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If liver cancer is diagnosed early enough and the tumor has not spread, liver transplantation may be a good treatment option.
It may also lead to healing.
Am I a good transplant candidate?
“If your cancer is a primary cancer, meaning it started in your liver and has not spread to other organs, and if you are in good overall health and young enough, you are very likely to be a good candidate for a transplant. “It’s expensive,” Brown said.
Dr. Brown said that doctors treat cancer as milan standards This takes into account the following factors:
- Diagnosis of hepatocellular carcinoma (HCC), the most common type of liver cancer
- There may be up to three tumors, none larger than 3 cm.
- or just one tumor, but no larger than 5 cm.
- The cancer has not spread outside the liver.
- There is no major blood vessel involvement by the cancer.
“And of course, the other criterion for transplantation is that you have to be healthy enough to undergo the surgery,” Dr. Brown added. “So we do all the heart tests, lung tests and other tests to make sure everything else is okay.”
Related: What to expect after liver cancer surgery
How long should I wait before transplanting?
Patients who meet transplant criteria are immediately placed on a waiting list for a matched donor liver.
“Once someone meets the criteria, we give them further priority to access their liver. On average, liver cancer patients wait six to nine months. Most are completed within a year,” Brown said. says.
Match factors include:
- Blood type compatibility to prevent rejection
- The size of the donor liver must be suitable for the available space in the recipient’s body
- Donor liver must be in good health and free of disease or significant damage
- The donor liver must be free of active infections that can be transmitted to the recipient.
- Functional tests check if the donor liver functions properly in the recipient’s body
Donated livers come from one of two types of recipients:
- Deceased donor: Recently deceased person and his family agree to donate organs to save life
- Living donor: A healthy person who volunteers to donate part of his liver to someone in need. Usually this is a family member or friend, and the liver’s ability to regenerate allows the donor to make a full recovery.
In some cases, you can receive part of a liver from a living donor instead of waiting for a deceased donor’s liver to become available.
Who is on the transplant team?
If you are undergoing a transplant, there are several professionals who will support you during the transplant process, including doctors, specialists, and other professionals who usually work at a hospital or cancer center.
This team may include:
- The transplant surgeon says: Who will discuss the risks and benefits of surgery with you and assess your health before surgery
- Clinical liver specialist: A gastroenterologist with extensive training in liver diseases will review your medical history and determine what tests need to be done for evaluation. While you wait for your donor liver, this specialist will keep you healthy and provide most of your post-surgery care.
- Nursing coordinator: Provide education and assist in navigating the evaluation process
- social worker: Assess how well you will cope with the stress of transplantation and manage your pre- and post-surgery care plan.
- clinical psychologist or psychiatrist: Evaluate your mental health and recommend drug or alcohol abuse rehabilitation programs, if necessary.
- nutritionist: Evaluate diet and provide education before and after transplant to increase the chances of a successful transplant.
- pharmacist: We will work with you and your transplant team to find the best medicine to prevent organ rejection and minimize side effects.
Related: Difference between bile duct cancer and liver cancer
How is the surgery performed?
Once a match is found, the medical team immediately prepares the patient for surgery. If the liver is from a deceased donor, the liver can only survive for up to eight hours after being removed, so you will need to rush to the hospital day or night.
This is because they often travel from different locations. However, if the liver comes from a living donor, the surgery can be planned in advance and both donor and recipient can undergo surgery at the same time.
During the surgery, a large incision is made under the ribs on the right side of the abdomen. The team then carefully separates the diseased liver from its connections, such as blood vessels and bile ducts.
To control bleeding and prevent bile leakage, clamps are used to secure the liver to the blood vessels and bile ducts before installing the new liver.
Liver transplant surgery can take 4 to 8 hours depending on the complexity of the case.
What does recovery feel like?
After a liver transplant, you wake up in intensive care. Patients are usually returned to the ward within a few days.
After surgery, patients undergo hospitalization and rehabilitation, which typically lasts 10 to 14 days.
Your care team will prescribe immunosuppressive drugs to prevent organ rejection. During this time, your doctor will monitor your immune system to see if it rejects your new liver.
“Of course, most of the complications are surgical in the early stages. However, you need to be careful about infections associated with immunosuppression, such as Epstein-Barr virus,” warns Dr. Brown.
Initially, you will have weekly follow-up appointments with your transplant doctor. During these visits, your doctor may check your healing progress and adjust your medications if necessary. Dr. Brown said many liver transplant patients require relatively small amounts of medication to stay healthy.
Most people who have this surgery are able to resume work and daily life after being discharged from the hospital. Remarkably, approximately 90% of transplanted livers remain functional one year after surgery.
“Our one-year survival rate is over 90%, and 90% of them are still alive after five years. The life expectancy of liver transplant patients is the same as age-matched control patients,” says Dr. Brown. .
What follow-up care should I expect?
As Dr. Brown points out, liver translation is often an effective treatment for liver cancer. That being said, patients always require follow-up care such as:
- Regular tests to monitor liver function and general health
- Drug therapy to prevent organ rejection and dosage adjustment based on response
- Lifestyle changes such as healthy eating, avoiding alcohol and smoking
- Physical rehabilitation is possible to recover physical strength and return to daily life.
- Long-term monitoring for signs of rejection, infection, and liver function problems
Dr. Brown says the cancer is unlikely to come back, but it is possible.
“If you treat the tumor and find that you still have cirrhosis, there’s a risk that new cirrhosis will develop, so new cancers may still develop,” he says.
Also, if your cancer is more advanced at the time of transplant or you have high-risk features, you are more likely to need chemotherapy or immunotherapy to prevent recurrence.
Related: Understanding Liver Cancer — Signs, Symptoms, and Treatments
Questions to ask your doctor
- Am I eligible for a liver transplant?
- Should I expect it to heal?
- What side effects can I expect? How should I deal with them?
- What follow-up care is required?
- What parts of my treatment will be covered by insurance, and how much will I have to pay out-of-pocket?
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