A liver transplant is a surgical procedure that removes a liver that no longer functions properly (liver failure) and replaces it with a healthy liver from a deceased donor or a portion of a healthy liver from a living donor.
A liver transplant is a lifesaving procedure for which you need a hospital with advanced infrastructure to carry out this complicated and crucial surgery and, most importantly, a highly experienced and skillful surgeon.
Dr. Gaurav Gupta provides one of the best Liver transplant in India. In the past five years, he has performed more than 500 liver transplant surgeries as a Chief Surgeon. Currently, he is the Head of Liver Transplant and HPB Surgery Department at Fortis Hospital, Mulund, Mumbai. He is an expert in all types of liver transplants and is the preferred choice for domestic as well as international patients. He is highly proficient in Pediatric liver transplant too.
Sources of liver for Liver transplantation
A family member who is the blood relative of the patient can be the donor. That person has to be healthy and relatively young. A person can be a living donor as the liver is the only organ that can grow and regenerate back to 90% of its volume within three months of being cut and divided.
Before accepting someone as a donor, they must undertake a comprehensive medical examination that includes laboratory tests and a heart and lung examination. A CT scan is done to ensure that the liver has sufficient volume for both the donor and the recipient. Only after a comprehensive exam, which involves therapy from a psychologist and a psychiatrist, is an individual approved as a donor candidate.
The liver can be sourced from a brain-dead person who has pledged their organs or if their family decides to donate the organs. However, the patient has to be listed on the waiting list, and for undergoing Liver Transplant in India organs are allocated as per Maharashtra Govt rules by ZTCC (Zonal Transplant Co-ordination Centre), a non-profit Government organization.
ABO-incompatible Liver Transplant:
As the gap between donor liver demand and donation widens, alternate strategies for increasing donor availability and allocation are paramount. Liver Transplant in India using ABO‐incompatible (ABOi) grafts is important because it can represent the only access to transplantation for patients where no compatible donor is available in the family. Generally, donor has to be a blood group compatible for a liver transplant. But in case no compatible blood group is available ABO-incompatible (ABOi) transplant can be done by using special drugs and blood exchange techniques. Results of such transplants are very good and almost approach top compatible transplants.
What tests are conducted to evaluate a patient for a Liver Transplant?
After a patient is diagnosed with end-stage liver disease and needs a transplant, he/she has to undergo a series of evaluation tests. These tests determine the precise cause of cirrhosis, the impact of liver disease on other organs, and other vital organs' health.
The assessment is a step-by-step procedure that starts with the evaluation of the recipient. The assessment, which is an outpatient procedure, usually takes 4-5 days.
- Blood and urine samples are used to measure the health of the organs, including the liver. Also, it's important to find a good donor match.
- Diagnostic examinations include X-rays, CT scans, Cardiopulmonary evaluation in form of 2D Echo, Stress Echo, ECG, and pulmonary function tests. A Pap test, gynecological exam, and mammogram are all options for women.
- All potential transplant recipients are seen by a multidisciplinary team which includes Transplant Surgeon, Hepatologist, Transplant Anesthetist, Intensivist, Dieticians, and physiotherapist.
- Stress, financial problems, and post-surgery support from family and friends are all part of the psychological and social assessment.
Selection of the right donor
The essential step in the process is deciding on a donor. The donor must fulfill the following requirements and adhere to all the guidelines that one must follow to undergo Liver Transplant in India.
- Blood relative, as mentioned in the HOTA Act.
- Approval from the government-appointed authorization committee if the donor is not a blood relative. Also, it will require a statement that there is no commercial interest.
- Donor should be between 18 to 55 years of age and not be overweight.
- Size of the donor’s liver should be sufficient to donate the required portion.
- Blood group compatibility with the recipient.
- Three-step Evaluation procedure of the Donor. In the first step, all blood urine tests are conducted, in the second step Donor, CT and MRI did to see liver quality and volume. In the last stage, donors undergo cardiopulmonary evaluation.
Liver Transplant procedure in India
Generally, liver transplant surgery lasts for around 8-10 hours. If it is a living donor liver transplant (LDLT), then it will be planned according to the severity of the disease. But if it is a deceased donor liver transplant (DDLT), the patient is called for surgery when the organ is available.
After the transplantation, the patient usually wakes up in the Operating room and shifted to Transplant ICU for close monitoring. Here, the patient will be strictly monitored for infection, bleeding, and other complications. Gradually patients are made to start walking, physiotherapy, their diet is gradually advanced. Usually, 90% of patients are discharged within two weeks of transplant.
Living Donor Transplant Surgery
A living donor is a relatively safe surgery. Donors are extensively evaluated and only if found fit are accepted as donors. Donor surgery lasts for 5-6 hours. After surgery donors are shifted to ICU for close monitoring. They receive adequate pain relief from medications. Generally, by day 2 donors are able to walk and move around. Mostly after Liver donor surgery donors are discharged by day 6-7. We advise them home rest and light work for the next 1-2 weeks. By week 3 they are ready to resume all activities as before surgery.
Liver Transplant Cost in India
The cost of any treatment is one of the major factors that any patient is concerned about before choosing a center for liver transplant surgery. As you know, liver transplant surgery can be expensive, and the cost varies among hospitals. However, the liver transplant cost in Fortis Hospital, Mumbai is highly competitive. Here, you are assured excellent treatment with a high success rate at par with the best in the world. That's one of the reasons why patients opt for Fortis, Mulund, Mumbai when it comes to cost comparison for Liver transplant in India.
There is a myth that post Liver transplant medication and investigation charges are significantly high life long. Post-Liver transplant first three months patients may need to spend around Rs. 20,000-25,000 monthly for medications and investigations, but this cost comes down to Rs. 5,000 - Rs. 8,000 monthly within 6 to 8 months. This much is generally what patients need to spend for lifelong immunosuppression which is comparatively low when compared to other Organ transplants.
Guidelines for Out-Station and International patients:
International patients, as well as patients from all over India, prefer coming to Fortis Hospital, Mumbai, for their liver transplantation and liver cancer treatment as we have excellent results, and the healthcare services at our hospital are unparalleled and cost-competitive.
However, they will have to take account of the following guidelines in addition to the actual liver transplant surgery cost.
Guidelines for the patient and the attendant
- Planned stay for around 6 weeks in the city of treatment.
- Cost of Travelling to Mumbai
- Medical visa (in case of an International patient)
- Follow-up visits
- Transportation to the Hospital and additional requirements
Even after adding up all the overhead expenses, the cost of liver transplant in India is quite reasonable than other western countries.
Result of Liver Transplant
The one-year survival rate of liver transplants is around 90%, and it is approximately 70% for 5years. Compared to DDLT, the survival rate for LDLT is slightly higher as it is done in a planned manner.
The improvement in a patient's quality of life after a transplant is truly remarkable. People can return to work, participate in sports, and engage in a variety of other events. The recipients experience a general improvement in their lifestyle and expect a normal life, including survival, reproductive function, and physical activity.
After a liver transplant, the majority of women have a normal pregnancy. Also, children with growth failure due to liver disease resume growing after transplant. A liver transplant is a truly life-changing event not only for liver failure patients but also for their families.
Make an appointment with Dr. Gaurav Gupta to avail the best Liver treatment in India.