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Yes, once we remove it by surgical means, the new liver will be implanted in the same location and liver anatomy is restored.
Each patient is evaluated on a case-by-case basis to assess the performance status and the fitness for transplant, but it is uncommon to offer transplantation to patients who are older than 75 years of age.
Each patient is evaluated on a case-by-case basis to assess the performance status and the fitness for transplant, but it is uncommon to offer transplantation to patients who are older than 75 years of age.
Yes, we are experienced in ABOi (incompatible) liver transplantation. It carries an additional 5% complication rate for the recipient and the donor risk remains the same as any other donor. For further details and process kindly contact the team.
Early-stage cirrhosis with no life-threatening infections, controlled ascites, mild jaundice and good performance status patients can afford to wait and be under close follow up with their Liver specialist.
The success is about 90-95% in our experience but the key factor is the performance status of the patient which is the ability to take care of their daily needs independently
Transplantation is the last chance of ensuring a better quality of life for many and helps patients enjoy a life filled with more freedom, energy and productivity. Long-term follow-up care is less time-consuming than before. It is also more cost-effective than multiple admissions and supportive liver care medicines. Therefore is a preferable treatment for many patients. You will have no restrictions on fluid intake and diet after receiving a transplant. Many patients also return to work and lead a full life after transplant.
Early rejection happens in about 4-6% percent of patients, which is the lowest it has ever been. However, most people will not lose their liver from this kind of rejection. Among all other solid organ transplants, the rejection rate is much lesser in the liver as it is the most tolerant one.
Liver Transplant is a major surgery and as such, carries a risk of significant complication
The complication rate overall is 5-8%
Yes, we have a pediatric transplant programme
Living donor cost 18 lakhs and a cadaveric donor costs between 22-24 lakhs
Yes, Most hospitals cancel electives during this period. But priority cases are performed based on donor availability and presurgical evaluation. Covid wards and general wards are strictly separated without any overlap or contact, also doctors undergo rigorous covid testing often.
Yes, Current studies show that comorbidities like liver cirrhosis can be fatal coupled with Covid 19. Patients need to adhere to certain guidelines set by the World Health Organization strictly to avoid dire outcomes. They should:
Recent studies show that Covid 19 does have a direct impact on a healthy liver. The studies are still underway but researchers believe that there seem to be direct relation and more solid verification. Lancet reports that ‘Patients with severe COVID-19 seem to have higher rates of liver dysfunction and 2%‐11% of fatalities had prolonged liver disease or underlying liver conditions’.
Yes, the National Organ & Tissue Transplant Organisation issued a statement regarding this:
A rigorous epidemiological survey should be conducted among potential donors and their families Individuals who have been exposed to a confirmed or suspected COVID-19 patient within the last 14 days, who have returned from nations with more than 10 infected patients and those whose cause of death was unexplained respiratory failure should not be accepted as deceased donors. In case a transplant is to be done in an acute emergency setting, it should be performed with appropriate assessment and evaluation of COVID-19 infection in the donor as well as the recipient. American Society of Transplantation also recently put out the statement that the risk of acquiring COVID-19 from organ donation is low.
Yes, By following the appropriate:
Yes, the National Organ & Tissue Transplant Organisation issued an advisory specifically for post transplant patients. It is as follows.
Transplant patients might be at risk for COVID 19 due to immunosuppressed state. They may not manifest symptoms like the general population. Fever may be absent in all cases as reported from study from China. Transplant units are advised to consider ways to limit hospital attendance for patients, such as:
Patients with stable graft function and adequate drug supply can avoid routine follow up visits to transplant hospitals
Yes, once we remove it by surgical means, the new liver will be implanted in the same location and liver anatomy is restored.
After careful evaluation of their diabetic /hypertensive/thyroid status, the team will decide upon the risk involved of such donors.
An obese or overweight individual is at the risk of having fatty liver disease, such donors will be enrolled on the weight loss programme under the guidance of our dietician and physiotherapist and reassessed.
After carefully choosing the donor through 3 phases of evaluation the risk involved is only about 0.1 – 0.2% in the best of our hands.
No. You are at no statistically greater risk of developing liver failure after donating than anyone else.
Yes, 90% of the liver regrows in 2-3 months span.
While considering a donor we make sure it is safe, feasible and donation has no long term effect on the donor. You will have multiple follow-up office visits and laboratory tests with the Transplant Team up to a year after the surgery. Although recovery time varies, most donors return to normal activities after four to six weeks, depending on the physical demands of your daily living and work tasks. You may not be able to drive for up to four weeks. You may have lifting restrictions for at least six weeks. It is important to talk to the Transplant Team about what to expect.
No, the procedure itself will not shorten your lifespan. In fact, donors have typically lived longer than the average population because they are usually in very good health, to begin with.
No, it doesn’t affect your future pregnancy and fathering a child. It is typically recommended that you wait for pregnancy at least six months after surgery. Be sure to talk with your physician or gynaecologist about your interest in the donation and the effect it could have on future pregnancies. Living donors must be in good overall health, both physically and psychologically. Gender and race are not factors. We ensure the safety, feasibility and no long term effect on the donors from their donation
Periodic assessment is required to assess the fitness and performance status of the patient who is listed with us.
Your position on the waitlist changes based on many factors according to the organ allocation system through NOTTO (national organ & tissue transplant). These factors include your blood type, your time of registration and the characteristics of the donor. Given the current system, it is not possible to give you an actual number.
The average waiting time varies according to different blood types and organs specifically and can range from 3 months to 1 year. Waiting time differs from a transplant centre to the next.
Each centre maintains its own waitlist for their patients. Because not all patients are listed at the same centre, the lists are always different.
Yes, if you choose to. Being on more than one waitlist in different states can potentially decrease the time you are waiting for a transplant because you could now draw on a larger pool of deceased donors. Therefore, for multiple listings may be beneficial, it would be important to be listed in transplant programs that are located in different states.
There are times when your status might change from being “active” on the waitlist to being “on hold”. During the time when you’re listed as on hold, you continue to accrue waiting time and seniority. However, you will not be available for a deceased-donor transplant. Your coordinator will let you know what is needed prior to reactivating you on the waiting list. The reasons for being on hold vary but might include health changes such as infection or hospitalizations. It may also include compliance issues or administrative issues such as your chart not being up-to-date.
Because you never know where you will be when they reachback, it is important to always be ready. The Transplant Team must have a list of contact phone numbers for you so they can reach you 24-hours a day. Carry your phone with you at all times. Keep your cell phone with you at all times and be sure that the ringer is always turned on. Update the Transplant Team if you go on a trip. Upon your return, call the Transplant Coordinator to update your status. Again, it is your responsibility to be available. Your place on the waiting list may be jeopardized if they cannot reach you and you cannot get there in a timely fashion.
Ideally, you should be at the hospital just after the transplant team calls you about an organ has become available. Cadaver organs can deteriorate quickly so the sooner you can get to the hospital, the better—measured in hours, not days.
Generally speaking, your recipient surgery takes 10-12 hours and for the donor will be 6-8 hours long, although many factors can affect the time required. You will be under general anaesthesia.
After your transplant, you will wake up in the Operating Room and will then be transferred to the Isolated Liver Transplant ICU for close monitoring. The average stay depends on individual needs. Usually, the recipient will be moved out of ICU on the 4th day and the donor will be out on the 2nd postoperative day. Infection and rejection are serious concerns with any organ transplant. Precautions to prevent infection and rejection will be started as soon as you are moved to the ICU. Adequate pain management, Medications and fluid will be given to you through an IV for the first few days after your transplant. You will then learn your medications and how to care for your transplanted liver.
The average time in the hospital after an uncomplicated liver transplant is 11-14 days for the recipient and 5-6 days for the donor.
The odds are excellent. The living liver donation has the best track record of all forms of donation. Statistics from the Organ Procurement and Transplant Network show that the liver donated from living donors is still functioning in 90% cases after 5 years.
Both donor and recipient will be admitted to the hospital evening before the day of surgery. All preoperative testing will have been completed, so you and your recipient will proceed for the surgery. Once there, the staff will start an intravenous (IV) line through which fluids are administered. You will then meet with your surgeon, who will answer any remaining questions and will have you complete a consent form for the procedure. A nurse will escort you to the operating room when it is time for surgery. Shortly after arriving in the operating room, the anesthesiologist will give you sedation medicine through the IV, and a urinary catheter will be inserted into the bladder. Shortly thereafter, the surgery will begin.
Although recovery time varies, post-surgery donor and recipient return to normal activities after four to six weeks, depending on the physical demands of your daily living and work tasks. You may not be able to drive for up to four weeks. You may have lifting restrictions for at least six weeks. It is important to talk to the Transplant Team about what to expect. Recipients will have multiple follow-up office visits and laboratory tests with the Transplant Team. It’s important to attend all appointments to make sure that you are recovering appropriately. The information collected during the follow-up process is also critical to help future potential living donors to make informed decisions.
Routine exams, blood work, laboratory testing and frequent clinical visits are necessary to a successful recovery. Prepare for at least two to three visits to the clinic each week to have blood drawn and participate in a thorough review of your recovery progress. These tests will determine whether or not your current medications are appropriate or need to be adjusted. The main test used to monitor your new liver is the liver function and creatinine test. As you progress through your recovery, the need to visit the Transplant Center will be less frequent, and you’ll eventually be on our long-term programme
Yes, recipients need to take immunosuppression lifelong and adjust the dose based on the serum tac level. For the donor, only short-term painkillers will be necessary after the completion of the operation and during recovery. You will not need any long-term medication as a result of your donation.
We have nurses who are specialized in the field of pre and post-transplant care.
Our organ and patient survival rates at 1 and 5 years are 90 & 89% and 88 & 86% respectively. Our results are on par with any top-notch Centre across the globe.
The quality of organ depends on multiple factors including:
The quality and & longevity of the organ may be better in a living donor situation where all the above criteria may not come into play. We ensure that the donor will undergo a safe operation whose feasibility to donate has been properly evaluated and will have no long term effects of donation.
A registered dietician specializing in the care of transplant patients assists with nutritional care before transplant to help with weight loss or maintenance, as well as guidelines for preserving liver function. Post-transplant, patients often experience side effects of medications that benefit from nutritional interventions. Additionally, Medicare regulations require the transplant centre to have a dietician assess each patient before waitlist placement.
The transplant coordinator will guide you through the transplantation process.
Even with the use of immunosuppressants, your body can at times recognize your transplanted organ as a foreign object and attempt to protect you by attacking it If and when you suffer an episode of rejection, remember it does not mean you will lose your new liver but your new liver is failing . Most rejections are mild and easily treated by making adjustments to immunosuppression medication dosages. Rejection occurs most often in the first six months after transplant. The chance of rejecting your new liver decreases with time, but rejection can occur at any time after transplant. Most rejection episodes do not have symptoms and are usually picked up through routine blood work. However, if symptoms do occur, the most common signs of rejection are:
After the transplant, medications are given that lower the immune system to protect the new liver. These medications leave your loved one at a much higher risk of infection. You will be asked to wash your hands, wear gloves and a mask—all for the safety of your loved one
A very common question. While a liver transplant may allow you to have a better quality of life, it is not a cure. It is an ongoing treatment that requires a lifetime commitment full of medications, doctor visits and tests. It will, however, provide you with a better lifestyle, more energy and should provide you with a level of self-worth that you may not have had while on medication.
Liver transplant patients, on average, cannot drive for up to 8 weeks following the surgery. Post-operative medications generally cause drowsiness, weakness, blurred vision and hand tremors and could make handling a motor vehicle very difficult. Please do not attempt to drive a vehicle without the consent and clearance of the transplant team.
Patients usually return to work within 60 to 90 days.
The only other lifestyle change we encourage is for transplant patients is to wear a mask if more than 10 people in a closed room & not to be involved in contact sports for a year. We recommend that you stay active, avoid smoking and alcohol, and stick to a healthy diet.
The goal should be complete abstinence and the first year post-transplant is the highest risk period.
Yes, it is important to stop drinking and if you have a history of heavy alcohol use, it is very important to tell your doctor.
Strict abstinence at least 6 months post-donation and your doctor will tell you when it is safe for you to drink again.
Rejection is the most common and important complication that may occur after receiving a transplant. Since you were not born with your transplanted liver, your body will think this new tissue is “foreign” and will try to protect you by “attacking” it. Rejection is a normal response from your body after any transplant surgery. You must take anti-rejection medicine exactly as prescribed to prevent rejection.
There are two common types of rejection:
Even with the use of immunosuppressants, your body can at times recognize your transplanted organ as a foreign object and attempt to protect you by attacking it If and when you suffer an episode of rejection, remember it does not mean: You will lose your new liver is failing Most rejections are mild and easily treated by making adjustments to immunosuppression medication dosages. Rejection occurs most often in the first six months after transplant. The chance of rejecting your new liver decreases with time, but rejection can occur at any time after transplant. Most rejection episodes do not have symptoms and are usually picked up through routine blood work. However, if liver damage symptoms do occur, the most common signs of rejection are:
Rejection is due to the same immune response that protects yourself against colds and other viruses. Though we run tests to indicate how likely rejection will be, there is no way to be sure about whether rejection will happen or not.
Early rejection happens in about 6-7% percent of patients, which is the lowest it has ever been. However, most people will not lose their liver from this kind of rejection. It can be easily treated if identified early.
Rejection is a signal that your immune system has identified the new kidney as foreign tissue and is trying to get rid of it. Preventing rejection with immune-suppressing medication is a priority. The most common sign of rejection is a change in liver function (an increase in liver enzymes), as measured by a blood liver test. This is why you need frequent blood testing in the first three months after transplantation and regular testing after that. If a liver confirms the rejection episode, then the transplant team will increase the amount of anti-rejection medication or prescribe a different combination of anti-rejection drug therapy. Using medicine, we can successfully reverse most rejection episodes, if we detect it early enough. However, if the episode is severe, it may shorten the overall life span of the new liver.
Anti-rejection (immunosuppressant) medications decrease the body’s natural immune response to a foreign substance (your transplanted kidney). They suppress your immune system and prevent your body from rejecting your new liver.
Liver rejection is hard to diagnose in its early stages. Rejection is often not reversible once it starts. You should never stop taking your anti-rejection medication no matter how good you feel and even if you think your transplanted liver is working well. Stopping or missing them may cause rejection to occur.
Here are some tips to help you take your anti-rejection (immunosuppressant) medication as directed:
Make taking your medicine part of your daily routine Use digital alarms and alerts to remember when to take your medication. Be creative because it is easy to forget, especially once you are feeling well. Know all of your medications by name and dose. Know the reason for taking each medication. Ask for and review all written instructions for any change in medication dose or frequency Tell your transplant team of problems and concerns about medications during every clinic visit If a doctor other than a member of your transplant team gives you a prescription, notify the transplant team before taking.
Certain medications can interfere with your anti-rejection medications and keep them from working.
Continue to take your anti-rejection medication no matter how great you feel, even if you think your transplanted liver is working well. Stopping them may cause rejection to occur.
Yes Anti-rejection (immunosuppressant do have side-effects like high blood pressure, and weight gain, an increased chance of having infections, and increased risk of some forms of cancer etc. which are usually manageable for most patients. Blood levels of anti-rejection medications will be checked regularly to prevent rejection and lessen side-effects. If side-effects do occur, your doctor may change the dose or type of medications.
There are 3 groups of anti-rejection (immunosuppressant) medications:
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