Liver Transplant is the complex surgical procedure where the diseased liver is removed from the body of the patient and a healthy liver (complete or partial liver) is placed and new anatomical connections are restored.
The patients who present with complications arising from long standing chronic liver disease or cirrhosis are candidates for Liver transplantation. The complications / symptoms seen in patients with cirrhosis are:
Liver Transplant is broadly classified into two types
Liver has a unique ability to regrow thus enabling donation of a part of liver from living donors. A healthy individual can donate 60-70 % of liver without any issue.
In India, only a family member is allowed to be a potential donor. The relationship is established by legal documents, government issued ID’s and also by DNA finger printing. These documents are scrutinized by ethical committee independently.
Any individual who is a Family Member can donate a part of his/her liver provided:
The living donors undergo thorough evaluation so that the surgery and post operative period is uneventful. The donor stays in hospital for 5-10 days after surgery. The most common complaint after surgery is pain along the incision site. The donors are given a special pain control pump so as to keep them comfortable. The donors are able to move and do all activities of daily living prior to discharge. There are no dietary restrictions and diet is advanced slowly during hospital stay.
The donors are discharged on oral medicines and multivitamins. They can resume desk type job with in a period of 3-4 weeks. Heavy physical activity can be resumed in 3 months time. Donation has no long term impact on an individual’s personal, sexual and professional life.
The risk of death arising from donation is <0.1% as per current data available.
The patient who is a candidate for liver transplant undergoes a thorough multidisciplinary team evaluation. This includes conducting detailed blood tests, heart, chest, nutritional, psychological and other tests if required.
The liver transplant evaluation once complete is reviewed by liver transplant team (hepatologists and Transplant Surgery), liver anesthesia team and transplant coordinator. Appropriate clearances are obtained from cardiologist, chest medicine, neurologist, clinical psychologist, physiotherapist etc prior to surgery.
Once work up is complete and the patient is declared fit for liver transplant appropriate date for surgery is decided pending ethical committee clearance.
The procedure involves thorough multi-disciplinary team evaluation of the patient to decide if he / she is a suitable candidate to undergo liver transplant. A suitable family member is then evaluated as a liver donor. If the tests reveal that the donor to be suitable for donation all required medical and ethical clearances are obtained to proceed for Living Donor Liver Transplant.
The patients who do not have a suitable donor are listed for Deceased Donor (commonly called Cadaver) Liver Transplant. These patient are offered the benefit of centralized listing for various centers in India without the need for patient to travel to individual centers. This reduces the expenditure involved in travelling for listing. Dr. Dhir along with the team conducts transplants at the various centers across India for such wait listed patients. The time period from listing to transplant is variable depending on blood group and center of listing.
Liver transplant was started in India at Sir Ganga Ram Hospital, New Delhi. The transplant team has incredible experience of conducting liver transplants both living and deceased donor transplants. A dedicated transplant ICU and nursing staff are there to take care of recipient round the clock.
The success rate of >90 % and reasonable cost is another reason to choose our program in India for Liver transplantation.
The patients who undergo Liver Transplant need to take anti rejection medicines for life time. This anti rejection medicine is called immunosuppression. These medicines prevent a patient from rejecting the transplanted organ. There is a fine balance between immunosuppression and infection. So the recipients and the family is explained in detail about these medicines and side effects prior to surgery and they prior to discharge.
Most patients are started on a triple drug regimen. The number and dosage medicines reduce with time but cannot be completely stopped. These medicines have lot of interactions and patients are advised against self medication. These medicines should not be missed and taken in dosage advised.
The recipient stays in the transplant ICU for 5 days and then shifted to room. Most recipients are discharged in 2-3 weeks time for home. The recipient and his/her care giver is explained in detail about medicines to be taken after discharge. They are provided with guidance about nutrition/ physical activity/ precautions and necessary do’s and dont’s.
Initially the patient visits twice a week in the clinic and then once a week. Blood tests are conducted twice a week for first few weeks and then weekly blood tests are done. Once stable liver function is achieved patients can go to home town and can follow up on email (info@bestlivertransplantindia.com).
The patient needs to report to the team in case of fever or any other issue.
The cost of liver transplant in India ranges $35000-$45000(USD). The cost of Liver transplant under Dr. Dhir, at Sir Ganga Ram Hospital is $35000(USD) approximately. We are the most cost effective transplant programs in India.
The Living donor liver transplant package includes the following:
Pre-transplant work up and evaluation of recipient and donor on OPD basis. The package includes post transplant stay up to 21 days for the recipient: 15 days in Single Room and 5 days stay in ICU. It includes donor stay of 8 days. It also includes the following: Surgeon fees, Anaesthetist fee, Anaesthesia charges, Operation theatre Charges, Medicines / Medical Consumables/ Blood Transfusion Service Charges up to Rs. 5.0 Lakhs (INR), and all other conditions as applicable under the normal packages will remain the same.
The following are excluded from the package:
Pre transplant admission for any reason, any stay over and above period of mentioned hospital/ICU stay, any repeat CT Scan and Ultrasound Any MRI/PET scan/ Nuclear Medicine Imaging Charges and outsourced Lab Charges, all medicines and Medical Consumables over and above the prescribed limit, Nephrology related treatment Charges, any non liver transplant consultants visit charges and procedure charges, additional Echo Charges etc. In case of unexpected complications the charges can go beyond package.
There is special provision for poor patients, provided they have requisite documents. Dr. Dhir’s office coordinates with several funding agencies to help such patients to get a transplant.
We have an overall success rate of > 90% following liver transplant. The success rate depends on several patient and donor factors. The patients with good performance status do much better than individual who have had multiple hospital admissions and infections in past.
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