Liver transplantation (LTX)
A liver transplant is the last option for curing patients with severely damaged livers that can no longer fulfil their metabolic function. Liver failure - both sudden onset as well as the kind that develops over time - is life-threatening. Chronic liver diseases, bile duct diseases, metabolic disorders, acute liver failure most commonly due to toxic substances, and liver cancer that is not too advanced are the most common conditions that require liver transplantation. Around 100 liver transplants are performed in Switzerland annually. The preparation and investigation of patients prior to inclusion on the transplant waiting list is complex and is accompanied by a team of numerous physicians from a wide range of specialties (hepatology, surgery, anesthesiology, psychiatry and others).
Criteria for a liver transplant
Unfortunately, not every patient on the waiting list in Switzerland can also receive a liver transplant. There are too few organs available. Some patients die while on the waiting list because an organ does not become available in time.
A liver transplant cannot always be carried out even if a suitable organ is available. n cases of blood poisoning (sepsis), other cancers not (only) affecting the liver, advanced heart or lung disease, or advances AIDS, liver transplantation is not performed.
Liver transplantation may also be difficult in patients with thrombosis of the entire portal vein system, advanced malnutrition or additional severe organ diseases, alcohol or drug abuse or HIV positivity.
A national liver transplant waiting list is maintained for the "distribution" of donor organs. Patients on this waiting list are prioritised according to the MELD score (Model for End Stage Liver Disease). This is to ensure that in each case the most seriously ill patient is the first to receive an organ offer.
A patient is then placed on the waiting list if he/she meets the required criteria and will need a transplant in the foreseeable future. For patients with chronic liver disease, blood values are used to determine the risk of dying within the next three months without a new liver. If the risk is high, the chance of an organ transplant increases.
“When does a liver transplant become necessary?” PD Dr. Mertens faces this and other comprehensive questions in the interview. He makes the serious clarifications and far-reaching coordination around a vital topic clear to us and raises awareness of how important the liver is.
PD Dr. Mertens talks about “When do you have to think about a transplantation?” and other important questions concerning the various aspects before and after a liver transplant. He expertly brings us closer to this existential topic and emphasizes the need for discussion and readiness for an organ donation card.
When an acute consequence has to be drawn from a small sign and observation. Peter impressively describes his journey from a biliary tumor and transplantation to his newfound quality of life with gratitude and optimism.