The procedure of removing a part/whole of diseased liver and replacing it with a new functioning liver is called liver transplantation.
Liver is an important organ in the body. It performs many essential functions. Broadly liver functions can be classified as synthetic functions, excretory functions, and metabolic functions. The healthy functioning of the liver is imperative for general well-being of a person and for normal functioning of the other organs of the body like the kidney, lungs, brain, heart, blood clotting/coagulation, and circulatory system.
Liver has a remarkable capacity to regenerate when it suffers any injury in form of substance abuse, infection, metabolic disease, poisoning or other insults. However, in the event of recurrent insults, the liver’s regenerative capability gets impacted and it regenerates with scarring. This is called chronic liver disease. The liver function starts declining as the scarring progresses. When the liver function declines, it starts impacting other organ systems of the body, which is medically called ‘a decompensated state’. Once the body is not able to compensate the failing liver, one requires a liver transplantation.
Liver transplantation can be done in two ways – deceased donor liver transplantation (DDLT) and living donor liver transplantation (LDLT). DDLT involves liver donation from a brain-dead donor to a patient, who needs a liver transplant and who is listed on the DDLT recipient waiting list. Liver is donated by a healthy person from the family in LDLT.
Liver transplantation is a complex surgery and requires experience and teamwork. The recipient surgery and donor surgery go on simultaneously in two different operation suites. The donor liver is taken out and prepared for implantation. At the same time, recipient’s liver is also taken out. The donor liver, once prepared, is then placed in recipient’s body. The donor hepatic vein, portal vein, hepatic artery and bile duct are joined with recipient’s blood vessels and bile duct. The whole procedure takes approximately 10-12 hours.
After surgery, the recipient has to stay in ICU for approximately 5-7 days. The total hospital stay is approximately 10-14 days. In a living donor liver transplant, the donor needs to stay in the hospital for approximately 6-8 days. There are generally no long-term effects of donor surgery. The livers in the donor and recipient grow back to normal size in approximately 2-3 months.
Thomas Starzl is credited with the first attempt at human liver transplantation in 1963. The first successful liver transplantation was done in 1967. The initial liver transplantation surgeries were all done with deceased organ donors. The first living donor liver transplantation was done in 1989 for a pediatric patient. The first adult living donor liver transplantation was done in 1996. The first living donor and deceased donor liver transplantations in India were done in 1998. Over the years liver transplantation surgery has come a long way. It is now safer, protocolized, and has now good long-term outcomes in most patients. Presently, approximately 1500-2000 liver transplants are done in India.
Liver transplant Cost in Ahmedabad and India
The transplant surgery used to cost a fortune in its initial days. With major advances in technology and medicines and more centers coming up with transplant programs, the cost has come down significantly in last few years. Presently, the surgery costs anywhere between 15 lacs and 30 lacs in our country. There are few government hospitals, who have started liver transplant surgeries. The surgical cost is quite lower in such hospitals.
