Life Expectancy After Liver Transplant

Last Modified: September 23, 2022  |   Created on: August 3, 2021
Transplants
How-long-can-you-live-with-a-liver-transplant

What is the average life expectancy after a liver transplant?

The life expectancy after successful liver transplantation depends on several factors. These include the underlying diseases being treated by the transplant surgery, comorbidities, the patient’s age and overall health, and response to the post-transplant drugs.

On average, recipients of liver transplants live for more than 10 years after the surgery. Many have been known to live for up to 20 years or more after the transplant. It is indicated that 90% of people with transplants survive for at least 1 year, while 70% of people may live for at least 5 years after the transplant.

They usually have excellent results in terms of a good quality of life, resumption of normal activities including schooling and jobs, and reduced need for hospitalization as compared to those who do not undergo the procedure.

Studies have shown significant improvement in patient and graft survival over time, and graft loss from acute or chronic rejection is becoming rarer. However, age-related and disease-related causes of graft loss remain some of the greatest concerns of long-term survival.

Liver transplantation is an option for the therapeutic care of patients with end-stage liver disease since 1983. The continual improvements in patient survival rate are based on the advances in immunosuppression, surgical care, and post-operative management, technical achievements, and improvements in procurement and preservation.

How much does a liver transplant cost?

Liver transplant is a major operation that can cost a significant amount of money. It is even more expensive in some countries, especially in the USA, UK, Australia and many others, in comparison to several other countries.

The cost of liver transplantation in India, UAE, Turkey, Thailand and other top medical travel countries is significantly lower. Therefore, patients with living donor plan for having treatment in these countries.

Liver transplant cost in India starts from USD 27000 and may range for different hospitals, depending on factors such as the facilities, infrastructure, location, surgeon’s experience and many others.

The liver transplant cost in Turkey starts from USD 50000 at the top hospitals in Turkey. These prices are more affordable when compared to Western countries, and with equally good quality patient care services. 

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What may disqualify a candidate from having a liver transplant?

A liver transplant may not be an option for all patients. It is contraindicated to people who are

  • Above the age, 65 years and have other serious illnesses.
  • Suffering from severe organ disease due to diabetes.
  • Severely obese.
  • Suffering from severe and active liver disease such as hepatitis B.
  • Actively using alcohol and drugs.
  • Suffering from severe or uncontrollable infection (human immunodeficiency virus (HIV).
  • Diagnosed with aggressive cancers such as bile duct cancer, lymphomas, bone cancer, and myeloma type cancer.
  • Having a history of failure of other organs apart from the liver.
  • Suffering from irreversible brain damage or disease, severe untreatable lung, liver, and heart diseases.
  • Diagnosed with portal vein thrombosis (PVT), which is a vascular disease of the liver that occurs when a blood clot occurs in the hepatic portal vein. It can lead to increased pressure in the portal vein system and reduced blood supply to the liver.
  • Diagnosed with hepatorenal syndrome (HRS), a type of progressive kidney failure seen in people with severe liver damage, typically caused by cirrhosis. As the kidneys stop functioning, toxins begin to build up in the body and eventually cause liver failure.
  • Suffering from pulmonary hypertension, a condition of increased blood pressure within the arteries of the lungs. The symptoms are shortness of breath, syncope, tiredness, chest pain, swelling of the legs, and a fast heartbeat. 
  • Having an autoimmune disease, such as rheumatoid arthritis or multiple sclerosis

Can an alcoholic get a liver transplant?

Most candidates for liver transplantation come with a diagnosis of irreversible cirrhosis, which is typically caused by long-term alcohol abuse. There had been arguments against offering liver transplantation for alcoholics, due to the chances of relapse to heavy drinking, which might damage the new liver or lead to its rejection.

The ethical arguments have also been focused on the belief that alcoholics brought their condition upon themselves as it was their choice to over-consume, and non-alcoholics should not compete with them for scarcely available donor livers.

However, the research data demonstrated that carefully selected alcoholics can also survive liver transplantation and be productive citizens in the future. Additionally, it is not considered ethical for clinicians to refuse treatment to patients for diseases that can be prevented.

Liver transplantation for saving patients with alcoholic liver disease might have once been considered inappropriate use of such a limited resource, but now the data supports that the outcomes for these transplants are as good as or better than outcomes for other diagnoses.

Many programs are available for such candidates, but they are required to commit to abstinence for at least six months. Alcoholic relapse has been associated with many problems that frustrate both clinical management and research on liver transplantation for patients with alcoholic liver disease.

The alcoholics feel pressured to conceal their drinking in the transplant setting because the penalty for the discovery of alcohol use by the alcoholic candidate for liver transplantation is severe.

How can Lyfboat assist you getting Liver Transplantation in India?

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Lyfboat is a free advisory platform; we do not charge any fees from patients. In fact, we negotiate the price that Indian hospitals offer. In some cases we are able to reduce the cost by negotiating upto 20% of what Hospitals generally offer. We advise the best treatment from the top hospital/surgeon at best price.

How long does liver transplant surgery take?

The surgery for donor and recipient is usually synchronized to ensure minimal storage damage for the donor’s liver. In the case of a deceased donor transplant, the surgery for the patient starts after the donor’s liver has been assessed and found satisfactory.

It takes time for the operation to start as the patient is taken to the operation theatre and prepped for the surgery, which takes 2 hours. The donors, as well as recipients, are given general anesthesia during the surgery and they remain asleep, with no consciousness, pain, during the operation.

They are also put on a ventilator and various lines/catheters (arterial line, central line, endotracheal tube, urinary catheter, and others) are used to monitor their health status. 

Donor Operation

This surgery takes about 6 – 8 hours. For a living donor operation, a portion of the liver is taken, which can be done using different types of incisions or even with laparoscopy (keyhole) surgery. The choice of the incision will depend on the donor’s anatomy and is usually made during surgery.

The transplant surgeons consider the factors, such as the cosmetic results and safety, while choosing an incision. The liver is split in two parts, and one of these parts is removed along with the blood vessels and bile ducts associated with the lobe, while the other half is left in the donor with its blood vessels and bile ducts intact.

A drain tube is kept in the abdomen to drain the fluid and manage to bleed. The incision line is closed with absorbable sutures or staples.

Recipient Operation

This surgery generally takes 8 – 12 hours. The patient’s damaged liver, along with gall bladder, is removed to make space for the new donor liver. The cirrhotic liver is usually shrunken and has multiple thin-walled blood vessels around it under high pressure.

The new liver is transplanted by connecting all blood vessels and allowing blood circulation through the liver. The liver usually starts working immediately after transplantation. Bile ducts of the new liver are joined with the bile duct or directly with the intestine in the patient’s body.

A drain tube is kept in the abdomen to manage any bleeding and drain fluid. The incision is closed using staples. 

Does the liver grow back after transplant?

The liver is the only solid internal organ in the body that is capable of completely regenerating and growing back. This means a portion of the liver can grow back to form a whole organ after the transplantation surgery. As little as 30 percent of the liver can regrow and develop into its original volume.

After the liver is donated, the liver will slowly regrow to nearly its full original volume in about a year, but the liver function returns to normal in two to four weeks. 

A donor may worry about the removal of the part of the liver will hurt the health. But they can give up to 75% of it, and still not worry. It will grow back to its original size quickly and work as well as it was before. The liver starts regenerating almost immediately after surgery and will reach about its near-normal size by 6-8 weeks. 

How to donate a liver for a transplant?

Deceased Donor: This is a cadaveric transplant in which a brain-dead person can donate their whole liver for transplantation. Brain death occurs when there is a brain hemorrhage or stroke with irreversible brain damage, which can occur after sudden death after an accident.

Brain-dead patients can be supported on a ventilator and supportive medicines for a short duration, which provides a short window for organ donation for transplantation if their family desires or they are registered donors.

A single deceased donor can donate the entire liver, enabling as many as nine lifesaving organ transplants to different patients and numerous life-enhancing tissue replacements.

Livers from deceased donors are examined for the matching with the recipient’s blood group and size. The first patient on the waiting list, if suitable, is considered for the transplantation. The whole liver can be transplanted, or it might be divided into two portions and transplanted into two patients, generally a child and an adult. 

Living Donor Transplant

Living donors are alive people who can donate a portion or lobe of the liver to a patient in need. A living donor can be a family member or close relative of the patient, but they need to be matched for tissue typing. The damaged liver is removed and a segment of liver from a healthy human donor is put in its place.

A living donation is a voluntary process and the donor must be willing to give away a part of their liver. Donors must have a compatible blood type and tissue to be a suitable candidate for donation. It is important for potential liver donor candidates to not have any serious medical conditions, such as liver disease, diabetes, heart disease or cancer.

Is liver transplant dangerous for the donor?

The liver has a unique property of regeneration. It regrows to its original size within six months of a liver donation surgery in a living person. However, like any surgery, there are some risks associated with the procedure. But overall, a living liver donation has been widely considered as safe.

The team will assess the donor candidate’s health and safety, before allowing a donation. The transplant team conducts psychosocial and medical tests to make sure they will be safe during surgery. This will include blood tests, urine tests, imaging exams of your liver, and cancer screening.

A person cannot be a liver donor if he or she:

  • Is under age 18 or over age 60
  • Diagnosed with heart disease or lung disease
  • Has an incompatible blood type
  • Has active infections, such as HIV or hepatitis
  • Actively involved in substance abuse
  • Has an uncontrolled psychiatric illness

What is the recovery time for a liver transplant?

The recovery timeline after liver transplantation will depend on multiple factors including patients’ age, general health, the severity of liver disease, secondary organ dysfunction, or complications before or after the surgery. It is important for the patient to have a clear understanding of the process, moral support and encouragement from family, as well as a positive attitude and commitment towards the recovery.

The recipients spend the night in the ICU or until the effects of anesthesia wear off. The team closely monitors the patient for any bleeding, infection, or other complications. The initial two days after the operation are critical. The team keeps a check on their condition and liver function by doing frequent blood tests.

The catheters and drains are usually removed over 3 – 4 days. The patients may start participating in the physiotherapy program, walk-in 4 – 5 days after the operation and gradually become more active. Generally, they do not have a lot of abdominal pain after surgery, but may experience back and shoulder pain because of lying down on the operating table for a prolonged time.

The doctor will give pain medicines as per their need. The patient is usually shifted to a normal room in 3 – 5 postoperatively and remains in the hospital for about 10 – 15 days. They receive instructions and prescriptions for medicines anti-rejection medicines, antibiotics and some other medicines, at discharge.

The patients are required to undergo tests and visit the doctor every 5 – 7 days post-transplant.

Who can donate liver for transplant?

A candidate for living liver donation must be willing and fulfill the criteria:

  • Between age 18 and 60
  • Prepared to commit to the pre-donation evaluation process, surgery and recovery
  • Have a good health status and psychological condition
  • Compatible blood type 
  • Have healthy liver and kidney function
  • Have a healthy weight, with BMI less than 32
  • Willing to abstain from alcohol until fully recovered

Does insurance pay for liver transplant?

This will depend on the medical insurance package that the patient has taken. Some companies offer packages that cover the cost of donor surgery as well as transplantation, while others may only pay for the transplantation. Private insurances usually cover the majority of the cost of the transplant, including medicines and tests.

There are many plans that will cover some post-operative care necessities. Additionally, the patient may have both private insurance and special packages in combination to cover more of their medical needs. It is important to talk with the insurance company and figure out what is and isn’t covered. 

How to get a liver transplant without insurance?

A liver transplant without insurance can be highly expensive for some people. Many patients consider traveling to affordable medical travel destinations such as India and Turkey to manage their funds. To get in touch with experts and have precise information based on your case, contact us at care@lyfboat.com or fill the inquiry form.

Our team works round the clock to provide you with the best packages and complete guidance at every step of the process. 

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