Liver Transplant

Liver Transplant


Liver Transplant Surgery in India - Donor Criteria, Recovery & Costs

The liver is a crucial organ that filters blood and has a role in many essential functions of the body. It is one of the largest organs which can be regenerated. The liver needs a replacement when it does not function or liver failure. It stops functioning because of the damage caused to the liver due to some diseases. Liver cancer, viral hepatitis disease, biliary atresia, metabolic disorder, hepatocellular carcinoma, and liver cirrhosis can lead to end-stage of the liver. When the liver fails due to diseases, it loses its ability to regenerate. Hence, it needs complete removal and replacement. This procedure is known as liver transplantation. If not transplanted, it Recipient Criteria for Liver Transplant Surgery in India can cause life-threatening complications in the body. After a person has been diagnosed with cirrhosis, it's important to wait until they are healthy enough to receive a liver transplant.

Every year nearly 200,000 patients require liver transplant surgery. Despite the huge demand for liver transplant donors, the number of transplants has decreased over the past few years. This has caused many people to wait longer and longer to get a transplant. However, there are 2-3 procedures for a liver transplant. One is a living donor liver transplant, which reduces waiting time and increases the life of the patient.

The African continent lags in organ transplant surgeries, due to a lack of healthcare resources. In addition, due to the socioeconomic challenges many patients fail to receive a healthy liver and die due to their diseased condition. According to the study, acute and chronic liver disease cases are expected to increase. Hence, the need for liver transplant surgery will also increase, especially in children.

A liver transplant surgery is the one where the patient's diseased liver is entirely replaced by a whole or partially healthy liver from another person. with a whole or partial healthy liver from another person. In most cases, the healthy liver that is implanted on the patient comes from someone who has just died. But in another case, a healthy living person may donate part of their liver. In order to be eligible as a liver donor, the blood match of the donor and the patient must match.

A Successful Living Liver Donor Transplant in India

A 4-month-old baby was suffering from liver disease at birth. By the time parents reach India, the disease leads to liver cirrhosis. The mother donated a part of her liver to the baby. Now, they have recovered well and are back in their country. Surgeon Dr. Giriraj Bora and his team have performed the surgery. Watch their testimonial in this video.

pediatric-liver-transplant-surgery-in-india

Liver transplantation in India at Fortis Hospital accredited by the Joint Commission International (JCI) in India

A Syrian patient suffering from Wilson's disease came to India to receive treatment. She underwent a successful liver transplant at Fortis Hospitals India, Gurgaon. The liver transplant surgery was performed by one of the best liver transplant surgeons in India, Dr. Vivek Vij. Her brother donated to her because her father and mother were not suitable as donors. She returned with her family after a successful liver transplant.

عملية زرع الكبد في الهند لدى أشهر المستشفى

Liver transplant for infant from Morocco in India at JCI-accredited ARTEMIS hospital in India

A couple from Morocco came to India for the treatment of their 4-month-old baby girl suffering from biliary atresia. She was admitted to the emergency room and her mother became her liver donor. She underwent a successful pediatric liver transplant at the JCI-accredited Artemis Hospital in Gurgaon, India. The operation was performed by India's leading liver transplant surgeon Dr. Giriraj Bora and she returned in good health with her parents.

عملية-زرع-الكبد-في-الهند-بشكل-ناجح-لعلاج-تليف-الكبد-مع-ارخص-تكلفة-عملية

What Medical Conditions Lead to Liver Failure?

The liver helps metabolism, filtering toxins from the blood, creating bile, and helping the body produce red blood cells. No one can survive after a liver failure. However, through a liver transplant, a person can regenerate the liver and lead a regular life. Some of the conditions for liver failure include liver cirrhosis, hepatitis, and fatty liver disease. There are many conditions that a hepatic transplantation can help with.

Liver transplant for cirrhosis:

The most common disease of the liver is cirrhosis. Cirrhosis is a liver disease in which the liver becomes scarred and damaged, which can lead to cirrhotic portal hypertension and eventually liver failure. Liver transplantation is usually only recommended for those who have end-stage liver disease and are at risk of dying from complications of cirrhosis.

What Medical Conditions Lead to Liver Failure

A person can't live with a non-working liver. If your liver functionally degrades to a point where it doesn't work at all, you will be strongly considered for a liver transplant surgery. A patient should be considered for liver transplant surgery if the following conditions are present:

  • Irreversible liver disease where no other medical treatment is effective.
  • Cholestatic Disease: primary biliary cirrhosis, secondary biliary cirrhosis, biliary atresia, etc.
  • Chronic Hepatitis: Hepatitis B, Hepatitis C, Hepatitis D, autoimmune chronic active hepatitis, cryptogenic cirrhosis, chronic drug toxicity or toxin exposure
  • Fulminant Acute Hepatic Necrosis or acute liver failure: Viral hepatitis, drug toxicity, etc.
  • Primary liver cancer: Primary liver cancer or hepatocellular carcinoma is a condition that requires liver transplantation
  • Metabolic Diseases: Hemochromatosis, Wilson's disease, Alpha-1-antitrypsin deficiency, glycogen storage disease, tyrosinemia, familial amyloidotic polyneuropathy, other metabolic disorders treatable by liver replacement
  • Alcoholic Cirrhosis: Patients with alcoholic cirrhosis are considered for transplant if they can achieve abstinence and rehabilitation.

Symptoms of a Failing Liver

The liver is the body's main organ for removing toxins and filtering blood. If your liver is not functioning properly, you may be at risk for developing conditions such as cirrhosis, hepatitis, fatty liver disease, and more. Many symptoms indicate that you have a problem in your liver. However, the most common symptoms that the patients have when the liver fails are listed below:

Symptoms of a Failing Liver

Fluid Retention: One function of our liver is to balance fluid in our body. A healthy liver synthesizes proteins including albumin. Albumin and other proteins retain fluid or water in vascular space through osmosis. But, in the case of liver cirrhosis, low albumins fluid out of the blood vessels, which are not re-absorbed. Fluid, therefore, accumulates in other tissues and body parts. Fluid retention is also termed “Edema".

Gastrointestinal Bleeding: When a liver becomes scarred, it resists the blood flow in the liver. This resistance leads to increased pressure on the portal venous system. Hence, the blood flow finds other routes to flow with increased pressure. As a result, small veins outside of the liver become fragile due to abnormal blood flow pressure. These weak veins are prone to cracking and bleeding which is life-threatening.

Jaundice: A liver eliminates degradation products of hemoglobin. Bilirubin is one of those degraded products which the liver eliminates. Bilirubin is not detoxed through a failed liver. This incident leads to an increase in bilirubin in the blood. Hence, our tissues and bodies become more yellowish.

Metabolic Encephalopathy: The term “Encephalopathy” means organ damage that affects the brain. When liver failure occurs, the liver cannot clear body toxins. Those toxins accumulate in one place and affect brain function. As a result, a person can experience confusion or coma.

■ Extreme fatigue, tiredness, and loss of appetite.

■ Diarrhea, vomiting and extreme weight loss.

Best Liver Transplant Surgeons in India

1. Dr. Giriraj Bora

Dr. Giriraj Bora is one of the famous Gastrointestinal Surgeons and Senior Consultant in India. He has done over 1500 liver/hepatic transplants successfully for national and international patients.

dr-giriraj-bora-liver-transplant-surgeon-in-india

2. Dr. Abhideep Chaudhary

Dr. Abhideep Chaudhary is a renowned liver transplant specialist. He is an expert in providing advanced medical services for treating liver diseases like Hepatitis B, Hepatitis C, and Liver Cancer.

Dr Abhideep Chaudhary Liver Transplant Surgeon in India

3. Dr. Arvinder Singh Soin

Dr. Arvinder Singh Soin Dr. Arvinder Singh Soin is the leading and most experienced liver transplant surgeon in India. Along with his team, he performed about 20 to 30 liver transplant surgeries with a success rate of 95 percent in one month. He and his team perform almost 25-30 liver transplants in a month with a 95% success rate.

Dr Arvinder Singh Soin Liver Transplant Surgeon in India

4. Dr. Vivek Vij

Dr. Vivek Vij is a liver transplant specialist in Delhi NCR, India. He is a pioneer in the transplant surgery of the liver and an expert in laparoscopic donor hepatectomy surgery. He delivers liver donor surgery with 100% safety protocols for the donors. He is a pioneer in liver transplant credited with liver donor surgery with 100% safety protocols for donors. He has expertise in laparoscopic donor hepatectomy.

Dr Vivek Vij Liver Transplant Surgeon in India

5. Dr. Subhash Gupta

Dr. Subhash Gupta is an expert in the biliary sciences and the transplant surgery of the liver. He has many years of experience in the top hospitals in India including Indraprastha Apollo Hospital, Max Super Speciality Hospital, etc.

Dr Subhash Gupta Liver Transplant Surgeon in India

6. Dr. Sanjay Singh Negi

Dr. Sanjay Singh Negi is a highly qualified doctor who is a successful Hepato-pancreato-biliary and liver transplantation doctor. He is an expert surgeon with expertise in Laparoscopic and Gastrointestinal surgeries, hepatobiliary surgeries, etc. including many complex surgeries for the liver.

Dr Sanjay Singh Negi Liver Transplant Surgeon in India

 

Cost of Liver Transplant in India

From many Arabic countries like Saudi Arabia, Oman, Sudan, and UAE, many people travel to India for Liver Transplant Surgery every year. The cost of Liver Transplant Surgery in India is the cheapest in the world, making India a boon for international patients. Surgeons in India regularly upgrade their knowledge and skills to maintain premium service for their patients. Indian hospitals have the latest arrangements and facilities, which help provide supreme medical care for liver transplant procedures like split liver grafts, marginal or extended criteria donors, LDLT, and other basic procedures available in India. The cost of Liver Transplant in India is listed below.

Treatment Cost
Liver Transplant in India 24000-28000 USD

 

Types of Liver Transplant Donor

Transplant surgery for a liver is performed in different ways depending on the availability of a donor's liver and the patient’s circumstances. There are 3 primary transplantation types for a liver which are mentioned below.

Deceased donor liver transplant (DDLT):

This type of transplant procedure involves receiving a healthy liver from a deceased person (died individual) who has given consent to donate the organ while he/she was living. The livers obtained from the deceased individual are mostly used for transplanting the whole liver.

Living donor liver transplant (LDLT):

It is a type of transplant in which part of the liver is donated by a healthy and living donor to the recipient (patient). Even if the major portion (90%) of the liver is removed from the body, the remaining part of the liver can regrow and attain its normal size. This method of transplant is used when the deceased donor is not available.

  1. Relative living donor: It means that the liver is donated by a family member such as a sibling, son or daughter, parent, or a close relative.
  2. Non-related living donor: It means the liver is donated by an unknown individual who has a similar blood group.

Split liver transplant:

This is a specialized transplant procedure in which the donor’s liver is split or divided into two parts, one part is transplanted in an adult patient and another part is transplanted in a child (pediatric liver transplant). In this case, the deceased person’s donated liver is used. This is a great approach that makes it possible to provide the transplanted liver to more than one patient from a single donated liver.

Tests Required Before Liver Transplantation

After a consultation, an expert doctor may ask for the following tests or examinations.

  • Doppler Ultrasound: This test helps to know whether blood vessels around your liver are open or not.
  • Echocardiogram: Echocardiogram helps to check your heart condition before the operation.
  • Laboratory Tests: Blood and urine test for assessing liver function and other organ functions.
  • Computer Tomography(CT): A CT is used to make a computer picture of a liver. The test also helps examine the heart and lungs.
  • General Health Exam: The general health exam evaluates overall health and checks other diseases or health concerns.

The diagnosing tests may also include,

  • Nutrition Counselling: Nutrition counseling recommends healthy meals before and after your surgery.
  • Psychological Evaluation: This process helps understand concerns like stress, anxiety, or depression related to surgery.

Eligibility Criteria for a Liver Transplant Donor

Liver Transplant Criteria

People can donate the part of their liver to a person whose liver has failed and needs a healthy liver if they wish to. The liver will regenerate over time within 2 to 3 weeks and hence there are no complications of donating a liver. However, not everyone is eligible to donate a liver. To become an eligible liver transplant donor in India, you need to meet certain criteria. Liver Transplantation in India grew in success rate because Indian surgeons follow some criteria:

■ The donor must be a relative. This fact helps fulfill the conditions like body size and from the same geographical area. The donor must happily donate a part of his or her liver for altruistic reasons.

■ The donor must be within the age range of 18-50 years. Also, he or she is healthy, fit, and has compatible or matching blood groups. Here is the chart that shows blood group compatibility.

Recipient’s Blood Group Donor’s Blood Group
A+ / A- A+ / A- / O+ / O-
B+ / B- B+ / B- / O+ / O-
AB+ / AB- Any Group
O+ / O- O+ / O-

■ Also, the donor must be an adult and psychologically sound for deciding whether she or he wants to become a donor or not.

■ After that, some tests are asked to be done to evaluate the donor. In Level I evaluation Blood group, HBsAg, Anti HCV, HIV I&II CBC, LFT, Urea, Creatinine, PT/ INR, HbA1c, Lipid profile, Serum T3, T4, and TSH.

■ Evaluating Level I tests, some tests are to be done at the center.

  • Level II: A good quality triple phase CT (Computer Tomography) including a plain scan to look at the liver. Level III: MRCP
  • Level IV: ECG, Chest X-ray, Lung function tests, and Stress Echocardiogram
  • For Women: USG breast & pelvis, Mammography for ladies above 40 years, PAP smear for married ladies, CA 125, and HLA tissue typing.

Recipient Criteria for Liver Transplant Surgery in India

Due to the increase in liver diseases worldwide, there is a high demand for liver transplants. However, not everyone who wants to receive this surgery will get one. The best liver transplant surgeons in India want to provide the best and most successful medical services to their patients. For that, the patients need to meet certain criteria to qualify for a liver transplant surgery. The minimum and common requirements or criteria to be eligible to receive a transplant procedure of a liver are as follows:

  • The recipient should have a letter or prescription from a physician/ gastroenterologist or a hepatologist who will recommend a liver transplant.
  • He / She requires a medical summary with the details of the recipients’ medical history prepared by a doctor.
  • Then, at the center, doctors will perform a few more tests to evaluate the recipients’ fitness for such a big surgery.

Liver Transplant Surgery Procedure

It is a complex surgical procedure that requires a highly experienced and skilled surgical team in the best hospital for liver transplant. CureIndia's best liver transplant surgeon will perform the surgery by first administering anesthesia to the donor and the recipient to keep them unconscious to achieve a pain-free surgery.

Then the surgeon will make the incision on the patient’s abdomen. Then the patient’s liver is carefully removed from the body by first disconnecting it from the blood vessels and bile ducts. Following that, the donor’s liver is prepared and implanted in the same location as the patient’s liver. This is known as an orthotopic transplantation.

After reaching this stage, now there is a time to connect the implanted donor’s liver to the blood vessels and the bile ducts of the patient’s body. This is done by suturing them together. Now, the final step is to ensure that the implanted liver is functioning correctly without any bleeding or leaks and close the incision with the stitches.

Different Types of Liver Transplant Surgeries Performed in India

With the advancement of technology around us, surgeries are also becoming more advanced and minimally invasive. In India, three methods of Liver Transplantation are usually practiced.

1. Conventional or Open Surgery:

In this method, surgeons first operate on the donor. Then remove a portion of his or her liver. After that, the recipient gets an operation to remove the liver and place the donor’s liver.

2. Advanced Laparoscopic Surgery:

This surgery is minimally invasive. It is also an open surgery where surgeons make an incision in the abdomen. The whole surgery happens through that incision. In addition, the incision is not more than ½ inch in length.

3. Da Vinci Robotic Donor Surgery:

The robotic system is used here to aid surgical procedures. It is also a minimally invasive method. Surgeons make a tiny keyhole through which he or she puts a camera and other surgical instruments. The surgeon observes The surgery procedure through a video monitor and controls robotic arms manually for the operation. Surgeons at Da Vinci Robotic Surgery can see anatomical structures in their natural colors through a high-resolution 3D vision system.

Recovery After a Liver Transplantation for Both Donor and Recipient

Right after a liver transplant surgery, the recipient and donor both shifted to an Intensive Care Unit for a few days. The stay in the ICU depends upon the condition of the person after surgery. At this time, doctors and nurses will monitor the condition of both donor and recipient. After 5-10 days, the liver continues to recover. Then, the recipient and donor undergo frequent checkups and blood tests a few times a week. With time the checkups and tests become less frequent.

15-20 days after surgery, the recipient can go back home from the hospital. And the donor can return home after staying 8-10 days in the hospital under medical supervision.

However, a recipient's full recovery requires 6 months or less after transplant surgery. Liver transplant donors will recover within 1.5 - 2 months. After that, the recipient can resume work life. The recovery time varies on the condition of the recipient's health before the surgery. Recipients need to take some immunosuppressant drugs for their entire life.

Pediatric Liver Transplant

Liver Transplant in India

Pediatric liver transplant is quite similar to adult transplantation. However, the children face new challenges which need extra care. On the other hand, pediatric liver transplant has a greater success rate. Some drugs are suggested by doctors to prevent rejection. After that, the child must go through post-transplantation care. The post-transplantation care involves the reference and collaboration of pediatricians, pediatric transplant hepatologists, transplant surgeons, nurses, transplant coordinators, and psychologists.

Cost of Liver Transplantation in India

The total cost of the transplant surgery in India depends on several factors such as the choice of hospital and the location of the hospital, the overall health and age of a patient, the cost of the tests required before and after the surgery, the surgeon’s expertise and fees, travel cost, stay cost, etc. However, the average cost of liver transplant surgery in India can be about 25,000 USD to 30,000 USD.

Liver Transplant Cost In India

The cost of this surgical treatment varies from city to city in India. The total cost of transplant surgery in India is much lower than the average cost of transplant surgery in other countries like the United States, the United Kingdom, Australia, Singapore, Thailand, Turkey, etc. However, The medical facilities, level of medical services, hospitality, and success rates are the same. The main advantage of receiving treatment in India is that, at just a fraction of the treatment cost in other countries, the total cost of the treatment including travel, stay, etc. can be covered.

Procedure Name Cost in USA Cost in Thailand Cost in India
Liver Transplantation $80,000 - $100,000 $45,000 - $55,000 $25,000 - $30,000

Conclusion

The liver plays an important role in the body. Due to the healthcare challenges that people have to face in their country, many African people fail to receive liver implantation, and hence they die when the liver fails due to certain liver diseases. Seeking the correct and early healthcare services, people from African countries like Ethiopia, Kenya, Cameroon, and Ghana, decide to travel to another country. The best option for them is India as the surgery or any other treatment in India is the most cost-effective than in other countries. The medical facility is of high quality at an affordable cost which is highly profitable to them.

Liver Transplantation FAQs

What is the success rate of liver replacement surgery?

The surgeries for the transplantation of the liver are as successful in India as in any other country. The studies show that there is a 64 to 88% survival rate for transplant surgeries of the liver in India in patients who have acute liver failure. About 75 to 80% of people receive successful transplant surgery. The success of the transplant surgery depends on many factors including a patient’s overall health.

How long does the person live after a liver transplant?

The average life expectancy for someone who has undergone a liver transplant is around 15 years. The number of people living with the transplanted liver is increasing as more people undergo the procedure and live longer. However, it is important to note that this is not always the case and that some people who have had liver transplants do not live as long as others. The lifespan after the transplantation of the liver depends on the patient’s overall health and lifestyle.

What is the duration of the operation for the transplantation of a liver?

The duration of the surgery varies from person to person, and it depends on the type of transplant you are undergoing. If you are receiving a partial liver implantation, then the operation will be completed within 3 to 6 hours. However, if you are receiving complete/whole liver implantation, then the operation can take about 8 to 12 hours.

Does the donor face any problems after donating?

No. The donor may face some symptoms initially after the surgery such as nausea, tiredness, pain at the incision site, bleeding, etc. However, these are temporary issues and they go away as the donor heals and recovers. The liver can regenerate and the part of the liver that is removed from the donor will be regenerated within 3 to 4 weeks. There are no long-term consequences or complications of donating a liver.

Who can be a liver donor?

Most of the live liver donors are family members. However, anybody can become a liver donor with their choice if the criteria match. An individual who is under 18 to 55 years of age, who has a fit and healthy body, and whose blood type is compatible with the patient’s blood is eligible to donate their liver.

Which are the best hospitals for transplant surgeries?

There are several hospitals with amazing infrastructure for transplant surgeries in India. CureIndia is associated with many best hospitals for liver transplant at an affordable price in India. Some of them are Max Hospital, Fortis Memorial Research Hospital, Artemis Hospital, BLK-MAX Hospital, Apollo Hospital, and many more.

Do I need a liver transplant for cirrhosis?

The initial stage of cirrhosis can be reversed by the treatment procedures but at a certain point, the treatments do not show effective improvement and the disease progression becomes relentless. At this point, only the transplantation of a healthy liver can save the life of a patient. Hence, if you have advanced alcoholic cirrhosis, transplantation surgery is the only cure for you.

What is the age limit for receiving a transplanted liver?

Any patient whose liver has failed is evaluated to assess their performance status and their overall health. There is no specific age at which you can or cannot receive a transplant. The eligibility of a transplant depends on the recipient’s health. However, cases of liver implantation surgery are very rare in patients over 75 years of age.

What happens if a patient does not find an eligible liver donor?

If the transplantation of the liver is not done because a patient didn’t find a donor, then there are no other solutions and the patient can die within a few weeks or months. However, we don't need an entire liver to be transplanted, only a part of the liver is enough for the transplantation. The rest of the liver will be generated from this implanted part.