Liver Transplant Surgery in India

A Liver Transplant is a surgical procedure, which takes anywhere between 6 - 12 hours, involves the replacement of a malfunctioning liver (due to liver failure) with a healthy liver obtained from a deceased donor or a section of a healthy liver provided by a living donor. A liver transplant is the most preferred treatment option for patients with end-stage liver disease or liver failure, who have stopped responding to the conservative treatments and are struggling with a compromised quality of life. As per the best doctors for liver transplant in India, the procedure can not only help to improve the patient’s survival chances but also the quality of their lives.

Why is Liver Transplant done?

Liver Transplant in India, is generally the last resort of treatment recommended for patients with liver failure, a condition marked by the inability of the liver to perform the vital functions that it is responsible for, such as detoxification of blood, supporting healthy metabolism, building immunity, aiding in digestion and so on. 

If the liver fails to perform these functions, it can give rise to serious, and even life-threatening complications. Liver failure is the result of an underlying disease or ailments. The most common causes of this include:

Acute Liver Failure - Also known as fulminant hepatic failure, it is marked by the rapid deterioration of liver function due to the sudden onset of a disease involving the liver.  
Viral Hepatitis - It is the most dangerous form of hepatitis, characterized by inflammation and progressive liver damage.
Alcoholic Liver Disease - Triggered by excessive alcohol intake, the condition is characterized by excessive fat build-up in the liver, leading to inflammation and scarring.
Non-Alcoholic Fatty Liver - It is marked by fat accumulation in the liver due to factors other than drinking alcohol.
Liver Cancer - It is a progressive disease marked by the gradual replacement of all healthy liver cells and tissues with malignant cells.

Transplantation of Liver becomes necessary when both acute and chronic end-stage liver diseases prove unresponsive to medical treatment. Patients facing hepatic decompensation, which includes conditions like hepatic encephalopathy, variceal hemorrhage, or ascites, should initially undergo medical therapy. Subsequently, a comprehensive evaluation for potential transplantation candidates should be initiated. A significant portion, approximately 80%, of liver transplants are attributed to cases of decompensated cirrhosis. Individuals with cirrhosis are usually classified according to the Child-Turcotte-Pugh (CTP) score, a system incorporating clinical information and biochemical tests to determine their prognosis.

A strong indication for Liver Transplant assessment arises when cirrhotic patients develop ascites, bleeding varices, Hepatic Encephalopathy, or Hepatocellular dysfunction, resulting in a MELD (Model of End-Stage Liver Disease) score exceeding 15.

Although a Liver Transplant is a very effective procedure, not every patient may qualify for it. In order to undergo the transplant, the patients have to fit into the eligibility criteria which is determined by detailed pre-evaluation. Various modalities used for the evaluation of such patients, by liver transplant experts in India, include:

Medical History: Your medical practitioner could discuss your personal medical history, any occurrences of liver diseases within your family, and any possible symptoms you might be experiencing. Elements like your age, whether there's a family history of liver diseases, and any genetic conditions that could heighten the risk of developing this liver failure might be taken into account.

Initial Screening and Referral - This involves a few primary tests that may be recommended by a doctor/general physician to analyze the underlying cause of the symptoms that you have been experiencing. If diagnosed with a serious liver ailment that may call for the need for a transplant, you will be referred to a specialist.

Assessment of Medical History and Physical Examinations: Your medical records will be thoroughly evaluated to analyze the progression of the disease and a general physical examination will be conducted to assess the symptoms.

Blood Analysis - Blood samples collected from the patients are examined to assess liver function by measuring blood toxicity and enzyme levels. 

Biopsy: This involves the collection of a small tissue sample from the liver, which is examined under a high-definition microscope to detect serious diseases like liver cancer, as well as to determine the severity of the same. 

Imaging Tests: This includes advanced interventions like Computerised Tomography (CT) scan, Magnetic Resonance Imaging (MRI) scan, Positron Emission Tomography (PET) scan and ultrasound for detecting any structural abnormalities or visible changes in the liver. 

Social and Psychological Evaluation: Although these are not related to your physical well-being, they are crucial in determining whether you are eligible for undergoing the transplant. This involves the evaluation of mental well-being, financial security and family ties and relationships.

Nutrition Counseling: A certified dietician will evaluate your nutritional status and recommend a balanced plan to help you make up for the nutritional deficits that might affect your eligibility to undergo the transplant. 

Cardiopulmonary Test: A liver transplant is a major surgery and it is important to ensure that your heart and lungs are healthy enough to tolerate it. Certain cardiac and pulmonary function tests will be performed to evaluate the same.

Liver Transplant procedure involves a series of steps, each of which is very crucial for determining the outcome of the procedure. Experts from the best Liver Transplant hospital in India suggest that these steps may, however, slightly vary depending on whether the patient is undergoing a living donor transplant or a deceased donor transplant.

Steps involved in a Liver Transplant

Step 1: Scheduling the Surgery 
This is the first and crucial step of a living donor transplant in which the date of the surgery is decided based on the availability of the doctor, recipient and donor. In the case of a deceased donor transplant, the surgery is generally performed on an urgent basis, depending on the availability of the donor. For this, you need to register yourself on the transplant list and you will receive a call as soon as a donor is available. 

Step 2: Pre-Surgical Evaluation
Once you check in on the day of the surgery, you will be required to undergo a few tests for proper evaluation and last-minute assessments.

Step 3: Anesthesia  
After clearing the pre-evaluation you will be taken to the operation theater. Your anesthesiologist will administer anesthesia to induce unconsciousness.

Step 4: Surgical Incision
Once you are under the influence of anesthesia, the surgical site will be prepared and an incision will be made carefully, to access the liver.

Step 5: Transecting and Removing the Liver
Doctors will carefully detach all the blood vessels and extract the unhealthy liver with some of the surrounding tissues if needed.

Step 6: Implanting the Donor Liver
The donor liver is carefully positioned in the patient’s abdominal cavity and attached to the blood vessels to restore the flow of blood.

Step 7: Closure and Bleeding Control 
Once the liver is implanted, the incision is closed, while following stringent measures for bleeding and infection control. 

Like other surgical interventions, liver transplant carries certain risks as well. However, as per the top specialists for Liver Transplant in India most of these can be alleviated, and even negated, with proper pre-planning. Some of the most common complications that should be taken into consideration include:

• Wound infection, which can be managed with adherence to strict infection control protocols
• Clotting, which can be taken care of with post-operative physiotherapy 
• Bile leakage, which can be prevented with precise anastomosis 
• Bleeding, which can be managed by taking necessary bleeding control measures. 
• Organ rejection, which can be managed with the use of prescribed anti-rejection medications 

• After the completion of the procedure, you will be taken to the observation room, with an assigned nurse to keep track of your vitals. 
• Once you gain consciousness, you will be shifted to the intensive care unit. 
• Medication and nutritional fluids will be given intravenously 
• On average, the patient needs to stay at the hospital for 5 - 7 days or even more in some cases
• Throughout your stay, doctors will keep on assessing your health by conducting regular physical examinations and assessments. 
• You will be briefed about physiotherapy, medication and diet.
• Patients who are recovering well are shifted to the general ward or room, from where they will be discharged depending on the overall prognosis.

Undergoing a Liver Transplant will definitely make a positive impact on your health and well-being, however, it is not only the procedure that matters. Post-operative care and follow-ups are equally important. Some of the most important things that you need to prioritize post-liver transplant, include:

Follow-ups - Even after undergoing the transplant, you need to stay in constant touch with your doctors by going for regular follow-ups for the first few months following the transplant. This will allow the doctors to track your prognosis better. 

Medication - You will be required to take the prescribed medication. This includes anti-rejection medicine, which is crucial for alleviating the risks of organ rejection.

Lifestyle modifications - You will be required to make some changes in your lifestyle and eating habits to ensure minimal risks of complications, There might be some dietary restrictions to be followed for a couple of months. 

In India, the success rate of liver transplant procedure is significantly high, with the overall survival rate soaring up to 90 per cent in the first year following the surgery. The survival rate for patients with acute liver failure is around 64 to 88 per cent.

This can be attributed to the unparalleled medical expertise offered by the doctors, as well as to the use of the latest and most innovative approaches, that add to the safety and efficacy of the procedure. Liver Transplant in India has given hope to countless patients over the years, helping them to lead a long and healthy life.

One of the reasons why a lot of people prefer undergoing Liver Transplant procedure in India is its affordability. Despite being highly successful and efficient, liver transplant in India is offered at a significantly lower rate as compared to most countries.

Domestic Cost Comparison 

Breakdown of the cost of LiverTtransplant in 6 major Indian cities 

Delhi -  $ 24000 -  $ 55000
Mumbai -  $ 28000 - $ 52000
Chennai - $ 25000 -  $ 57000
Hyderabad - $ 30000 -  $ 50000

International Cost Comparison 

Breakdown of the cost of Liver Transplant in 6 major countries

India - $ 24000 - $ 57000 
South Africa - $ 30000 - $ 70000
Singapore - $ 35,152 - $ 98,595
United Kingdom - $ 45,832 - $ 1,54,275
Germany - $ 1,08,550 - $ 1,68,864
USA - $ 1,68,864 - $ 3,61,853

There are several factors that influence the cost of Liver Transplant in a particular country. Some of the most prevalent of these include:

• Hospital facilities, infrastructure and services
• Location of the hospital
• Age of the patient 
• Expertise of the surgeon 
• Preoperative evaluation and diagnostic cost
• Room preference 
• Postoperative hospital stay, which varies depending on the patient’s prognosis 
• Physiotherapy and rehabilitation 
• Pre and post-operative medication 

Diagnostic tests, including blood testing, cross-matching, imaging, and other assessments, are normally priced between INR 75,000 and INR 1,50,000.

When these cost estimates are compared, they highlight India's affordability in the field of healthcare, without sacrificing quality. The potential to receive world-class medical care without breaking the wallet makes India an appealing destination for people seeking Liver Transplant.

Medflick is your trusted healthcare companion for planning a hassle-free and successful liver transplant in India. With us, you can expect:

• Access to world-class hospitals and healthcare facilities 
• Personalized assistance to suit your specific needs and requirements 
• Expert network of India’s renowned liver transplant experts 
• Satisfactory pricing and complete transparency 
• Travel and lodging support to ensure a smooth journey 
• Multilingual support 
• 24/7 assistance throughout your stay 

We are committed to simplifying your journey to better health by empowering you with reliable information, unparalleled assistance and access to the best hospitals and doctors in India.