At HCG, before recommending liver transplantation, each patient undergoes a transplant assessment to determine if a transplant is required. This assessment involves comprehensive medical tests and discussions with the transplant team, caregivers, and the patient. Additionally, a general check-up is conducted to evaluate the patient's existing medical conditions and how they may affect the planned transplantation.
Liver transplantation becomes necessary in the case of both acute and chronic liver failure. The liver specialists may recommend a liver transplant, if the patient is diagnosed with the following conditions:
Liver transplantation may be required in cases of acute or subacute fulminant liver failure, where the cause of liver failure is unknown and occurs suddenly.
Liver transplantation is classified into two types based on the donor:
To receive a deceased donor liver transplant, the patient needs to be registered with the Zonal Coordination Committee based on their blood group. When a liver becomes available, the hospital will inform the patient, and with their consent, the transplant team will prepare for the procedure.
Waiting periods can last several months, but for patients with aggressive hepatocellular carcinoma, minimally invasive procedures such as TACE, TARE, or RFA may be used to delay disease progression while waiting for a liver transplant. In some cases, the liver can be harvested from a brain-dead donor with family consent and transplanted to a suitable recipient.
The liver may be transplanted as a whole or split into two parts to help two patients.
Living donor liver transplantation is a successful alternative to deceased donor liver transplants, with benefits such as excellent graft function, reduced waiting time, and a decreased risk of death for the recipient. However, this procedure puts the donor's health at risk and can lead to other complications.
Donors are required to undergo a comprehensive evaluation process before the transplantation procedure. The evaluation process usually involves blood tests, imaging tests, and consultations with specialists. Living donors must be in excellent physical and emotional health, have no history of cancer or active infections, and have a normal and healthy liver function, as donor safety is the top priority during assessment and donation.
The living donor must be aged between 18 and 50.
Should be a blood relative or spouse of the recipient. Donations by first-degree relatives are cleared by a hospital committee, but donations by second-degree relatives need clearance from the state government. The transplant coordinator can provide guidance, but the family is responsible for obtaining clearance.
Living donations must be completely voluntary.
The blood vessels to the liver and the bile ducts in the liver must be suitable for transplantation.
Donors should have caregivers, family, and friends who can support them before, during, and after surgery.
It is the donor’s responsibility to communicate if there are any concerns or issues that need to be addressed regarding the assessment or if they have a change of heart and do not want to donate.
At any point, if the surgeon feels that the donor may not be a suitable candidate, he will not go ahead with the procedure, as the donor’s safety is crucial.
Once the tests and consultations are completed, the transplant team will meet to review the results. If there are no contraindications, the recipient is prepared to go forward; otherwise, they will be placed on the waiting list for a liver transplant.