A Successful Living Donor Liver Transplantation (LDLT) for Decompensated Cirrhosis

Pace Hospitals

Liver Transplant Team at PACE Hospitals, Hyderabad, achieved a successful Living Donor Liver Transplantation (LDLT) saving a decompensated liver cirrhotic patient.

A 40-year-old male patient with a history of a distended abdomen associated with breathlessness in the last five days was presented to the Chief Hepatologist, Dr Govind Verma, at PACE Hospitals, Hitech City, Hyderabad. The patient has also complained of tremors involving both lower limbs accompanied by loss of appetite.

Medical History

Delving deeper, it was understood that the patient was diagnosed with chronic alcoholic liver disease in the past four months, and two months ago, he was diagnosed with hepatic encephalopathy, constantly distressed with recurrent abdominal distension.

Diagnosis

Upon admission to PACE Hospitals and undergoing necessary investigations, the patient was diagnosed with liver cirrhosis. The decompensation of liver disease is due to portal hypertension which explains the reason for coagulopathy, ascites, hepatic encephalopathy and damaged hepatorenal system. The MELD na score (Model for End-Stage Liver Disease) was found 23, and the Child-Turcotte-Pugh (CTP) score falls in the range of C.

Treatment

The diagnosing hepatologist asserted that a liver transplant was the only way to salvage/save the patient.

The patient was put on multiple lifesaving supports, efforts were made to obtain a liver from donors, and finally, after learning about his condition, the patient's brother came forward to donate a portion of his liver.

With necessary investigations done & clearances obtained, the patient underwent living donor liver transplantation (LDLT), receiving the right lobe modified liver graft. The liver transplant surgeon Dr. CH Madhusudhan supervised the procedure, and it was accomplished without any complications.

The aftermath

The post-operative period was uneventful except for a brief requirement of oxygen support, which was later weaned off & maintained with atmospheric air.

The necessary medicines, immunosuppressives, antibiotics, proton pump inhibitors, multivitamins, antiemetic, analgesics, antipyretics & other supportive care were given along with the counselling. Once the patient achieved hemodynamic stabilisation, he was discharged with the necessary medications and advice for follow-up.

Praising the selfless sacrifice of the brother, the liver transplant surgeon Dr. CH Madhusudhan remarked on the role of the healthcare team in the procedure, “Thanks to the haste search efforts of family members and the medical understanding of the PACE team of coordinators and medical specialists, we could accomplish the transplantation of the liver. The donor and the recipient are doing well," said Dr. CH Madhusudhan, Liver Transplant Surgeon at PACE Hospitals, Hyderabad.

Decompensated cirrhosis is the last stage which is accompanied by the development of various overt complications such as ascites (abdomen distension), jaundice (raised bile levels in the blood), variceal haemorrhage (bleeding from veins), or hepatic encephalopathy (increased liver). The median survival period of patients with decompensated cirrhosis could be around two years.