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A liver transplant is a surgical procedure by which a surgeon replaces a dysfunctional or damaged liver with a healthy one. Either a part of liver or whole liver is transplanted, according to the indication of the transplant.
In most cases, liver is taken from a deceased donor.
It is also possible to take a part of liver from living donor.
Since liver is the only organ in the body which can
regenerate to increase its size, a part of liver when transplantedin the body rebuilds
to the normal size liver within few weeks.
Liver transplantation is done only when the patient is critically ill becasue of liver failure. Main causes of liver failure include
In the following cases liver transplant may not pe performed:
After the patient is declared as the candidate for liver transplant, the surgeon will recommend the following tests
After the tests, the surgeon will discuss issue a letter that will allow you to be on the waiting list to get liver from deceased donor.
The surgeon will also discuss the possibility of getting a part of the liver from family or friend. Finding a compatible donor is the most important thing to do before liver transplant.
Once the liver is available for the transplant:
The team that performs a liver transplant comprises two or more surgeons, hepatologist, anesthesiologists, trained paramedical staff (transplant nurses & support staff).
Liver transplant procedure is a complex procedure of approximately 6 to 12 hours performed under general anesthesia. During the procedure:
After the procedure, the patient is closely observed in the ICU – Pulse, blood pressure, respiratory rate, temperature, oxygen saturation, etc are monitored at regular intervals.
After the surgery, the patient can expect
Blood tests are done to ensure the post surgery recovery of the patient. The tube in the lungs is removed after few hours or few days. The other tubes in the throat, urinary bladder are also removed after few days.
The patient will be allowed to take clear fluids after the condition stabilizes, followed by soft diet and normal diet. The patients are advised to move and walk around as much as possible.
The patient can go home in 10 to 15 days after the surgery.
Immunosuppressants and blood thinning medications will have to be taken for the rest of the life.
Liver transplant is a complex surgery, and has significant risks and complications:
Immunosuppressants and blood thinning medications may have the following side effects
Liver transplant cost in India ranges from INR 8L to 25L. The liver transplant cost also depends on whether the organ is obtained from live donor or cadaver. Typically, liver transplant cost includes surgeon fees for the procedure on donor and receiver both as well as fees for hepatologists, radiologists, anesthesiologist and recurrent lab testing during the hospital stay, 12 to 14 days of hospital stay post procedure, physical therapy and rehabilitation, drugs and consumables.
In government hospitals like AIIMS, the cost of liver transplant will be comparatively low. However, the waiting list for cadaver transplant will be very long. While in private hospitals, the liver transplant cost will be relatively higher, and the waiting list will be smaller.
If you have any additional questions regarding liver transplant cost or need help in choosing the right hospital or liver transplant surgeon, talk to Credihealth medical experts. Call 8010-994-994.
The liver, a dark reddish-brown organ is located in the upper right-hand quadrant of the abdominal cavity, beneath the diaphragm and on top of the stomach, right kidney, and intestines.
The liver has several functions, however, the most important job played by our lungs is to filter the blood coming from the digestive tract, before passing it to the rest of the body. Some of the other functions played by the lungs are, production of bile which helps carry away waste and break down fats in the small intestine during digestion, production of cholesterol and special proteins to help carry fats through the body, store and release glucose as needed, conversion of harmful ammonia to urea, regulating blood clotting and fighting off infections by producing immune factors and removing bacteria from the bloodstream.
Liver failure occurs when liver cells are damaged significantly and are no longer able to function. Acute liver failure can be caused due to the following reasons: birth defects, alcohol abuse, or chronic infection with diseases such as hepatitis B and C, hemochromatosis (a hereditary disease that results in excess iron in the liver), and cirrhosis.
Some of the common signs and symptoms of liver cirhhosis are: fatigue, loss of appetite, itching, easy bruising, weight loss, nose bleeds, jaundice and swelling of legs.
There are three different types of liver transplant that may be offered to a person based on the condition of his liver: Orthotopic transplant or transplant of a liver from a recently deceased donor, a living donor transplant and a split type of liver transplant.
Liver transplant donors must meet certain basic requirements. The important being that the donor should be donating at his own free will and not by any sort of coercion. Other important factors that make a person eligible to become a potential donor are as following: the donor must be 18 to 60 years of age, in good health with no major medical or psychiatric illnesses, have compatible blood type and be a non-smoker for at least six weeks prior to surgery. Also, s/he shouldn’t be pregnant or overweight.
A liver transplant is a serious operation that has a risk of some serious complications which can occur during, soon after, or even years after the transplant.
Some of the main complications and risks of a liver transplant are: your body attacking the new liver, graft failure i.e. the new liver not working properly, a blockage or leak in one of your bile ducts - that results in an increased risk of infections and kidney problems. Important to note that a liver transplant will only be recommended if the risks of not having a transplant outweigh the risks of having one.
Yes, the patient may not always have typical end stage liver disease symptoms such as accumulation of water in abdominal cavity, jaundice, blood in vomit etc. It has been seen that in cases of early diagnosis of Liver Cancer (HCC) without metastasis i.e. where cancer is localised only in the liver and has not spread to other organs or tissues, the patient can be advised LTP.
There are many instances where children might also need LTP. Congenital diseases like Biliary Atresia, GSD, Hepatic Fibrosis etc. can be the possible cases. However, to undergo the procedure, complete evaluation and investgations need to be done first.
Liver transplantation is a surgical procedure done to remove the old diseased liver and replace it with a new liver either from a live donor or brain dead donor.
Liver transplantation steps for the surgery are essentially the same i.e. diseased liver is replaced by new healthy liver and the arteries, veins and bile duct is anastomosed (joined) with new liver. The difference is in the weight of the donated liver taken. For a pediatric patient- the weight needed is much lesser than the adult patient.
The liver transplantation surgery takes around 10-12 hours. However the in-OT time may vary as per patient's clinical condition and the disease extent.
The damaged liver is removed from patient's body and discarded. It is replaced with a new, healthy donated liver.
LTP is essentially taken as a last resort for a critically damaged liver. It is usually recommended to the patients having severe progression of the symptoms such as involvement of brain tissue known as hepatic encephalopathy; recurrent ascites; blood loss from the body etc. A complete examination and investigations are done to know about the liver damage. MELD and Child Pugh scores are calculated. Typically a MELD of >15 is taken as an indication for LTP. The higher the MELD, more is the chance for patient undergoing LTP. PS: MELD of < 15 may be seen in some cases such as Liver cancer and might need LTP
Early Cirrhosis is typically managed with medicines and the progress is noted by the doctors. LTP is normally advised for an advanced stage liver damage or late liver cirrhosis where the patient's survival is on stake, the symptoms are progressing and hampering normal functions of other organs as well. Also the patient with metastatised liver cancer are not eligible for LTP.
As per govt guidelines for organ donation and transplantation; the donor either has to be a blood relative or a family member. The spouse of a family relative (taken as non-blood relative) is also legitimate for the donation. A friend/collegue or any other relative other than family relative is not allowed for organ donation.
As per govt guidelines, following cases are not eligible to be a liver transplant donor:
No. It is illegal in India to buy or sell the liver.
Post surgery, the donor usually has to stay for around 5-7 days and the patient has to stay for approx 2 weeks in the hospital. However, the stay is typically decided on the pre and post transplant conditions of the patient.
The liver is an organ with regenerative capacity. Post transplantation the liver regenerates to 90% of its total volume in 3 months.
Yes, the patient has to take immunosuppressants life long. The amount of dosage varies from patient to patient. The patient might also be suggested other supporting medication as per his medical conditions and clinical needs.
It takes roughly 6 to 10 hrs for the surgery to get completed. The actual time however might vary depending upon the patient’s clinical condition.
Under Pre-LTP work up there are a number of investigations that are done for patient and/or the donor (in case donor is available--for LDLT patients). The investigations are undertaken to know about the patients medical condition and extent of the disease. The same are done prior to the surgery as a patient evaluation protocol and/or prior to the registration for cadaveric liver transplantation process. In case of LDLT , the donor also has to undertake the investigations prior to be considered deemed fit for organ donation. The investigations for the donor are done in steps (4 steps) to avoid incurring extra expenses. This means that if during step 1 investigations; the donor is rejected or is declared medically unfit for the surgery, further investigations are not done.
The average cost of pre-work up for patients is around 70k to 1 lakhs.
The first requirement is the compatibility of blood group and the subsequent medical screening for the liver status. Followed by a complete body check up including clearance from other medical departments.
Legal Reasons:As per government rules, for ldlt , the donor has to be a blood or family relative of the patient. The same is established by a DNA Analysis between the donor and the patient. In case of relative or spouse of the relative; the analysis is done for the spouse and the dna line/family relation is medically documented with the patient. Where the donor is the patient's wife; the donor is accepted after medical screening and legal formalities.
No. If the probable donor is of the same or the compatible blood group; the investigations are done in steps with subsequent clearances at every step.
Post Surgery lifestyle changes will be dependant on the patient's pre-LTP status and on the recovery phase post surgery. Generally, patients would be advised to maintain an overall healthy lifestyle.
During early weeks, patient is advised to take strict care of him/herself to avoid catching any infections. As the patient improves and the new liver grows to its normal weight and size and starts performing functions; the follow ups are reduced and medications are adjusted accordingly. The patient is also advised to avoid any intake of alcohol, quit smoking, drug abuse or any unhealthy practices.
In case of donated liver rejection, the patient is initially managed with medications and an attempt is made to assist the transplanted liver and the body to adapt. But if the Liver goes into complete failure, then re-LTP may be done.
It has been globally seen, that the LTP from the donor perspective is comparitively safer. An incidence of a major liver disease post donation is 1 in 10000 for the donor. However, the following complications in donors have been noticed post Liver donation:Bile leakage:  Some liver donors face this problem. However, most often it resolves itself. In cases, where it doesn’t, doctors aid the healing process by placing a tube in the liver.
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