Reserve and Regeneration are the two important functions and factors that make the function of the liver to be unique. The liver serves as the important organs of the body and these factors help them to be replaced through the transplantation.
RESERVE – Though 70% of the liver is removed, the functions of liver remain normal by the remaining 30% healthy liver. So, for the cancerous liver, even a large portion of the liver is removed without compromising the liver to function or harm, it functions normally. In some cases of transplantation purpose, more than half of the liver is removed from the donor. It still does not cause derangement of the function of the liver of the donor and there will be no serious harm.
REGENERATION – The only organ in the human body, which can regenerate itself, is the liver. So, after a large portion of the liver is removed, it can regenerate itself. Within just a few weeks, the small remnants of it are grown back to reach the normal size. It is sometimes mandatory to be done for the patients with liver tumours. This is the reason, there is no harm removing a large portion of the liver, no matter from the patients with liver tumours or living donors.
The liver has a large functional reserve and capacity to regenerate itself. In a person who has a normal functioning liver, up-to 75% of it can be safely removed. In an adult patient the right lobe is generally taken as the graft as it constitutes 60% of the liver volume, while the left lobe is 40% of whole liver volume and is generally used as a graft in small adults or in children. About 50%–70% of liver is removed from the donor. For children, only part of the left lobe, the left lateral segment is removed for the graft. The remaining liver regenerates and grows to the size of a normal liver. About 90% of this growth takes place in the first 3 months after the operation. The liver function tests return to near normal in less than one week. In liver donors we keep a margin of safety and do not remove more than 70% of the liver. In the majority of cases it is between 50% to 60%.
Dr Naimish Mehta has performed over 725 liver transplantation surgeries considered to be best liver transplant surgeon in India. Dr. Naimish Mehta is the Lead HPB and Liver Transplant Surgeon, in the Deptt of Surgical Gastroenterology & Liver Transplant Unit I, Sir Ganga Ram Hospital, New Delhi. He has 14 years of experience in the field of Hepato- Pancreatico-Biliary (HPB) Surgery performing complex operations on the Liver, Bile Ducts and Pancreas.