With unhealthy eating habits and sedentary lifestyle on the rise among Bangaloreans, they no longer are strangers to liver diseases. Dr Sanjay Govil, liver transplant surgeon, HCG in an interaction with DNA, spoke about various liver-related problems in the city, causes and remedies.
Considering the lifestyle change in Bangalore, has there been a rise in the number of cases with liver diseases?
There is a rising incidence of liver disease for the following reasons: metabolic syndrome among large number of patients, non-alcoholic steatohepatitis and alcoholism. Hepatitis C takes about 15 to 20 years to convert to cirrhosis. This virus was screened in blood donors routinely only from the mid 1990’s, so those infected by this virus are only being diagnosed as cirrhotic now – and will continue to do so at least till 2020. Young people are more likely to be affected by alcoholic liver disease and as a consequence of metabolic syndrome.
What is the impact of obesity and sedentary lifestyle on liver? Can it lead to liver failure?
Yes, it can. Obesity leads to fatty infiltration of the liver. In some people who develop fatty infiltration, this process is accompanied by inflammation and scarring of the liver that may lead to cirrhosis over time. The only treatment is a change in lifestyle.
Who are the candidates for liver transplant? Who can donate liver? Can there be cadaver donors too? Are there enough donors?
Liver transplants are performed for decompensated chronic liver disease, acute liver failure, certain liver cancers and for certain metabolic diseases. Cadaveric liver donation is the best and safest form of liver transplant whenever possible, but its drawbacks are that patients need to wait long periods to get an organ and many die on the waiting list. Also, certain indications for transplant – particularly acute liver failure or liver cancer need transplant to be done quickly so that there may not be time to wait for a cadaveric liver. In such instances live donors are necessary. A live donor needs to be a close relative with a compatible blood group, who is fit and healthy. The risk to the donor is only about 0.5%.
What are the possible risk factors associated with liver transplant?
The overall risk to life from undergoing a liver transplant is about 10%. However it is important to remember that this is in patients, who would survive less than a year without transplant. The risks are related most commonly to either rejection or infection – although there are good drugs to control these problems in the majority of affected patients. Rarely there may be complications related to technical issues during operation. Finally there are certain diseases that can recur in the new liver that need to be identified and treated.
How is the quality of life post liver transplant? Does the recipient need to be on medication for rest of life?
The quality of life is excellent in most cases and patients can lead a normal life. They need to be on immunosuppressive drugs for rest of life and so need to avoid infection by drinking clean water and eating healthy food