Liver Transplant Surgery

There is a rise in liver diseases and negligence towards its subsequent treatment. No wonder after kidney transplantation, liver transplant is the next most common transplant surgery recommended by the doctors with good prognosis. However, due to lack of awareness about the available facilities, unavailability of the donor, and the high cost of the surgery, not all opt for this mode of treatment. There are also many apprehensions and fears surrounding organ transplant.

But you should be aware that liver transplant is a curative surgery and majority returns to normal lives after a transplant, thanks to the advancement in medical science.

Liver transplant is a major surgery that needs a high level of care, pre- and post-transplant to avoid any risk that may reduce its benefits. It is important to understand the procedure and be well-informed about the treatment for best results.

In this article, we will look at the following:

  • Understanding about liver transplant
  • Diseases that may lead to liver transplant
  • Who can donate liver in India
  • Living donor liver transplant and Cadaveric (deceased) donor liver transplant
  • Liver Transplant process: step-by-step
  • Recovery after the liver transplant
  • Precautions after liver transplant
  • Cost of Liver Transplant in India
  • Top surgeons of Liver Transplant in India
  • Top hospitals for Liver Transplant in India

Liver Diseases that may lead to Liver Transplantation

  • Viral hepatitis (Hepatitis, B, C, and D)
  • Liver Cirrhosis (alcoholic liver disease)
  • Autoimmune hepatitis which leads to cirrhosis and liver failure
  • Primary Biliary Cirrhosis (PBC) and Primary Sclerosing Cholangitis (PSC), progressive diseases that cause liver failure
  • Biliary Atresia in children
  • Liver tumors
  • Metabolic and genetic disorders, such as alpha 1 antitrypsin deficiency, hemochromatosis, Wilson’s disease, and polycystic liver disease
  • Non-Alcoholic Fatty Liver Disease (NAFLD) and Non-Alcoholic Steato Hepatitis (NASH)

Before giving the nod for the liver transplant surgery, the medical team will evaluate the severity of your disease; history of any comorbid conditions and infections; overall general physical and psychological condition.

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What is Liver Transplant Surgery?

A liver transplant is a surgical procedure in which a diseased liver is partially or fully replaced with a healthy one from a donor. Liver transplant is only advised when a liver failure cannot be cured and the only choice is liver transplant. The donor may be a living or a deceased person based on which it can be of two types:

Living Donor Liver Transplant (LDLT)

In case of LDLT only a half of the liver of the donor is used for transplant. This does not affect the donor’s health as our liver has the tendency to regenerate or to regrow. So the new liver grows back and regains its complete functionality within two to three weeks of the transplant in both the donor and the recipient. A living donor transplant surgery duration is slightly longer as compared to the cadaveric transplant. The hospital stay of the donor is about a week to 10 days and is advised two-three weeks rest at home.

The reality is liver transplant is a safe procedure both for the donor and the recipient.

Cadaveric/Deceased Donor Liver Transplant (DDLT)

Organ donation is still in its infancy stage in India owing to lack of awareness and myths surrounding it.

DDLT procedure involves transfer of complete liver from the deceased donor who is brain dead to the patient. The liver has to be removed from the body within eight hours of the person’s death. After the liver retrieval from the deceased donor, the liver can safely be preserved in special preservative solutions for up to 12-15 hours before the transplant surgery.

Cadaveric livers are not easily available and there is a long waiting list may be up to few months. The priority recipient is decided on the basis of the severity of the disease and also first-come first served.

Who are eligible to donate liver in India?

  • In India, donor should be a blood-relative to the patient
  • Donate liver on his/her free will
  • Age above 18 to 55 years can donate a part of his/her liver
  • Body weight between 50-85 kg (should not be overweight or obese)
  • Liver donor should have same blood group as patient or O group
  • Medically and psychologically fit and healthy for surgery

Basic Tests required before getting a Liver Transplant

  • Doppler ultrasound of abdomen
  • Blood tests (complete blood count, liver function test, kidney function test, serology screening, blood group, prothrombin time)
  • CT scan of abdomen
  • ECG, Echocardiogram and stress testing to evaluate heart function
  • UGI endoscopy/fibroscan of liver

Liver Transplant Procedure

  1. Pre-evaluation for Liver transplant:
    Once your doctor decides that liver transplant is the only option to cure the liver disease, he checks if the patient is fit enough for the surgical procedure via series of tests before the surgery.
  2. Register with liver transplant hospital:
    After a thorough evaluation and confirmation by a team of liver transplant surgeons and gastroenterologist, the patient has to get registered at a high-end tertiary care liver transplant hospital as a candidate for transplant.
  3. Getting a donor liver:
    The next step is finding the right liver donor for the patient. If you receive a live donor whose medical specifications matches with the patient, the surgery can be planned within a stipulated time while in case of cadaveric/deceased liver donor, there would be a long wait of few months to get a matching liver. Often hospitals help the patient to get matching cadaveric donor or assist to connect with the organizations who work in finding the right organ donor. Once the donor liver is received the hospital immediately contacts the registered patient (recipient) for preoperative evaluation via series of tests (CT scan, MRI, blood tests with viral markers, and cardiac function test, etc.)
  4. Undergoing liver transplant surgery:
    In case of cadaveric transplant, once the donor’s liver is matched, the medical team starts the procedure immediately after the new liver reaches the hospital. In case of a live donor liver transplant, after the series of preoperative tests of both the patient and the donor, the transplant is planned on a set date. The surgery of both the patient and donor starts together.  The liver transplant surgery can last for about 10-14 hours and even more in case of a live donor transplant.
  5. Post-operation hospital stay:
    The hospital stay of the liver recipient (patient) is of about three weeks while the donor is discharged within seven to 10 days of surgery.

Recovery Time after the liver transplant

Recovery after the liver transplant is a gradual process, and mostly depends upon your physical condition before the liver transplant. It takes almost a year for complete recovery, although you can get back to normal activities after three months of transplant. For fast recovery and best results, it is essential to follow the recommended instructions and all the precautions after the surgery given by your doctor. Immunosuppressant medicines have to be taken as advised by the treating doctor. They are necessary to combat the risk of your body rejecting the new liver.

Post-liver transplant you need to do constant follow-up visits with the gastroenterologist, stick to a healthy diet regime and do regular exercises after consulting the treating doctor.

Precautions after Liver Transplant Surgery

  • Maintain higher standards of hygiene to avoid any infection
  • Abstain from alcohol and smoking
  • Drink treated or boiled water
  • Follow recommended exercise regime
  • Stick to healthy diet

Liver Transplant Cost in India

Liver transplant is an expensive procedure. The average cost of liver transplant in India is between US $31,000-46,000 depending upon the hospital, surgeon and other medical conditions.

There will be some recurring expenses on medicines, follow-up evaluation post-transplant. After the transplant, for first five to six months, you would be spending around US$ 385 per month; next six months the expenditure per month would be around US $ 277 and thereafter US $154-230 for few months. The cost may vary with patients based on their medical conditions.

Cost in case of live donor’s liver is more than that of cost in case of deceased donor’s liver.

International patients in India for liver transplant

The country witnesses a large influx of international patients from the U.S., UK, UAE, Africa, Sri Lanka, Bangladesh etc., coming here for liver transplant surgery. The reason being although one of the expensive procedures, in India, liver transplant is still very economical compared to developed countries. The treatment in India is at par with developed nations available at one-twentieth of cost in the U.S. or UK. Once recommended the organ transplant, it is better to understand your treatment costs so as to plan your finances and make well-informed decisions. As an international patient you should also include travelling, hotel stay, and food expenses too in your treatment budget.

Liver Transplant Doctors in India

India has some of the best internationally acclaimed surgeons with high level of expertise and experience who perform the complex and sophisticated state-of-the-art liver transplant surgery. Owing to thousands of cases, the Indian doctors handle every year they have an upper hand in dealing with all types of complications in such complex surgeries.

Dr. Mohamed Rela, Dr. A.S. Soin, Dr. Suresh Singhvi, Dr. Vivek Vij, Dr. Abhideep Chaudhary, Dr. Chetan Kataria, Dr. Rahul Kakodkar, Dr. A Olithselvan, Dr Mathew Jacob, Dr. Moh. A. Nayeem , Dr. Naimish Mehta, etc., are among the best liver transplant surgeons of the country.

Liver Transplant hospitals in India

India has many world-class liver transplant hospitals at par with international standards that successfully perform the intricate liver transplant surgery to treat severely damaged liver that cannot function properly. The world-class infrastructure at the hospitals in India has technologically advanced set-up for organ transplant.

Some of the best hospitals in India for liver transplant are Medanta- The Medicity, Fortis Group of HospitalsApollo Group of Hospitals, Kokilaben Dhirubhai Ambani Hospital, Jaypee Hospital, BLK HospitalGlobal Hospital, Artemis Health and Research Institute, Dr. L. H. Hiranandani Hospital, Breach Candy Hospital, Lilavati Hospital, Sir Ganga Ram Hospital, and KEM Hospital etc.

How can MedGurus help you?

Based on our multilevel research on liver transplant treatment procedures in India, we see Indian hospitals as a reliable and appropriate location for organ transplant not just for people living in the country but foreign nationals too. So if you or your loved one is recommended liver transplant, you need not worry as you will be in safe hands at the best of hospitals in the country.

MedGurus, an initiative by Global Medi Advisors is happy to advise you for high quality and affordable liver transplant hospitals in any part of India and make your job (of selecting liver transplant hospital and best liver transplant specialist in India) simpler.

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