A Liver transplant is a procedure for removing a damaged or diseased liver and replacing it with a healthy liver.
Usually, the doctors recommend this procedure when the liver becomes damaged and cannot perform normal functions. This stage of the liver is known as end-stage liver disease or liver failure.
Gradually it becomes damaged as a result of infection, alcohol, or illness. This causes the liver to become scarred, which is called Cirrhosis. Liver failure can also develop very rapidly as a result of death and inflammation of liver tissue, known as necrosis.
The main causes of liver cirrhosis and liver damage in India are:
ARLD (alcohol-related liver disease)– is when the liver becomes scarred because of persistent misuse of alcohol.
Hepatitis – blood-borne viruses can cause severe liver damage, including Hepatitis B and Hepatitis C.
Primary biliary cirrhosis – is a poorly understood condition that can cause progressive liver damage
PSC or Primary sclerosing cholangitis – causes prolonged inflammation of the liver
Sometimes a Liver transplant may also be recommended as a liver cancer treatment.
No device like dialysis for the kidney, lungs, or heart can replicate the liver functions permanently. So, a Liver transplant is the only hope for the long-term survival of a person with liver damage or failure.
Liver transplantation in Delhi is a surgery where the diseased liver is removed and replaced with a new liver at the same anatomical position.
Identifying the ideal candidate for a liver transplant in Delhi involves assessing various factors, including symptoms. Symptoms indicating the need for a liver transplant may include-
However, a doctor will evaluate the patient's overall health and the severity of liver disease to determine the need of a liver transplant.
Liver transplant is performed to replace a damaged or failing liver with a healthy one. It is typically done when the liver can no longer perform its essential functions due to conditions like cirrhosis, hepatitis, or acute liver failure. The primary goal of liver transplant is to improve the quality of a patient's life and extend their lifespan by providing them with a functional liver.
Like any major surgical procedure, liver transplant carries certain risks. These risks can include rejection of the transplanted liver by the recipient's immune system, infection, bleeding, and complications associated with anesthesia. Thus it is essential for patients to be aware of these potential risks and discuss them thoroughly with their doctor before the procedure.
All These conditions can be treated by medicines and various interventions like endoscopic banding to a certain extent. Primary causative factors are critical, like stopping alcohol, treating Hepatitis B and C, reducing weight in NAFLD-related cirrhosis. But beyond a specific limit, patients with liver cirrhosis can’t have complication-free survival without replacing the non-functioning liver. There are various parameters like Child’s score (CTP), Mayo Clinic End Liver Disease (MELD) score, which serve as selection criteria for a Liver transplant in delhi. These are well-validated robust guidelines for patient selection.
Usually, you are only considered a suitable candidate if you meet 2 conditions:
Without a Liver transplant, the quality of life is likely so poor as to be intolerable or the expected lifespan would be shorter than normal.
Expected minimum 50% chance of surviving for at least 5 years after the transplant with good quality of life.
People who come in these above criteria will be eligible for a Liver transplant, except few conditions that maybe some considered unsuitable for Liver transplant
For example, if you have liver cancer or are unable to stop misusing alcohol, you may not be able for a Liver transplant.
The doctor also recommends some tests that will show whether the patient is suitable for a Liver transplant.
There are main three types of a Liver transplant that can be carried out:
Deceased organ donation – involves a Liver transplantation procedure that has been removed from a recently dead person
Living donor Liver transplant – a section of the liver is removed from a Living donor; because both the remaining section and transplanted section of the liver can regenerate itself, or able to regrow into a normal-sized
Split Donation – removal of the liver is done and split into two pieces from a recently dead person and each piece of liver is transplanted into a different person, where the liver will grow to normal size.
1- Living donor liver transplant:- LDLT donor should be of the same blood group, own relative , aged between 18-55 and healthy individual.
2- Deceased donor liver transplant:- DDLT registration needs to be done with NOTTO and the organ is allocated depending upon availability.
Medical Investigations: Before the transplant, extensive medical evaluations, tests, and imaging studies are conducted to assess the recipient and donor's suitability.
For transplant the packages are usually for 15 days stay of both recipient and donor. This cost may vary slightly in different hospitals.
In post transplant period there may be complications like , rejection, bile leak, stricture , infection. All these can add to stay and cost.
Immunosuppressive Medications: Post-transplant, patients must take immunosuppressive medications to prevent organ rejection. These medications can be a recurring cost and may vary based on the specific drugs prescribed.
Insurance Coverage: The extent of insurance coverage plays a crucial role in determining the out-of-pocket expenses for patients. It's essential to check with the insurance provider about the coverage for liver transplants.
Many common benefits of Living-liver donation are mentioned below:
Living donation helps save the lives of people with liver cirrhosis. This increased the number of Liver transplant waiting list people.
Living donors can also feel blessed that they’ve had a huge impact or given one more life to a needy person.
Transplant recipients and Living donors can schedule surgery time that is suitable for both people.
Flexible scheduling allows the Liver transplant to be done soon. It saves valuable time for the Liver transplant waitlist and also reduces the risk factors of liver damage getting worse.
As they are receiving a healthy portion of the donor’s liver, recipients have quicker recovery times and improved long-term outcomes.
Mostly Liver donors do not experience any major or serious long-term complications in portion because the liver has the unique ability to regenerate among all the body’s organs. After giving the portion of the liver, eventually, it will return to its original size.
After surgery, during the first six weeks, the most rapid regeneration occurs—during this time, typically the liver returns to almost 80 percent of its original size. The remaining growth of the liver will continue for up to a year to reach 90 percent of its original size.
The recovery process after liver donation surgery usually follows these steps.
Alcohol and Other Toxins
The liver recipients avoid the overuse of alcoholic beverages after Liver transplantation because the transplanted liver may be more sensitive to damage by chemicals, including alcohol.
Toxic Chemical Exposures
Many household chemicals like pesticides, drain cleaners, paint, gasoline, paint removers, and insecticide can be toxic. For Liver transplant recipients, the fumes of these substances can be harmful
Drinking Water
Liver transplant recipients may drink chlorinated or treated municipal tap water.
Medical Alert Identification
In an emergency, the simple precaution for Liver transplant recipients is to wear medical alert identification like a bracelet or pendant under the brand name Medic Alert. can be life-saving.
Liver transplant patients should always keep a list of prescribed medications in their wallets, in case of emergency treatment.
Reducing the Risk of Infection
Pets
Liver transplant recipients try not to come in contact with animal feces, urine, or vomit (emesis). Some birds, especially pigeon droppings, generally carry a fungus that is dangerous to immunosuppressed patients.
Pregnancy
Some doctors do not recommend becoming pregnant for 1 or 2 years after transplantation. Because at this time medication doses are highest and most complications occur
Travel
Try to avoid travel but it’s impossible for a long period so you will need to take extra precautions while traveling and follow all instructions given by your doctors.
It is almost impossible to predict the exact survival rate for an individual due to a variety of complicated factors
So, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) lists the following average survival rates.
People who have had a Liver transplant from a deceased donor:
After a liver transplant surgery, patients need to follow specific guidelines to ensure a successful recovery. This includes taking immunosuppressive medications as prescribed, maintaining a healthy lifestyle, avoiding alcohol and tobacco, and attending regular follow-up appointments. Patients should also be cautious about potential infections and report any unusual symptoms to their healthcare provider promptly.
Life after a liver transplant in Delhi can significantly improve for individuals who were previously struggling with liver disease. Many people can return to their normal activities, work, and enjoy a better quality of life. However, it's essential to continue medical follow-ups, take medications as directed, and make healthy lifestyle choices to ensure the long-term success of the transplant.
Choosing the best liver transplant surgeon in India is a critical decision. In Delhi, there are experienced liver transplant surgeons who have a proven track record of successful surgeries. It's advisable to consult one of the best Dr Piyush Ranjan for the expert guidance.
The liver transplant procedure is generally considered safe when performed by experienced surgeons and with proper post-operative care. The decision to undergo a liver transplant is made after a thorough evaluation of the patient's overall health and the severity of their liver condition. Patients should have open discussions with their doctor to fully understand and mitigate potential risks.
Determining the best type of liver transplant in Delhi, whether living donor or deceased donor, depends on individual circumstances and medical evaluations. Both types have their advantages and considerations. It's crucial for patients to consult with their healthcare providers to determine the most suitable transplant approach based on their specific condition and availablity of donor.
Dr. Piyush Ranjan, a distinguished Gastroenterologist at Sir Ganga Ram Hospital, New Delhi has done his medical schooling from Maulana Azad Medical College New Delhi and subsequent training in Gastroenterology from SGPGI, Lucknow in 2003.
