Liver transplant surgery removes a diseased and failing organ and replaces it with a healthy, functional whole liver or partial liver. These organs must be harvested from a recently deceased donor or, in the case of a partial liver donation, from a voluntary live donor. Nearly 6,000 liver transplants are performed each year in the United States, MayoClinic.com estimates. For most liver recipients, the positive effects far outweigh the risks and negative side effects.
Longer Life
End-stage liver disease is characterized by development of cirrhosis, a severe scarring of liver. Once it begins, life-threatening complications develop. While lifespan varies, the survival rate according to the Child-Purcotte-Pugh score, which evaluates various factors of liver disease, is 45 percent at one year and 35 percent at two years, says the Merck Manuals Online Medical Library. The MELD score, widely used to rank patients on the liver transplant waiting list, measures three blood tests and arrives at a score based on an algorithm designed by the Mayo Clinic. Depending on the disease cause, 76 percent of people hospitalized with a MELD score of 20 or higher, the national average at time of transplant according to the California Pacific Medical Center in 2010, will die within three months without transplant. Fifty percent of ambulatory patients with a MELD score of 20 will die within the same time frame.
After transplant, survival rates range from more than 80 percent at five years to more than 65 percent at 10 years, the Merck Manuals report.
Increased Quality of Life
Studies, such as one reported in "Gastroenterology Nursing" in the May/June 2010 issue, that use questionnaires given to post-transplant patients to gauge transplant results, report an increase in quality of life after transplant. Interestingly, men reported overall higher quality of life than women in this study. Ability to function, feelings about life and health perception questions were included in the questionnaire.
Fewer Health Problems
A meta-analysis of literature reported by Dena Bravata, M.D. of Stanford University in 1999 found an increase in health-related quality of life ranging from 11 to 50 percent after transplant, as reported by various studies. Physical health and sexual functioning were among the factors rated more positively after transplant, while the smallest gains occurred in areas of psycho-social functioning. While certain health risks, such as complications associated with rejection medications, can occur after transplant, others, such as fatigue, encephalopathy, fluid retention, anemia and bleeding from low platelets improve.
References
- California Pacific Medical Center: MELD and the Waiting List for Liver Transplant
- American Academy of Family Physicians: Point of Care Guides: Predicting Prognosis in Patients With End-Stage Liver Disease
- MayoClinic.com: Liver Transplant
- Stanford University: Health-Related Quality of Life After Liver Transplantation: Dana Bravata
- "Gastroenterology Nursing": Longitudinal Quality of Life in Liver Transplant Recipients; Susan Rugiari, RN, PhD; May-June 2006
