Decompensated Liver Disease: Liver Transplantation is the Best Option, Not the Last Option
Abstract
The incidence of end stage liver disease and liver transplantation is on the rise in Kerala. All practicing doctors should have an insight into the indications, contraindications, évaluation leading to and complications following liver transplantation. Liver transplantation is now an accepted modality of treatment in end stage liver disease and hepatocellular carcinoma. With potent immunosuppression and newer surgical techniques the 5 year survival rate following liver transplantation is above 75%. It is higher than that for surgeries for most gastro-intestinal cancers. The process to reach liver transplantation starts with early referral to the transplant centre, where extensive investigations performed. Once the patient is accepted into the waiting list, then prioritization for the transplant relies on the MELD score as well as matching the blood group and patient size. Immunosuppression after transplant requires a balance between prevention of graft rejection and minimization of the side effects of immunosuppressive drugs. Lifelong after-care is crucial for long-term graft and patient survival after liver transplantation.
When publishing with Kerala Medicial Journal (KMJ), authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal. Work includes the material submitted for publication and any other related material submitted to KMJ. In the event that KMJ does not publish said work, the author(s) will be so notified and all rights assigned hereunder will revert to the author(s).
The assignment of rights to KMJ includes but is not expressly limited to rights to edit, publish, reproduce, distribute copies, include in indexes or search databases in print, electronic, or other media, whether or not in use at the time of execution of this agreement.
Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
The author(s) hereby represents and warrants that they are sole author(s) of the work, that all authors have participated in and agree with the content and conclusions of the work, that the work is original, and does not infringe upon any copyright, propriety, or personal right of any third party, and that no part of it nor any work based on substantially similar data has been submitted to another publication.
