Liver Transplant

Introduction:

Liver transplant is a surgical procedure to remove a diseased liver and replace it with a healthy liver (whole or part) from a donor. Liver transplant operations use livers from deceased donors (Brain death) or from living donors. Liver transplant done as last treatment option for people who have end-stage liver failure that can’t be controlled by other treatments. 

Two specialized team of liver transplant surgeons work simultaneously in two equipped operation theatres. In case of living donor liver transplant, one team for donor operation for retrieval of part of donor liver and another team for removal of damaged (cirrhotic/cancer liver) and finally implantation of donated liver (Liver graft) to the recipient.

In case of deceased donor liver transplant the retrieval of liver (Liver graft) may be done in the same or other center and the liver is passed as quickly as possible to the recipient surgery theater. 

Liver transplant surgery carries a risk of complications, including bleeding, bile leaks, failure of donated liver (Graft), infection, sepsis and rejections of donated liver. Liver graft usually grows & regain its function within six to eight weeks after the transplant.

Recipient must have to take a number of medications after the liver transplant, may be for the rest of life. Drugs called immunosuppressants help keep the immune system from attacking new liver. Immunosuppressants also have side effects. Other drugs help reduce the risk of other complications after transplant Six months to one year of recovery period is needed for full recovery after a liver transplant.

However, normal activities may be resumed after a few months of transplant. In general, about 75% of people who undergo liver transplant live for at least five years. People who receive a liver from a living donor often have better survival rates than those who receive a deceased-donor liver. Ccomparing long-term results is difficult because people who have a living donor usually have a shorter wait for a transplant and aren't as sick as those who receive a deceased-donor liver.

Liver transplant in Bangladesh

Starting of Liver transplant in Bangladesh was a long time due. BIRDEM General Hospital took the initiative for starting liver transplant in Bangladesh. The fundamental of Liver transplant programme is the fully functioning Hepato -Biliary Surgery. Diabetic Association of Bangladesh (BADAS) invited Prof. Mohammad Ali to join the institute after his return from abroad, who received fellowship training on Hepato-Biliary-Pancreatic Surgery & Liver transplant at the Queensland Liver transplant Services, Queensland, Australia.

The first department of Hepato-Biliary-Pancreatic Surgery of Bangladesh started by Prof. Mohammad Ali on July 26,1999 at BIREDEM General Hospital. The complex surgeries of liver, biliary system, pancreas, which include various forms of liver resections, pancreatic
resections, biliary reconstructions and other surgeries of these vital organs.

The department of Hepato-Biliary-Pancreatic Surgery played the key role for initiating Liver transplant in Bangladesh. Prof. Mohammad Ali, as head of the Dept Hepato-Biliary-Pancreatic Surgery & chief Liver transplant surgeon organized multidisciplinary liver transplant team. Members of the team received training in New Delhi, India & Kyoto, Japan. Technical expertise of vascular & biliary anastomosis was practiced at Cow & sheep liver. Pork to Pork (Porcine model) liver transplant also carried out to practice more accurate vascular & biliary anastomotic techniques.

Operation theaters of Ibrahim Cardiac Hospital & Research Institute (ICHRI) was prepared for starting the first liver transplant of Bangladesh. There was shortage of equipment for the transplant. Some essential equipment & services were borrowed from other friendly institutes like National Heart Foundation of Bangladesh, Combined Military Hospital (CMH), Dhaka, Popular Medical College Hospital & Gastro liver Hospital & Research Institute, Dhaka.

Recipient & donor was selected but there was difficulty in convincing them to be the first candidate of liver transplant of Bangladesh. However, finally they were convinced & agreed for the transplant.

The first successful liver transplants in Bangladesh done on June 03, 2010. It acted as mile stone of initiation of Liver transplant in Bangladesh. Received appreciation from home & abroad. Ministry of Health acknowledged it with great appreciation. Members of the Bangladesh National Parliament (Jatiya Sangsad) congratulated it at its session.

Th second successful liver transplant of BIREDM done on August 06, 2011.It was done at the same operation theater of ICHRI and also borrowing equipment from other institutes. Diabetic Association of Bangladesh (BADAS) & Government of Bangladesh jointly made a liver transplant project. The third Successful Liver transplant done in the new complex on February 13.2020. Liver transplant team of BIRDEM General Hospital & Ibrahim Cardiac Hospital & Research Institute (ICHRI) was helped by Prof. Subhash Gupta & his team from New Delhi, India.

Three more liver transplant done in Bangladesh. Two at Lab Aid Specialized Hospital, Dhaka and another one at Bangabandhu Sheikh Mujib Medical University (BSMMU). Liver transplant team of BIREDM General Hospital is working hard to continue liver transplant services in Bangladesh so that the patients suffering with end stage liver diseases can continuously get liver transplant services at their own country.

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