There are a lot of things that go into determining the success of a liver transplant. First and foremost, the transplant will be deferred if there is any suspicion of recent infection. After that, they will have to look at your co-morbidities. Do you have any heart or lung problems? If you do, especially right heart issues or pulmonary hypertension, your risks involved in this surgery
rise significantly. In addition, a failing liver can often affect kidneys. Do you have any kidney problems? Are you on dialysis
? These are also factors which will complicate a liver transplant. Lab values will need to be checked and will help determine your need for transplant. Your creatinine, bilirubin, and INR are part of what is called the MELD score which determines how severe your liver function is. Obviously the worse the score, the more urgently you need a new liver. Do you have any psychosocial problems? Any drug use or alcohol abuse? If so, have you gone through rehabilitation? The workup and evaluation of a liver transplant is a complex process that includes all of these issues and more.
That said, livers are precious organ that are in short supply, so if you are accepted for transplant, it is with the assumption that it will be successful. After all, we are not in the business of wasting livers. You should understand that while these operations are done every day, they are one of the most significant surgeries that are performed and can tax even a healthy body, which of course yours isn't otherwise you wouldn't be undergoing the operation in the first place. That's why the workup is so extensive.
To answer your question in short, are liver transplants likely to be successful? Yes, initially transplants are up to 90% successful because we are very careful in selecting our patients. Is it worth the risks involved? If your liver is failing and you need a new one, then there's no two ways about it. If your liver function is adequate and other interventions may be tried first, the transplant will be deferred until there are no other options left.
Once you go through a transplant, you will have to be on drugs to suppress your immune system for the rest of your life. These will be high initially and then will slowly be tapered down to a lower level. This is so that your body does not reject the new liver and vice versa. This of course will increase your risk of infection and some cancers in the long run, but in the end, the risk is acceptable, and certainly smaller than the certain risk of death with a non-functioning liver.
See your transplant surgeon
, who will explain all of these things in great detail. I wish you good luck in this process. I see many patients live long and happy lives after these operations, but I understand it is an anxiety-provoking process to go through to know that you may need a new liver.