The first program of this type in the region will provide transplants to patients with end-stage liver disease, acute liver failure, and liver tumors. The program is enhanced by Jefferson's resources, including access to the tools and services needed and cross-training with Jefferson's liver transplant specialists.
“This is a huge development for Lehigh Valley. We need large organizations to build and maintain the liver transplant program, and support from Jefferson has made this possible,” said Lehigh of Jefferson's Health Perioperative Services. said Dr. Michael Pasquale, a doctor at the Valley Institute. “This population requires dedicated liver transplant services. The existing transplant programme has doubled in the last year and continues to expand. We offer more services, and more They have the opportunity to continue to thrive as they transplant patients.”
The liver transplant program is created in almost 10 years and consists of “hundreds of people.” It requires the skills and coordination of professionals from all levels of LVHN, as well as extensive education and training on the part of nursing and administrative staff. This program uses the liver of a deceased donor. This accounts for 85-90% of liver donations nationwide. Dr. Rofaiel said the team will not currently undergo liver transplants from live donors.
Eligible candidates for surgery will undergo extensive testing from multiple specialties, including social work and psychology. This is necessary to ensure that patients are appropriate for long medically and physical implant procedures and ensure the support system needed for subsequent recovery.
“I always say 500 people need to do a transplant,” says Dr. Rofaiel. “It's a huge disruption in the body and even affects circulation to the heart and brain. All of the surgeons, including two surgeons who perform the transplant, along with anesthesiologists, perfusionists, dialysis nurses and cardiologists. There are about 12 people in the surgery. Then there are pharmacists, nutritionists, social workers, rehabilitation specialists and coordinators. Liver transplants take villages as well as quite a few villages.”
The patient is considered a liver transplant after referral from a liver specialist or through self-referencing. Additionally, if the situation requires an emergency assessment, it may be accepted through your local emergency department or hospital. In most cases, transplantation is only discussed when patients are at a very high risk of succumbing to the disease within six months to one year.
If the patient is a candidate, blood type testing is performed and countless clinical tests and imaging are performed. These tests will result in a model of end-stage liver disease (MELD) scores that estimate the likelihood of each patient's survival of the disease over the next three months. Organ allocation is determined by organ procurement and transplant networks. The liver of a deceased donor is first assigned to the most ill patient (the patient with the highest MELD score).
One of the long challenges of liver transplantation is to make healthy livers available and maintain them long enough to make them useful. “The number of patients diagnosed with liver disease continues to increase, but the number of donors is flat-riding,” says Dr. Malik. “We are also selective. If we get healthy, we're competing against time because our liver is only present for six to 12 hours.”
LVHN is preparing to add normal temperature perfusion (NMP) as a tool for pre-implanting liver. NMP, or “liver pump,” refers to the technique of preserving organs during the implantation process, involving circulating perfusion that mimics blood flow. This technique can extend the lifespan of the liver by more times. This means that the program can accept liver from afar and increase the donor pool.
Once a patient has a liver transplant surgery, he will be monitored for life by Dr. Malik and his team. Liver rejection rates are low, but sometimes occurs and the team prescribes immunosuppressant medications. In many cases, people continue to live healthy and productive lives with liver that lasts for 25 years.
“Live transplants are truly one of the miracles of medicine,” says Dr. Malik. “Many of these patients are at the door to death. With the implant, they lease their lives new.”
