For someone who has developed a serious liver disease, a liver transplant or other surgery may be the best option. The liver is the largest internal organ. It makes nearly all the proteins, many of the fats, and several hormones that keep us alive and healthy. It is the only solid organ that has the ability to regenerate.
Yale Medicine is recognized internationally for being a pioneer in liver transplant surgeries, including such complex procedures as transplantation from living donors. “We have a long history of success with liver transplants, a reputation for clinical excellence and patient-centered care, and a tradition of cutting-edge research and innovation,” says David Mulligan, MD, chief of Yale Medicine Transplant & Immunology Surgery.
Who should have liver surgery?
Liver surgery, including liver transplant, may be the best—and is sometimes the only— treatment for someone who has primary liver cancer, which starts in the liver, or metastatic liver cancer, which starts elsewhere and spreads to the liver.
Other liver conditions that may be helped by liver transplant or other liver surgeries include:
- Hepatitis and cirrhosis
- Bacterial and parasitic infections
- Gaucher disease
- Liver cysts
- Benign liver masses
- Portal hypertension, a common complication of cirrhosis
- Wilson disease
What are the different types of liver surgery?
Yale Medicine provides organ transplants using organs from both deceased and living donors. Our comprehensive transplant program offers the full array of treatments and support services, including genetic testing, for adults and children with all types of liver disease. We can transfer patients to Yale New Haven Hospital in a timely manner for transplant evaluation and medical management.
Yale Medicine surgeons are skilled in such cutting-edge treatments as split-liver transplants, which divide a portion of a donor's liver divided between two recipients. Our Pediatric Liver Transplant Program works with such innovative treatments as reduced liver transplants, in which an infant or child receives a portion of an adult liver. Our specialists are sensitive to the special needs and unique medical complications that can come up among pediatric patients.
Yale Medicine's services include:
- Living donor liver transplant, in which care is provided for the recipient and lifelong follow-up for the donor
- Deceased donor liver transplant
- Treatment for liver cancer
- Liver transplant for people with HIV
- Pre- and post-transplant antiviral therapy to prevent or treat recurrent hepatitis C
How are living donor transplants different from deceased donor transplants?
In a deceased donor transplant, the liver comes from someone who has died suddenly. The donor is usually a person who was healthy when they were alive, and they or their family decided to donate their organs to help someone in need.
In a living donor transplant, the organ comes from a person who is alive and well, who may be a family member, a friend, or even a complete stranger. While a person only has one liver and would die without it, living donor transplants are possible because of the liver’s “regenerative” properties: When a portion of a healthy liver is removed from a healthy living person’s body, what remains is left regrows within a few weeks. So a healthy person can donate a portion of their liver to someone with liver disease if it's an appropriate match.
How does a patient get on the list for a liver transplant?
Nationally, more than 13,000 people are waiting for a liver to become available, and there are far from enough organs to meet the demand. Living donors expand the pool of available donations
Yale Medicine transplant surgeons accept patients who call the Yale New Haven Transplantation Center (YNHTC) directly or whose doctors have recommended them for a transplant. If they find a patient is eligible for a transplant, they will add them to the national transplant waiting list.
The waiting list for a deceased donor prioritizes people who are the sickest. So the waiting time for a liver can be unpredictable. A living donor can save lives by reducing a wait that can last years down to weeks.
What is the experience of liver transplant surgery like for the patient?
A liver transplant is a complex operation that can take 12 hours or longer. Patients who’ve received a liver transplant typically spend five to 10 days in the hospital, and full recovery takes several months.
Liver transplant patients need to follow up on their surgery with regular checkups and blood tests to assess liver function and can expect to take medication for the rest of their lives.
What makes Yale Medicine's approach to liver surgery and liver transplant unique?
People from around the world seek out Yale Medicine transplant surgeons for liver, kidney, pancreas, and heart transplantation. We are the region’s leader in evaluating and treating advanced liver disease. We also specialize in genetic testing for liver diseases.
Other hospitals depend on the Yale New Haven Transplantation Center (YNHTC) to be a major referral center for particularly challenging cases. Our surgeons often provide options for high-risk patients who have been turned down for transplantation elsewhere. But even though we treat some of the most seriously ill patients, our patients' survival rates are consistently higher than the national average.
"We are particularly expert at adult and pediatric living donor liver transplantation,” Dr. Mulligan says, adding that Yale transplant surgeons expect their research into enhancing liver regeneration and repair will continue to improve this area of donation in the future. The Center for Living Donors at Yale New Health has created supportive communities of living donors throughout the state, and provides them with free, lifelong local medical monitoring for any health issues that may arise related to their organ donation.
Yale New Haven Hospital is the only transplant center in Connecticut and one of the 17 centers in United States who has the ability to enroll its patients in the Federal HOPE in Action Clinical Trial.
YNHTC and Yale Medicine specialist teams, which include transplant surgeons, hepatologists, nephrologists, and infectious disease specialists, along with specially trained surgical teams, nurses, social workers, and pharmacists are a recognized leader in organ transplantation from both deceased and living donors. For years, the unique nature of combined research and clinical collaboration between YNHTC and Yale Medicine has been instrumental in benefiting patients.