Liver Transplant in India

Organ transplant laws in India are very strict, prohibiting any commercial transaction for liver transplants. Organ transplant law in India allows only blood relatives to donate liver to the patient. A special permission from the Govt. of India is to be taken if an unrelated person wants to donate a part of his or her liver to the patient.

There should be no commercial transaction involved between the donor and the recipient for a liver transplant in India. If the proposed donor or the recipient or both are foreigners and are seeking liver transplant operation in India, a senior Embassy official of the country of origin or the government of the country concerned (authenticated by the Embassy concerned in India) has to certify the relationship between the donor and the recipient.

There is a long waiting time for liver from dead or cadavers, so foreigners usually never get cadaveric donations if they wish to undergo cadaveric liver transplant in India.

Steps for Liver Transplant Surgery in India

• Identify a donor from your country- preferably a close relative
• Investigate donor- patient compatibility in your country. If it is not available, get it done in a country closest to you else, or you may have to come to India for investigations.
• When the compatibility is confirmed, both the patient and the donor shall be investigated for operability.
• Liver transplant in India will happen after the above confirmations and completion of documents related to liver transplant operation.

NOTE: IT IS IMPORTANT TO NOTE THAT INDICURE DOES NOT ARRANGE DONORS. THE DONOR FOR LIVER TRANSPLANT HAS TO BE A CLOSE RELATIVE OF THE PATIENT (SIBLING/ PARENTS/ CHILDREN/SPOUSE). IN CASE THE DONOR IS NOT A CLOSE RELATIVE, GOVERNMENT PERMISSION IS REQUIRED AND IS GIVEN ONLY IF IT IS ESTABLISHED THAT THERE IS NO COMMERCIAL TRANSACTION INVOLVED BETWEEN THE DONOR AND THE RECIPIENT.

As the latest techniques of liver transplant are advancing, many people from around the world come for Liver transplantation in India. Owing to the low cost of liver transplant in India, highly skilled & experienced surgeons and state-of-the-art hospital facilities, India has emerged as one of the most favorable destinations for organ transplants in the world.

Comparing the cost of liver transplant in India and Western countries, one would find a huge cost difference. The cost of a liver transplant in the US varies between USD 250,000 – USD 315,000 whereas the cost of Liver transplantation in India ranges between US $28, 000 – $50, 000 which is less than one-fourth of the cost of the surgery in the US.

What is a Liver Transplant?

The liver is one of the most vital and largest organs of the human body that serves as the powerhouse of energy as it produces:

• Glucose which is the basic sugar and source of energy
• Proteins which are the building blocks essential for growth
• Bile, a fluid stored in the gallbladder that is necessary for absorption of the fats and vitamins
• Blood clotting factors that aid in healing wounds

Being the largest organ of the human body, it is ideal for storage of essential substances like vitamins and minerals. It metabolizes and detoxifies the substances ingested by the body. Moreover, it also acts as a filter that removes impurities from the blood.

Liver transplantation is a complex and major surgical procedure that is done to replace the damaged or diseased liver with a healthy and normally functioning liver taken from the donor. A liver transplant is the second most commonly performed transplantation in the world after kidney transplant. It is indicated when the liver fails to perform its normal functions due to severe damage to the liver leading to its failure.

Deceased liver donation: involves transplantation of a liver that has been taken from the person who died recently.

Living donor liver transplant: a section of the liver is removed from the living donor and transplanted to the patient. As the liver has a tendency to regenerate itself, both the transplanted and the remaining part of the donor’s liver can regrow into the normal-sized liver.

A liver transplant is the option left when all other lifestyle modifications and treatments have not prevented liver failure. Liver failure, however, can happen slowly known as chronic liver failure, or can happen suddenly called acute liver failure.

Regardless of the type, liver failure can occur due to multiple causes but the most common cause for liver transplant is liver cirrhosis which is characterized by chronic scarring of the liver mostly due to hepatitis virus infection or chronic alcohol abuse.

Several other common conditions for liver transplant are:

• Bile duct disease like biliary duct atresia
• Chronic hepatitis B and hepatitis C infection
• Excessive iron in the body i.e. hemochromatosis
• Genetic diseases like Wilson’s disease
• Fatty liver disease
• Primary or early-stage liver cancer
• Autoimmune liver disease
• Alcoholic liver disease.

When is Liver Transplant required?

If the patient is suffering from a liver failure but his heart, lungs, kidneys, and immune system are strong enough to cope with the surgery, if he is mentally and emotionally stable, if the patient has family and friends who can take care of the patient before and after the surgery and if a cadaveric or a living donor is available, the patient is considered good for the liver transplant.

How is a Liver Transplant done?

Before the transplant surgery, both the patient and the donor are assessed and made to undergo a battery of tests to ensure that the donor is healthy enough to survive the surgery. The test includes blood testing and matching to check the compatibility. Various other tests and investigations include EKG, Echo, Chest X-ray, Abdominal CT scan, CT Cholangiogram, physical assessment by a physician, hepatologist, and psychological tests.

Liver transplant surgery is a major surgical procedure done under general anesthesia and takes about 12 hours to complete.
The donor is operated first to remove either the left or right lobe of his liver. Once the donor’s liver is removed, the surgeon prepares for the transplant of the liver into the patient’s body.

What is the Recovery after Liver Transplant like?

One needs to come to India about 2-3 weeks prior to the surgery for pre-operative assessment and paperwork formalities to be completed. A stay for around 6-8 weeks post-discharge would be needed for you to recover enough before you can go back. So, a total of about 12-16 weeks are required for your liver transplant surgery in India.

One needs to stay in the ICU for a week after the surgery and another 3 weeks in the transplant care unit following which the patient is discharged from the hospital. However, the donor will stay at the hospital for about a week.

After the surgery, the patient is moved to the intensive care unit (ICU) for 5-6 days, after which he is shifted to the transplant care unit/room where he would stay for another 3 weeks. It is normal to experience some pain and discomfort which shall be controlled with medications. The doctor will keep a check for any signs of bleeding, infections, or liver rejection. The patient is prescribed medicines to suppress the immune system so that the body does not reject the new liver.

Recovery after liver transplant is a very slow and long process that aims at steadily building the patient’s health and fitness. It may take 6 months to resume normal daily activities.

What Results Can I Expect from Liver Transplant?

One can expect gratifying results after liver transplant surgery. Most of the patients resume their regular lifestyle after 6 months of successful liver transplant. If supplemented with a healthy diet, regular exercise, and medication, one can lead a healthy and active life after a liver transplant.