Re: why does cirrhosis complicate orthtopic Liver Transplantation, and how?

Orthotopic liver transplantation refers to replacing a patient's diseased liver with a new liver from a donor. (In heterotopic liver transplantation, the donor liver is implanted alongside the old liver.) Liver transplantation has become much more successful recently, allowing many patients with end-stage liver disease to live longer lives with fewer complications. Liver transplantation in adults is most commonly done to treat liver failure due to end-stage chronic hepatitis (often arising from viral hepatitis B or C) and primary biliary cirrhosis.

Rejection of a transplanted liver occurs when the recipient's immune system recognizes the new liver as "foreign" and attacks it. Rejection occurs frequently and may range from mild to severe. Immunosuppressive drugs are routinely given following liver transplantation to suppress the immune reaction that leads to rejection.

Cirrhosis refers to a specific pattern of liver damage which is characterized by the presence of fibrosis (scarring) and regenerative nodules, and may be due to various underlying diseases. Many patients who undergo liver transplantation may have cirrhosis of their old liver (which may be the reason for the transplant). Cirrhosis occurring after liver transplantation may be the result of severe rejection, or may be due to recurrence of the disease which led to transplantation in the first place (such as primary biliary cirrhosis or viral hepatitis).

I'm not aware of any relationship between cirrhosis and colectomy (removal of part or all of the colon). Sorry I can't be of assistance on this part of your question.

Thanks for your question!

Stephen C. Lattanzi, M.D.
New London Cancer Center, Inc.

References

1. The Merck manual of diagnosis and therapy. Section 12: Immunology; allergic disorders. Chapter 149: Transplantation.

2. Dorland's illustrated medical dictionary, edition 26. Philadelphia: Saunders, 1985. p. 273.