Liver Transplantation

Currently, the liver for transplantation is obtained from three different groups of donors.

Live donors:

In this case, it is possible for a liver failure patient to receive a liver from his/her blood relative. The rate of success is better if the liver is obtained from a first degree relative (father, mother, brother or sister). It is however important to match the tissue of the recipient with the donor so that the body will not reject it at a later stage. If a patient does not have any matched first-degree donor, then other relatives can be approached. Only a segment of the liver from the donor would be transplanted to the recipient, as there is only one liver in the human body. The liver would then grow, as it has an excellent regenerative capacity.

Living unrelated donors:

Under exceptional circumstances, it might be possible to consider a living unrelated donor for a liver transplantation as the supply of organs far exceeds the demand. It can be done only when it is medically and ethically acceptable to do so. It is medically acceptable if better results are anticipated when compared with a cadaveric organ donation. It is ethically acceptable if an enduring relationship exists between the donor and recipient (husband, wife, friend). This can be done only after an approval by the hospital appointed committee members to do so. This ensures prevention of any illicit trading of human organs.

Cadaveric donors:

This kind of donation is usually seen following a road traffic accident or an irreversible injury to the brain. In these individuals, a part of the brain known as the brain stem fails to function. If this happens, the patient is said to have been brain dead. It has now been accepted that brain death equates in medical and ethical terms to the death of an individual. Following brain death, the brain stops functioning, however some organs like the heart, kidneys, and lungs may still continue to function. It is therefore possible to obtain organs for donation from such individuals as neither consciousness nor spontaneous respiration is possible in the absence of a functional brain stem. This condition is different from coma, as a comatose patient has chances of revival and recovery, whereas a person who is brain dead cannot be revived by any known means. The patient is usually in the intensive care unit. The patient's relatives are explained about the condition of the patient and requested for organ donation. Following their consent, it might be possible to retrieve the organs from a brain dead donor. The diagnosis of brain death can only be made when certain medical criteria have been met. There is an increasing need to spread awareness about this concept of organ donation as most of the organs from potential brain dead donors often get wasted.