Best Liver Transplantation Service in India

OVERVIEWLiver transplantation is the process of replacing the diseased liver with a healthy liver from another person (allograft). Liver transplantation is considered a viable treatment option for various end-stage liver diseases and acute liver failure.

At HCG, before recommending liver transplantation, each patient undergoes a transplant assessment to determine if a transplant is required. This assessment involves comprehensive medical tests and discussions with the transplant team, caregivers, and the patient. Additionally, a general check-up is conducted to evaluate the patient's existing medical conditions and how they may affect the planned transplantation.

Who Needs a Liver Transplant?

Liver transplantation becomes necessary in the case of both acute and chronic liver failure. The liver specialists may recommend a liver transplant, if the patient is diagnosed with the following conditions:

Primary liver cancers, or hepatocellular carcinoma
Viral infections (hepatitis B and C)
Chronic alcohol consumption
Non-alcoholic steatohepatitis (fatty liver)
Autoimmune disorders
Cryptogenic cirrhosis
Drug-induced liver damage

Liver transplantation may be required in cases of acute or subacute fulminant liver failure, where the cause of liver failure is unknown and occurs suddenly.

Types of Liver Transplantation

Liver transplantation is classified into two types based on the donor:

To receive a deceased donor liver transplant, the patient needs to be registered with the Zonal Coordination Committee based on their blood group. When a liver becomes available, the hospital will inform the patient, and with their consent, the transplant team will prepare for the procedure.

Waiting periods can last several months, but for patients with aggressive hepatocellular carcinoma, minimally invasive procedures such as TACE, TARE, or RFA may be used to delay disease progression while waiting for a liver transplant. In some cases, the liver can be harvested from a brain-dead donor with family consent and transplanted to a suitable recipient.

The liver may be transplanted as a whole or split into two parts to help two patients.

Living donor liver transplantation is a successful alternative to deceased donor liver transplants, with benefits such as excellent graft function, reduced waiting time, and a decreased risk of death for the recipient. However, this procedure puts the donor's health at risk and can lead to other complications.

Donors are required to undergo a comprehensive evaluation process before the transplantation procedure. The evaluation process usually involves blood tests, imaging tests, and consultations with specialists. Living donors must be in excellent physical and emotional health, have no history of cancer or active infections, and have a normal and healthy liver function, as donor safety is the top priority during assessment and donation.

Guidelines for Living Donors

The living donor must be aged between 18 and 50.

Should be a blood relative or spouse of the recipient. Donations by first-degree relatives are cleared by a hospital committee, but donations by second-degree relatives need clearance from the state government. The transplant coordinator can provide guidance, but the family is responsible for obtaining clearance.

Living donations must be completely voluntary.

The blood vessels to the liver and the bile ducts in the liver must be suitable for transplantation.

Donors should have caregivers, family, and friends who can support them before, during, and after surgery.

It is the donor’s responsibility to communicate if there are any concerns or issues that need to be addressed regarding the assessment or if they have a change of heart and do not want to donate.

At any point, if the surgeon feels that the donor may not be a suitable candidate, he will not go ahead with the procedure, as the donor’s safety is crucial.

Once the tests and consultations are completed, the transplant team will meet to review the results. If there are no contraindications, the recipient is prepared to go forward; otherwise, they will be placed on the waiting list for a liver transplant.

Frequently Asked Questions

Mild to moderate liver diseases show no symptoms in most cases. On the other hand, severe liver diseases lead to water retention (swelling in the ankles and stomach), fatigue, jaundice, blood vomiting or black stools, drowsiness, confusion or some behavioural changes, and frequent infections. If any of these symptoms are observed, it is important for you to see a doctor.

Yes, a liver donation is safe. Like every other surgical procedure, it comes with certain risks, such as bleeding, infection, and other treatment-related complications. However, there are no long-term side effects seen among the donors. In donors, liver functions will return to normal within 2–6 weeks. It is also important to note that the liver is a regenerative organ, and the donated portion of the liver grows back within a year.

This surgical procedure is complex and takes up to 4–18 hours.

Liver transplants have excellent clinical outcomes. Some patients live up to 30 years after receiving a transplant. This span can vary from person to person. For more information on your prognosis, you must get in touch with your doctor.

Not necessarily. Right after the transplant, the patient will be on immunosuppressants, and therefore, they will be relatively more vulnerable to infections. However, once the body accepts the organ as its own and the immunosuppressants are stopped, patients can lead a normal life without major restrictions.

This is a rare case, as the specialists make sure to pick the right match before the transplant and carry out numerous tests to reduce the risk of organ rejection.

However, if organ rejection does occur, your doctors may put you on immunosuppressants for some time to reduce the organ damage. This treatment regimen has been found to be extremely effective among transplant patients.