regeneration process causes the liver to achieve an adequate volume and function after major
hepatectomy or living donor liver transplantation.
Sildenafil, a selective phosphodiesterase-5 inhibitor
used for erectile dysfunction, impacts the liver by enhancing the effects of nitric oxide. The aim of this
study was to investigate the influence of sildenafil on liver regeneration in rats after partial hepatectomy.
CONCLUSION: Sildenafil
treatment accelerated hepatic regeneration after partial hepatectomy in rats.
Avoid Before Surgery
Try After Surgery
Graphic Liver Transplant Image
MELD Score
Dr. Marie Hogan on Polycystic Liver DiseaseModel for End-Stage Liver Disease
Numeric system ranks transplant individuals from 6 to 40
Based on three lab test results:
Bilirubin (how effectively the liver excretes bile)
INR (prothrombin time, ability to clot blood)
Creatinine (kidney function)
Moving Up MELD Score
Massive liver enlargement is a reason to move up the MELD score.Massive hepatomegaly due to PLD
Caution reading the following can be upsetting
The following is not meant to frighten; it is to help you move up the MELD score at your transplant facility. Report the following to
your transplant centers to help move you up the waiting list:
PLD is a life threatening illness. Several individuals have died from PLD.
One woman was from Japan. She had massive liver cysts. The doctors told her cystic livers never fail and there was nothing to do. Her liver continued to enlarge and grow until (as many of us have noted) the bones of the ribs began becoming slightly deformed. Eventually one of her ribs cracked. The broken rib pierced her bowel and she died from septicemia, blood poisoning.
Another individual developed HVOO, hepatic venous outlet obstruction. Blood from the body in the inferior vena cava (the biggest vein in the body) became more and more obstructed until it began to clot and she died.
A gentleman I knew developed severe emaciation and muscle wasting. Everything he ate came back up. There was no room for his compressed stomach nor his intestine to absorb any nourishment from the food. They gave him feedings via a stomach tube. They tried to feed him hyperalimentation through a big blood vessel. Eventually he died of malnourishment and total body shut down.
There was another death from PLD. A woman 50 y/o developed an infection within the liver cyst. The doctors tried very hard to clear up this infection and were unsuccessful. She lived in Greece and died from liver failure directly related to her cystic liver.
It can be terribly upsetting to hear of individuals being told there is nothing to do for PLD. My dear friend Anne had ADPKD along with massive liver cysts. She was not a candidate for a liver resection. While awaiting a call for a liver transplant her kidneys failed suddenly. There was nothing to do because her massive liver would not allow for peritoneal dialysis. A shunt had not been prepared. She died within the week from massive organ failure.
My oldest sister died long before there was anything called dialysis, transplant or imaging. The doctors performed exploratory surgery on her expecting to find cancer and instead found massive polycystic liver disease and polycystic kidney disease. She too died within the week.
The diagnoses of liver cysts can occur in childhood and even prenatally, especially when ARPKD is present, a recessive form of PKD polycystic kidney disease. With this disease, it too is most commonly found in children, but not always. I have communicated with a woman who discovered ARPKD as an adult. She was 37. Just recently, we received word that Joe, age 67, received a dual transplant, kidney and liver, from Omaha, Nebraska. Congratulations Joe!
Japanese Clone Functioning Liver Cells
The team of researchers at Yokohama City University began with human skin cells, which they genetically reverted to an embryonic stem-cell state and then coaxed into liver-precursor cells. They then exposed these cells to environments similar to what the developing liver experiences in a fetus, adding to the dish stem cells that line blood vessels and form tissues. Within 48 hours the cells had amassed into tiny proto-organs visible to the naked eye. Once the liver buds were about 4 or 5 millimeters, the team implanted 12 liver buds into either the brain or abdomen of each mouse-sites chosen for their ease of access. The researchers had labeled the cells with fluorescent proteins, which helped them monitor the buds for formation of blood vessels. They found that the organ developed a vascular system almost immediately and performed liver-specific functions within weeks.
Sometimes Liver transplants from older donors result in Hepatic Artery Thrombosis
Hepatic Artery Thrombosis is the most common complication from a liver transplant. It increases progressively for each decade from the donor's age greater than 50. With a 61% increased risk of hepatic artery thrombosis-related graft loss associated with donor age of 70 year. This risks loss of the newly transplanted liver.