Verified By: Dr. Rakesh Rai (American Society of Transplant Fellowship, MD, FRCS, CCST) |Updated On January 21, 2021
An Overview of planning your liver transplant in India:
The liver is one of the vital organs in the body and is essential for digesting food and removing all the toxic substances from the body. It helps to produce proteins necessary for blood clotting, it produces bile juice necessary for digestion, etc. A liver transplant is the surgical replacement of a damaged or diseased liver with a donor’s liver. If your liver does not function to the level needed to sustain your life, a liver transplant is the only option. If you are planning for your transplant in India then this article will help you understand every step and criteria that will be followed for your liver transplant surgery so that you can make sound decisions during planning your surgery in India.
There are two types of liver donors:
- Deceased donor transplant – Also know as a cadaver donor in which the liver is taken from a person who has recently passed away. The person would have signed a donor organ card before death. The organ can also be donated post-mortem with the consent of the family. In India, it is difficult to get a deceased donor for foreign nationals, as priority is given to Indian nationals.
- Living donor transplant – In this process, someone who is alive and a matching donor who is a relative is preferred. The matching relative can help because the risk is low. The willing donor should match the liver size and compatible blood type. The donor is not at a permanent loss because the liver grows back to its size within 6-8 weeks, which means the donor’s quality of life is not compromised.
Already have a donor?
The video below will help you plan your treatment in India:
When will you need a liver transplant?
Your doctor will recommend you to undergo a liver transplant if your liver is not functioning properly and is in a stage that it cannot be repaired, some of the cases that may require a transplant are:
- Acute liver failure: A liver failure that happens very quickly and occurs due to drug overdose or poisoning.
- Congenital defects: Defects that you or your child may be having since birth that includes biliary atresia. Biliary atresia is the absence, damage or blockage of bile ducts and is the most common reason for liver transplant in children.
- End-stage liver disease: As the name suggests it is the most advanced form of chronic liver failure. When the Liver damage is severe, it results in scarring (fibrosis) of the liver and this is called cirrhosis, which is the most common cause of end-stage liver disease in adults. Liver cirrhosis is caused by hepatitis B and C, alcohol abuse, autoimmune liver diseases, hereditary liver diseases, bile duct diseases, and non-alcoholic fatty liver disease.
- Liver cancer: It includes hepatocellular carcinoma, hepatoblastoma, and cholangiocarcinoma
But before you are considered a suitable candidate for a liver transplant, you will need a pre-transplant evaluation.
What is a pre-transplant evaluation?
Your surgeon will consider your current medical tests, health history, and support system as the transplant team wants you to have the best chance of accepting the new organ. The pre-transplant evaluation will include tests such as:
- X-ray and imaging tests like CT or MRI scans
- Doppler ultrasound to study blood flow to and from your liver.
- ECG, stress test and other cardiac evaluation to check cardiac fitness.
- Pulmonary Function Test.
- Complete haematology (blood) study.
After your evaluation has been completed, a committee which is made up of hepatologists and a transplant surgeon will review the findings from the tests and evaluations. They will decide if a transplant is a right option for you. Once decided that you are a fit candidate for a transplant then you will require a liver donor.
What are the requirements of a Liver Donor?
To be a living donor, a person should meet the following requirements:
- Donation of the liver is completely voluntary
- Good physical and mental health
- The donor should be between the age of 18 and 60
- Body mass index (BMI) should be less than 35
- Compatible blood type with the recipient
- No organ diseases such as heart disease or kidney disease
- No ongoing malignancy (cancer)
- No HIV/AIDS
- No hepatitis
- No active or chronic infections
- No active substance abuse
While waiting for a liver from a deceased donor:
After your complete medical evaluation, if you are eligible for a liver transplant you can become an active liver candidate. Your name will be placed on a waiting list according to your blood group and medical condition. Each waiting list candidate is given a score based on their blood tests. These scores are known as the MELD (Model Of End-Stage Liver Disease) score in adults, and PELD (Pediatric End-Stage Liver Disease) in children. Depending on your score, you will be prioritised. This score is revised regularly. In case your blood test reveals that your liver has further deteriorated then your score will go higher. Accordingly, the candidate goes up in the list and has a better chance of being chosen as a recipient.
Donors and recipients are matched based on compatible blood types and size. Once a donor’s liver is matched, it should be transplanted within eight hours. The wait for a donor’s liver can vary. Some people wait days, while others wait months or may never receive a deceased-donor liver. While you wait for your turn to receive a liver, we make sure that you are regularly examined by surgeons so that your health can be maintained. We make sure that you are not charged extra during the waiting period.
How is liver transplant surgery performed?
The whole operation can last between 6 to 12 hours and is done under general anaesthesia. The Procedure for Liver Transplant Surgery is as follows:
- Step 1 – The surgeon will make a long incision across your abdomen and will disconnect the blood supply to and from the liver and bile ducts and then remove the diseased portion of the liver.
- Step 2 – The surgeon will place the donor’s liver in the patient’s abdomen and reattach the bile ducts and blood vessels to the new liver.
- Step 3 – Then the surgeon will close the incision using staples and stitches.
What happens after your surgery?
After surgery, you will be taken to the intensive care unit (ICU) where you will be monitored. You will be discharged from the hospital in two or three weeks. Once home, you will need to continue to undergo tests so that your doctors can monitor your health and that of your new liver. They are primarily concerned about:
- Acute rejection
- The return of a liver disease
- Medical complications like high blood pressure, infection, diabetes, and high cholesterol
To maintain the quality of life, you should follow anti-rejection procedures and make sure to keep the follow-up appointments with your transplant team so that they can monitor the efficiency of your new liver. Recovery time depends on the procedure, type of anaesthesia, your general health, age, and other factors. The full recovery may take 6 to 12 months.
What are the risk factors and complications of liver transplant surgery?
A liver transplant is a major surgery having significant risks and complications which include:
- Bile duct complications, such as bile duct leaks and shrinking of the bile ducts
- Blood clots
- The new liver may not work for a short time right after the surgery
- Rejection of donated liver
Long-term complications also include recurrence of liver disease in the transplanted liver. When a new liver is transplanted in your body, your immune system thinks it is a threat and attacks it. To help the new liver survive in your body, you should take anti-rejection medicines (immunosuppressants) for the rest of your life.
What are the side effects of Immunosuppressants (Anti-rejection medication)?
Like any other organ transplant, Liver transplant also has the risk of rejection. Our body thinks that the new liver is a foreign object and our immune system attacks the new liver. Therefore anti-rejection medicine is given before and after the surgery to stop the immune system from attacking the liver. You should take immediate medical assistance if you have symptoms like fever, fatigue, chills, nausea and jaundice after surgery. This can even happen after years of transplant. The anti-rejection medications can cause side effects which may include:
- Bone thinning
- High blood pressure
- High cholesterol
Because anti-rejection drugs work by suppressing the immune system, they also increase the risk of infection. Your doctor may give you medications to help you fight infections.
What is the survival rate after a Liver transplant?
According to a study, people who have a liver transplant have an 89% chance of survival after one year. The five-year survival rate after a liver transplant is 75%.
Life after liver transplant:
After 3-4 months of your liver transplant surgery, you can return to a normal life routine. But you should not take your health casually after an organ transplant. Your diet needs to be as per dietician’s advice, you should regularly take the medicines prescribed by the doctor, and you should reduce or abstain from alcohol. Your work, exercise and sex life will be as normal as any average person. You will surely benefit from liver transplant surgery and regain a normal life.
What is the cost of Liver Transplant In India?
The table below shows the cost (USD) comparison for liver transplant surgery in various countries:
United Kingdom (U.K.)
Compared to any other medical destination India offers the lowest cost for liver transplant surgery. The cost of Liver Transplant in India is $28500. That is 90% cheaper than most of the western countries like the U.S.A. You will get the entire package of pre-surgery investigation, surgery for the patient, surgery for the donor, hospital stay in private room and medicines. India is the third most preferred country by most of the foreign nationals for their treatment as hospitals in India provides excellent medical services at an affordable cost. You can email us about your query or get a second opinion of an experienced surgeon. Email: email@example.com
What will be the cost of accommodation in India during a Liver Transplant?
Other than the cost of surgery you also need to be aware of other miscellaneous costs that comes up such as the cost of accommodation during your stay in India. The hospital provides stay only after surgery. While your total stay in India will be for 2 months (if a donor is available). But if you have to wait for a deceased person’s liver then you may have to wait anywhere from 1 month to 6 months. There will be a total of 3 people travelling (patient, donor and attendant).
|Cost of accommodation if you opt to stay in a hotel:||Cost of accommodation if you opt for a service apartment:|
If you stay in a hotel then it will cost you a minimum of $55 a day. This means $1650 a month.
Cost of service apartment is free.
Your daily food will cost around $20 per day (minimum). That will be a total of $600 a month
You will only have to spend on food that will be an average cost of $180 a month (if you make it at home – which means you can cook as per your preference)
The total amount of expense spent on accommodation & food will be $2250 a month.
The total amount of expense will be the cost spent on food only. An average cost of $180 a month.
In service apartments, you can cook your food which is much cheaper and healthier than ordering food from outside(hotel/restaurant). That means you save $400 per month on food alone. As service apartments are free of cost you save in total $2000 – $3000 every month on food and accommodation.
|Cost of Liver Transplant Surgery in India||Cost of stay in hotel||Service Apartment (Foreign Nationals)||Cost of food||Total duration of stay in India (if donor available)|
$20 /day (minimum)**
Want to book a service apartment?
How do we help you with your liver transplant in India?
About almost for a decade Treatment Possible has been involved in guiding patients to undergo treatment in India, our main objective is to provide the best options for your liver transplant surgery in India at the lowest cost. Thus, we recognize the significance of the excellent health and well being of our guests by preferring association with the Best Hospitals and hepatologists in India. How does it help you?
- You find the best hospitals and surgeons in India for a liver transplant.
- You also do not need to worry about accommodation as we provide service apartments.
- You save money as your overall transplant surgery will cost you $35000 including treatment, medicines & accommodation.
We encourage you to educate yourself about the procedure, side-effects, cost of surgery, treatment plan, travel & stay, etc and then make an informed decision. An individually allocated case manager takes a personalized interest to design a tailor-made treatment plan for every guest and provide a specific time.
For an early response from a case manager, Medical History and Diagnostic Reports can be sent to our Email: firstname.lastname@example.org. We invite you for a Free Consultation with the best hepatologists in India with the assurance of hassle-free arrangements for examinations, procedures, recovery, travel and stay.
The checklist below will help you in planning your surgery in India:
Want to plan your treatment in India?
Best Liver Transplant Surgeons in India
Top 10 liver transplant hospitals in India
- Fortis Hospitals – Mulund
- Artemis Hospitals – Gurgaon
- Fortis Memorial Research Institute – Gurgaon
- Sahyadri Hospitals – Pune
- Medanta The Medcity Hospital – Gurgaon
- Gleneagles Global Health City – Chennai
Frequently Asked Question (FAQ)
The cost in India for Liver Transplant surgery is $28500.
People who have a liver transplant have an 89% chance of survival after one year. The five-year survival rate is 75%.
Transplantation is usually done in patients based on the following criteria:
- Patients who have a single liver tumor which is greater than or equal to 5cm across
- Patients who have up to five tumors smaller than or equal to 3cm across
- Patients who have a single tumor of 5-7 cm but has not grown from the last 6 months
Doctors will properly assess the patient before a liver transplant to increase the success rate.
- Water from lakes and rivers
- Unpasteurized milk products.
- Raw or undercooked eggs, meats, particularly pork and poultry, fish and other seafood.
Your total stay in India for a liver transplant will be for 2 months (if your donor is available).
Like any other organ transplant, Liver transplant also carries the risk of rejection (25-50%). Our body will see the new liver as a foreign object. Therefore our immune system works against the new liver. It can occur rapidly or gradually over some time. Therefore anti-rejection medicine is given before and after the surgery to suppress the immune system from attacking the liver. The anti-rejection drug continues for life in most of the cases but it is a low dosage. You should always be alert to symptoms of rejection like fever, fatigue, chills, nausea and jaundice. If detected early then it can be managed. This can happen even after years of transplant.
After a liver transplant, patients will be taking immunosuppression medications for the rest of their lives in virtually all cases. It is vital that these medications are taken as prescribed, in the proper amounts and at the specified times. Missing medication doses or discontinuing them on one’s own can lead to rejection and organ failure.
The age limit is individualized as it varies with a patient’s overall health condition. However, it is rare to offer liver transplant to someone greater than 70 years old.
Liver transplant is only indicated when patient can not be managed medically and their MELD or CTP scores are high. So unfortunately there is no alternative option for a liver transplant.
A physical therapist will be assigned to you after surgery who will help you do the appropriate exercise. Swimming is advised as it is a low impact exercise.
Eating a well-balanced diet is especially important after liver transplant to help you recover and keep you healthy. The hospital dietician will provide you diet chart that a liver transplant patient should consume to ensure the health of his/her liver. In general, your diet after liver transplant should be low in salt, cholesterol, fat and sugar. To prevent damaging your new liver, it’s important to avoid drinking alcohol.
Best diet practise after transplant includes:
- Eat at least five servings of fruits and vegetables each day
- Avoid fruits like grapefruit and grapefruit juice, pomegranates, or Seville oranges due to their effect on a group of immunosuppression medications.
- Have enough fibre in your daily diet
- Avoid all kinds of processed food
- Maintain optimal calcium and phosphorus levels
- Eat lean meats, poultry and fish
- Follow food safety guidelines
- Stay hydrated by drinking adequate water and other fluids each day