The demand for liver transplantation procedure increases continuously in the recent years. In 2002 alone, a total of 4, 437 liver transplants have been done in various countries around the world. Most of these surgical procedures were done in Spain, Germany, and Italy (WTCD). According to NHS Blood and Transplant (2009), from 1998 to 2007 there were 6,556 liver transplant procedures done in United Kingdom. In United States on the other hand, an estimate of 6,500 surgical procedures of this type have been done in the year 2005 (American Liver Foundation).
The raise of the number of this surgical procedure’s occurrence necessitates the thorough understanding of its various aspects especially among medical practioners and students. Liver or hepatic transplantation is the procedure of removing the diseased part of an individual’s liver and then replacing it with a healthy part taken from a donor (Torpy et al. , 2006). This operation can either involve the transfer of the entire or only a fraction of a donor’s liver to the recipient.
Majority of the transplanted liver tissues are taken from dead donors. Though there is a rising trend of getting liver tissues from a living donor that is a family member of the recipient. Transplantation of only a certain amount of liver tissues is possible because a fraction of the liver is capable of growing into a normal size organ. The critical nature of this procedure requires that this kind of surgery must only be done in specialized transplant centers. Specifics of the liver and its diseases
The liver, which is a dark-red organ, located in the upper part of the abdomen closely at the rear of the diaphragm, posses various functions for the body and is the largest organ of the human body. There are an estimate of 500 metabolic functions of the liver including the synthesis of glucose from glycogenesis; urea; plasma proteins; and clotting factors. The liver parenchyma functions as storage of fat and fat soluble vitamins; and, glycogen from the sugars of the food consumed. It also produces several antibodies are defense factors indicated in natural immunity (“Liver Transplantation”).
The major functional structures that can be seen in the liver are the blood vessels like portal vein and hepatic artery; lymphatics; hepatic bile duct; and, nerves. The capillary system inside the liver is the sinusoids. The sinusoids are canals made out of hepatocyte plates. These sinusoids have diameter ranging from 8 to 10 micrometers. In the lining of the sinusoids, the endothelial cells and Kupffer cells which have phagocytic functions are located (“Liver Anatomy and Physiology”).
Liver transplantation is done because of permanent liver damage due to hepatis C and hepatitis B viral infection; liver cirrhosis as a result of alcohol abuse or genetic inheritance; biliary atresia, which is common in children; toxic liver failure because of acetaminophen overdose and poisonous mushroom consumption; and, liver tissue cancer called hepatocellular carcinoma (Torpy et al. , 2006, 2208 ). Liver transplant procedure and its details There are various surgical methodologies utilized in liver transplantation.
These are orthotopic, reduced-size, and heterotropic transplantation. The transfer of an entire healthy liver to a patient who has a diseased liver is termed as orthotopic liver transplant. In orthotopic liver transplantations, the transplant of an entire healthy liver is accompanied by the transplant of portal vein, hepatic artery, inferior vena section, and bile ducts. The second liver transplant methodology called reduced- size liver transplantation is the transfer of a healthy liver fraction as substitute to the entire diseased liver of a patient (health-cares.
net). The latter liver transplant methodology is frequently done in cases of children patients. The second method called heterotropic transplant is the transfer a fraction of a donor’s liver to a patient without altering the location and nature of this patient’s diseased liver. This liver transplant surgical technique is done when the patient’s diseased liver has a chance of recovering. An entire healthy liver can be fractioned into eight with individual blood vessels. This sectioning of a healthy liver is called the split-liver technique (Genyk).
Transplanting only two fractions of this healthy liver can resolve a liver failure particularly in young patients. The growth of liver fractions into a whole liver is highly possible in young patients because the liver has regenerative characteristic. A whole healthy liver then can be utilized to replace the diseased livers of at least to patients. Liver transplant from a living healthy donor can be done with high survival rates for both the patient and the donor. The existence of 15 to 20 percent healthy parts of an individual’s liver can ensure his survival (health-cares. net).