Liver Transplantation

Liver transplantation is possible for patients whose tumors cannot be surgically removed and have not spread outside of the liver.  In this procedure, the cancerous liver can be removed and replace with a healthy one.

The success of liver transplantation represents one of the great miracles of modern medicine.  It is the only definitive method to cure most patients with end-stage liver disease. 

Liver Transplant Options

Deceased donor liver transplant

• In the US, patients waiting for liver transplants are prioritized based on the severity of their illness, measured by the Model for End-Stage Liver Disease (MELD) score.
• MELD score uses blood tests to determine how urgently a patient needs a liver transplant within the next 3 months. The sicker a patient is, the higher the MELD score; scores range from six (less ill) to 40 (critically ill).
• According to UNOS (United Network for Organ Sharing), as of February 15, 2018, there are 13,902 patients in the United States on the wait list for a liver transplant but only approximately 7,000 patients receive a transplant each year. 
• The average wait time for most patients measures in years depending on the region he/she resides
• Of the patients on the wait list, only 1 in 5 survive long enough to receive a transplant

Live donor liver transplant

• The major issue with liver transplantation, is not rejection or infections, but rather there are not enough livers for all patients who need them. 
  
• One in five patients dies waiting, a number that could significantly decreased with liver donations from living donors
• It is possible for a surgeon to take a portion of a liver from a healthy individual and use that for transplant.
• The procedure started first in children, with the first U.S. transplant in 1989. It then expanded for use in adults by 1996
• Living donor liver transplantation allows patients to receive a transplant from a living donor often a point sooner in the disease process, when they are healthier and better able to tolerate the procedure. This leads to a quicker and less complicated recovery
• Despite the advantages, living donor liver transplants in the U.S. account for less than 5 percent of all liver transplants.  In other countries, such as Korea, Japan and India, living donor liver transplants account for almost 90 percent of liver transplants
  
• The main reason for the underutilization is a lack of awareness of the procedure, both by patients and the health care community
  

References:
https://www.everydayhealth.com/liver-cancer/liver-cancer-transplant.aspx
http://theconversation.com/how-live-liver-transplants-could-save-thousands-of-lives-94698
https://unos.org/
https://www.hindawi.com/journals/ijh/2012/253517/
https://www.ucsfhealth.org/education/getting_a_liver_transplant/