How to assess the risks of liver transplantation surgery and reserve liver function

Generally, the assessment of surgical risks and residual liver function for liver transplantation requires integrating results from multiple types of examinations to comprehensively evaluate a patient's ability to tolerate surgery and potential for postoperative recovery. If there are any concerns, early medical consultation is recommended. The detailed analysis is as follows:

Risk assessment for liver transplantation involves multiple factors, including the patient’s age, functions of vital organs such as the heart, lungs, and kidneys, presence of underlying conditions like infections or malignancies, as well as the quality and compatibility of the donor liver. If the patient has normal organ function, no severe comorbidities, and receives a high-quality, well-matched donor liver, the surgical risk is relatively low. Conversely, if the patient suffers from severe cardiac or pulmonary diseases, uncontrolled infections, or if the donor liver is damaged, the risks of intraoperative bleeding and postoperative rejection increase significantly.

Evaluation of residual liver function primarily relies on liver function tests and clinical assessments. Key indicators such as bilirubin, albumin, and coagulation function are measured, along with imaging studies to determine the liver’s remaining functional capacity. Normal test results combined with absence of significant liver atrophy or cirrhosis indicate good functional reserve and strong postoperative compensatory capacity. In contrast, abnormal lab values and severe cirrhosis or atrophy suggest inadequate functional reserve, increasing the likelihood of postoperative complications such as liver failure.

This evaluation must be performed by a specialized liver transplant team. Patients are required to fully cooperate in completing all necessary examinations. Individualized surgical plans should be developed based on comprehensive assessment results; decisions should not be made based on a single indicator. If abnormalities are detected before surgery, appropriate treatment should first be administered to improve the patient's condition, followed by re-evaluation of surgical eligibility.