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The BNH Hospital Experience in Liver Transplants

22 Nov, 2023

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Introduction:


BNH Hospital, established in 1898 under the royal patronage of King Rama V, has evolved into an internationally recognized healthcare institution, known for its commitment to providing high-quality medical services. Among its many specialties, BNH Hospital stands out as a leading center for liver transplant procedures.

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Symptoms of Liver Disorders


Liver disorders can manifest through a variety of symptoms, indicating potential issues with the organ's functionality. Recognizing these signs is crucial for timely intervention. At BNH Hospital in Bangkok, specialists such as Dr. Chalomkwan Prayoonwech and Dr. Ong-arj Bovornsakulvong are adept at identifying and addressing liver-related symptoms. Here are some common indicators:

1. Fatigue

Persistent fatigue is a common symptom of liver disorders. The liver plays a key role in energy metabolism, and when compromised, it can lead to a lack of energy and persistent tiredness.

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2. Jaundice

Jaundice is characterized by yellowing of the skin and eyes. It occurs when the liver is unable to properly process bilirubin, a yellow pigment produced during the breakdown of red blood cells.

3. Abdominal Pain

Pain or discomfort in the upper right side of the abdomen may signal liver issues. The liver is located in this region, and inflammation or swelling can cause pain.

4. Swelling and Fluid Retention

Liver disorders can lead to the accumulation of fluid in the abdomen (ascites) and swelling in the legs and ankles. This occurs when the liver's ability to regulate fluid balance is compromised.

5. Unexplained Weight Loss

Unintentional weight loss can be a symptom of various liver conditions. The liver plays a role in nutrient processing, and dysfunction can impact weight regulation.

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6. Changes in Stool Color

Alterations in stool color, such as pale or clay-colored stools, may indicate issues with bile production and flow from the liver.

Dark Urine

Dark-colored urine can be a sign of liver problems. When the liver is not functioning properly, bilirubin can build up in the body and be excreted in the urine, causing it to appear dark.

Nausea and Vomiting

Liver disorders may lead to digestive issues, including nausea and vomiting. These symptoms can be related to the liver's role in processing nutrients and toxins.

Itchy Skin

Pruritus, or itchy skin, is a symptom that can occur when the liver is unable to properly excrete bile salts, leading to their accumulation in the skin.

Bruising Easily

A compromised liver may result in a decrease in clotting factors, leading to easy bruising and prolonged bleeding.


Diagnosis of Liver Disorders at BNH Hospital


Accurate diagnosis forms the foundation of effective treatment for liver disorders. BNH Hospital in Bangkok, with its team of specialized physicians such as Dr. Chalomkwan Prayoonwech and Dr. Ong-arj Bovornsakulvong, employs advanced diagnostic tools and comprehensive assessments to determine the nature and extent of liver conditions. Here is an overview of the diagnostic process:

1. Medical History and Physical Examination

A detailed medical history is the starting point of the diagnostic journey. Patients at BNH Hospital undergo a thorough examination by experienced healthcare professionals. This includes assessing symptoms, risk factors, and any relevant medical history.

2. Blood Tests

Blood tests are instrumental in evaluating liver function. Liver function tests measure the levels of enzymes and other substances produced by the liver. Elevated levels may indicate liver damage or dysfunction.

3. Imaging Studies

Advanced imaging studies play a crucial role in assessing the structure and condition of the liver. BNH Hospital utilizes imaging technologies such as ultrasound, CT scans, and MRI to visualize the liver and identify abnormalities, tumors, or cirrhosis.

4. Liver Biopsy

In some cases, a liver biopsy may be recommended to obtain a small sample of liver tissue for detailed examination. This can provide insights into the specific liver condition and help guide treatment decisions.

5. FibroScan

BNH Hospital employs innovative technologies like FibroScan to assess liver stiffness, a key indicator of liver fibrosis. This non-invasive procedure aids in determining the degree of liver scarring without the need for a traditional biopsy.

6. Endoscopic Procedures

Endoscopic procedures, such as endoscopic retrograde cholangiopancreatography (ERCP), may be utilized to examine the bile ducts and obtain samples for analysis. These procedures are performed by skilled specialists at BNH Hospital.

7. Genetic Testing

In cases of genetic liver disorders, genetic testing may be recommended to identify specific genetic mutations or conditions that contribute to liver issues.

8. Viral Hepatitis Screening

Given the prevalence of viral hepatitis, especially Hepatitis B and C, BNH Hospital conducts thorough screenings to identify the presence of these viruses, contributing factors to liver diseases.

9. Collaborative Consultations

The diagnostic process at BNH Hospital often involves collaboration between specialists, including gastroenterologists, hepatologists, and radiologists. This multidisciplinary approach ensures a comprehensive understanding of the patient's condition.

10. Patient Education and Communication

Throughout the diagnostic process, BNH Hospital places a strong emphasis on patient education and communication. Patients are informed about the procedures, test results, and the implications of their diagnosis. This collaborative approach empowers patients to actively participate in their healthcare decisions.



Risks and Complications Associated with Liver Transplants


Liver transplant procedures, while lifesaving, come with inherent risks and potential complications. The experienced medical team at BNH Hospital, including specialists like Dr. Sasawimol Preechapornkul and Dr. Chakkapong Chakkabat, prioritizes patient safety and provides thorough information about potential risks. Here is an overview of the risks and complications associated with liver transplants:

1. Surgical Risks:

Infection:

Post-surgery, there is a risk of infections, both at the incision site and internally. Strict infection control measures are implemented to minimize this risk.

Bleeding:

Liver transplant surgery involves complex vascular connections, and bleeding can occur. The surgical team takes precautions to control bleeding during and after the procedure.

Blood Clot Formation:

Blood clots may form in the blood vessels, posing a risk of complications. Medications and monitoring are utilized to reduce this risk.

2. Rejection of the Transplanted Liver:

The recipient's immune system may recognize the transplanted liver as foreign and attempt to attack it. Immunosuppressive medications are prescribed to prevent rejection, but the risk persists.

3. Side Effects of Immunosuppressive Medications:

Medications administered to suppress the immune system and prevent rejection can have side effects. These may include increased susceptibility to infections, kidney problems, and metabolic issues.


4. Biliary Complications:

Bile Duct Strictures:

Narrowing of the bile ducts (strictures) can occur, affecting the flow of bile. This may require interventions such as stent placement or surgical correction.

Biliary Leaks:

Leakage of bile from the bile ducts can happen, leading to abdominal pain and infection. Prompt identification and intervention are crucial.

5. Cardiovascular Complications:

Liver transplant recipients may be at an increased risk of cardiovascular issues, including high blood pressure and heart-related complications.

6. Renal Complications:

The use of immunosuppressive medications can impact kidney function, leading to renal complications. Regular monitoring and adjustments to medication dosages are implemented to mitigate this risk.

7. Metabolic Issues:

Liver transplant recipients may experience metabolic changes, including diabetes and changes in cholesterol levels. Monitoring and lifestyle adjustments are essential in managing these complications.

8. Psychological and Emotional Challenges:

The post-transplant period can bring about psychological and emotional challenges for recipients. This may include stress, anxiety, and depression. BNH Hospital provides psychological support services to address these aspects of recovery.

9. Long-Term Considerations:

Long-term considerations include the potential need for additional surgeries, ongoing medical management, and adapting to lifestyle changes. Regular follow-ups with the medical team are crucial for monitoring and addressing evolving health needs.


Liver Transplant Procedure at BNH Hospital in Bangkok:


Step 1: Initial Consultation

The process begins with an initial consultation with a specialist, such as Dr. Chalomkwan Prayoonwech or Dr. Ong-arj Bovornsakulvong. During this consultation, the patient's medical history is thoroughly reviewed, and a series of diagnostic tests are conducted to assess the condition of the liver and determine the necessity of a transplant.

Step 2: Pre-operative Assessment

Once the decision for a liver transplant is made, a comprehensive pre-operative assessment is conducted. This involves further diagnostic tests, including imaging studies and blood tests, to provide a detailed understanding of the patient's overall health and the extent of liver damage.

Step 3: Listing for Transplant

Based on the assessment, the patient is listed for a liver transplant. The medical team, led by specialists like Dr. Sasawimol Preechapornkul and Dr. Chakkapong Chakkabat, carefully reviews the patient's eligibility for the transplant list.

Step 4: Finding a Donor

In liver transplantation, having a suitable donor is crucial. Donors can be living or deceased. Living donors typically undergo a series of tests to ensure compatibility and assess their overall health. For deceased donors, the medical team coordinates with organ procurement organizations.

Step 5: Surgical Procedure

Once a compatible donor is identified, the surgical team at BNH Hospital proceeds with the transplant. The patient and donor are prepared for surgery, and the transplant procedure begins. The damaged liver is removed, and the healthy liver is transplanted into the patient. The surgical team, including Professor Dr. Kris Chatamra and Dr. Sudarat Chaipiancharoenkit, ensures precision and expertise throughout the procedure.

Step 6: Post-operative Care

After the transplant, the patient is moved to the recovery area. The post-operative care involves monitoring vital signs, managing pain, and ensuring the proper functioning of the transplanted liver. The medical team closely observes the patient's progress.

Step 7: Rehabilitation and Recovery

Rehabilitation programs, designed by experienced healthcare professionals, play a vital role in the recovery phase. These programs focus on rebuilding strength and helping patients resume normal activities. Ongoing monitoring, including regular check-ups with the medical team, is essential for long-term success.

Step 8: Nutritional Guidance

Nutritional specialists at BNH Hospital work closely with patients to create personalized dietary plans. These plans are designed to support optimal liver function and overall well-being post-transplant.

Step 9: Psychological Support

Recognizing the emotional challenges associated with major surgeries, BNH Hospital provides psychological support services. This holistic approach addresses both the physical and mental aspects of recovery.

Step 10: Long-Term Follow-Up

The patient continues to receive long-term follow-up care to monitor the health of the transplanted liver. This includes regular check-ups, diagnostic tests, and ongoing support from the healthcare team.


Treatment Plan for Liver Transplants at BNH Hospital


BNH Hospital in Bangkok is renowned for its comprehensive and patient-centric approach to liver transplant procedures. The skilled medical team, including specialists like Professor Dr. Kris Chatamra and Dr. Sudarat Chaipiancharoenkit, formulates individualized treatment plans aimed at ensuring the best possible outcomes. Here is a breakdown of the components included in the liver transplant treatment plan:

1. Treatment Package:

BNH Hospital provides a well-structured treatment package that encompasses the entire spectrum of care, from pre-operative assessments to post-operative follow-ups. This all-inclusive package is designed to streamline the healthcare journey, providing patients with a seamless and holistic experience.

1.1. Inclusions:

The treatment package includes various components:

- Medical Consultations:

Thorough consultations with specialists to assess the patient's condition and determine the suitability for a liver transplant.

- Diagnostic Tests:

Comprehensive blood tests, imaging studies, and other diagnostic assessments to evaluate liver function and overall health.

- Surgical Procedure:

The actual liver transplant surgery, performed by a highly skilled surgical team with extensive experience in the field.

- Post-operative Care:

Vigilant monitoring and care in the immediate aftermath of the surgery to ensure a smooth recovery.

- Rehabilitation Programs:

Tailored rehabilitation programs to help patients regain strength, mobility, and overall wellness.

- Medications:

Prescription of immunosuppressive medications to prevent organ rejection and other medications to manage pain and prevent complications.

- Follow-up Appointments:

Scheduled follow-up appointments to monitor the patient's progress, address concerns, and make any necessary adjustments to the treatment plan.


1.2. Exclusions:

  • The treatment plan also transparently outlines any services or items that are not covered by the package. This ensures that patients are fully informed about the financial aspects of their treatment and allows for clear communication regarding potential additional costs.

1.3. Duration:

  • The duration of the treatment plan varies based on individual cases. Factors such as the patient's overall health, the complexity of the surgery, and the post-operative recovery progress contribute to determining the length of the treatment.

1.4. Cost Benefits:

  • BNH Hospital strives to offer cost-effective solutions without compromising on the quality of care. The treatment plan takes into consideration the financial aspect of the procedure, providing competitive pricing and a transparent billing system.




Cost Breakdown for Liver Transplant at BNH Hospital Bangkok


At BNH Hospital in Bangkok, the cost of a liver transplant is approximately THB 2,000,000 (USD 60,000) to THB 3,000,000 (USD 90,000) or more, depending on the patient's specific case. The hospital emphasizes transparency in its pricing structure, and the actual cost is determined by various factors. Here is a breakdown of the components included in the cost:

1. Patient's Condition Severity:

The severity of the patient's condition plays a significant role in determining the overall cost. More complex cases may require additional resources, monitoring, and specialized care, impacting the overall expenses.

2. Type of Transplant Surgery:

The cost varies based on the type of transplant surgery, whether it is a live donor liver transplant or a deceased donor liver transplant. Each type involves unique considerations that influence the overall expenses.

3. Length of Hospital Stay:

The duration of hospitalization contributes to the cost. Longer stays may incur additional charges for accommodation, medical supervision, and post-operative care.

4. Cost of Medications:

Immunosuppressive medications, essential for preventing organ rejection, constitute a significant part of the overall cost. The type, dosage, and duration of medication influence this component.

5. Cost of Follow-Up Care:

Post-operative follow-up care, including consultations, diagnostic tests, and ongoing monitoring, is included in the overall cost. The frequency and duration of follow-up appointments contribute to this aspect.

6. Diagnostic and Preoperative Expenses:

Diagnostic tests, imaging studies, and preoperative assessments are conducted to evaluate the patient's suitability for a liver transplant. The associated costs are part of the overall package.

7. Surgeon and Medical Staff Fees:

Fees for the surgical team, including surgeons and medical staff, are incorporated into the cost. These professionals play a crucial role in the success of the transplant procedure.

8. Facility Charges:

Facility charges cover the use of hospital resources, including operating rooms, recovery areas, and other amenities. These charges contribute to the overall cost of the transplant.

9. Government Hospital Advantage:

BNH Hospital in Bangkok may offer a more competitive cost for liver transplants compared to other hospitals in Thailand due to its government hospital status. This can make the procedure more accessible to a broader range of patients.

10. Waiting Time Considerations:

While the cost may be advantageous, prospective patients should be aware that the waiting time for a liver transplant at BNH Hospital may be longer compared to other hospitals in Thailand. This consideration is crucial for individuals weighing the urgency of their medical needs against the potential duration of the waiting period.


Why Choose BNH Hospital for Liver Transplant?


1. Legacy of Excellence

BNH Hospital boasts a rich legacy dating back to its establishment in 1898 under the royal patronage of King Rama V. With over a century of healthcare expertise, the hospital has earned a reputation for excellence, trust, and commitment to international standards of care.

2. Comprehensive Healthcare Journey

The liver transplant program at BNH Hospital offers a comprehensive healthcare journey from initial consultation to post-operative care. The all-inclusive treatment package, under the guidance of specialists like Dr. Chalomkwan Prayoonwech and Dr. Ong-arj Bovornsakulvong, ensures a seamless and holistic experience for patients.

3. Skilled and Specialized Medical Team

The medical team at BNH Hospital comprises skilled professionals, including liver transplant specialists, surgeons, and support staff. Personalized treatment plans are formulated by experts like Professor Dr. Kris Chatamra and Dr. Sudarat Chaipiancharoenkit, ensuring a high level of expertise in every aspect of the transplant procedure.

4. Cutting-Edge Technology and Facilities

BNH Hospital is equipped with state-of-the-art technology and modern facilities. The intelligent building design, introduced in 1996, reflects the hospital's commitment to innovation, incorporating dust and germ filter systems and solar-powered energy-saving technology.

5. Transparent Communication

The hospital prioritizes transparent communication with patients. The cost of liver transplant procedures is clearly outlined, including inclusions and exclusions. This transparency ensures that patients are fully informed about the financial aspects of their treatment.

6. Patient-Centric Approach

BNH Hospital follows a patient-centric approach, valuing the concept of 'the Family Doctor.' The healthcare team, including specialists and general practitioners, is deeply involved in every aspect of patient care, from diagnosis to follow-up.

7. Multidisciplinary Collaboration

The hospital fosters a multidisciplinary approach to healthcare. Specialists collaborate to provide well-rounded care, addressing not only the medical aspects of the transplant but also psychological and emotional well-being.

8. Competitive Pricing

The cost of liver transplants at BNH Hospital is competitive, potentially lower than other hospitals in Thailand due to its government hospital status. This affordability enhances accessibility to quality healthcare for a diverse patient population.

9. Government Hospital Advantage

As a government hospital, BNH Hospital combines the advantages of a public healthcare institution with a commitment to international standards. This unique blend contributes to the hospital's status as a "Centre of Excellence."

10. Legacy of Royal Patronage

Founded under royal patronage and graced by the presence of Her Royal Highness Princess Maha Chakri Sirindhorn, BNH Hospital continues to hold and maintain the royal wish of providing the Thai people and foreigners with standards of international healthcare.


Patient Testimonials:



1. John's Journey to Renewed Health:


John, a 45-year-old professional, faced the daunting prospect of a liver transplant due to a chronic liver condition. His journey at BNH Hospital began with empathetic consultations with specialists like Dr. Chalomkwan Prayoonwech. The medical team not only assessed his physical health but also took the time to understand his concerns and fears.

Through a meticulously planned treatment package, John underwent a successful liver transplant led by Professor Dr. Kris Chatamra. The personalized attention didn't end in the operating room; John received continuous post-operative care, including rehabilitation programs tailored to his needs.

Months after the surgery, John shared his gratitude, expressing how the seamless healthcare journey at BNH Hospital not only restored his health but also renewed his hope for the future.

2. Emma's Empowering Experience:

Emma, a 38-year-old mother, faced the challenges of liver disease. BNH Hospital's liver transplant program, led by specialists like Dr. Ong-arj Bovornsakulvong, provided her with not just medical treatment but also emotional support. The hospital's holistic approach, including psychological services, made a significant impact on Emma's mental well-being.

Emma's liver transplant, facilitated by the skilled surgical team, was complemented by ongoing support for her emotional and psychological needs. Her testimonial highlighted the hospital's commitment to comprehensive care, acknowledging the real difference it made in her life and her family's.

3. Mark's Testimony to Transparency:

Mark, a 50-year-old professional, chose BNH Hospital for his liver transplant due to its reputation for transparent communication. The hospital's financial counseling department provided a clear breakdown of costs, ensuring Mark was fully informed about the financial aspects of his treatment.



Conclusion:


In conclusion, BNH Hospital in Bangkok stands as a beacon of excellence in liver transplant procedures. With a legacy rooted in royal patronage and over a century of healthcare expertise, BNH Hospital combines cutting-edge medical technology with a patient-centric approach.




Choosing BNH Hospital for a liver transplant means entrusting your care to a team of seasoned professionals, including Professor Dr. Kris Chatamra and Dr. Sudarat Chaipiancharoenkit, who are dedicated to achieving positive outcomes and ensuring the well-being of every patient.

The hospital's commitment to international standards, transparent communication, and a focus on the individual needs of patients make it a top choice for expatriates and locals alike. Whether it's the intelligent building design, the solar-powered energy-saving technology, or the all-inclusive medical services reminiscent of a 5-star hotel, BNH Hospital continues to set the benchmark for healthcare in Thailand.

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FAQs

At BNH Hospital, our legacy of over a century, commitment to international standards, and a multidisciplinary team of specialists, including Dr. Chalomkwan Prayoonwech and Professor Dr. Kris Chatamra, make us a trusted institution for liver transplants.