Liver Transplant and Biliary Sciences

Max Hospitals is one of India’s leading healthcare institutions with a rich history of providing top-quality medical care to patients. Established with the mission of promoting health and well-being, Max Hospitals has consistently strived for healthcare excellence, making Max Centre for Liver Transplant and Biliary Sciences a trusted choice for patients from India and overseas, who chose to come here for their treatment as the outcomes have been phenomenally successful. This has been possible because the Centre has experienced doctors and the entire team has established liver transplantation in India way back in 2001. Based in Max Centre for Liver and Biliary Sciences at Max Super Specialty Hospital, Saket & Vaishali, our team of over 200 members with 20 years of experience has performed over 2600 transplants.

Our Commitment to Excellence is Reflected in:

• World-class Facilities: Max Hospitals boasts state-of-the-art medical facilities, modern infrastructure, and a patient-centric environment. We continuously invest in upgrading our facilities to ensure the highest standards of patient care.
• Medical Expertise: Our hospitals are staffed with a team of highly skilled and experienced medical professionals, including liver doctors, surgeons, nurses, and support staff. We are dedicated to recruiting and retaining the best talent in the medical field.
• Patient-Centered Care: At Max Hospitals, the patient's well-being is our top priority. We provide compassionate care, personalized treatment plans, and support services to ensure a positive healthcare experience.
• Awards and Recognitions: Max Hospitals has received numerous awards and recognitions for our commitment to excellence in healthcare. These accolades affirm our dedication to maintaining the highest standards of patient care.

What is Liver Transplantation?

In liver transplantation surgery, the patient’s diseased liver is removed completely and a new one from a liver donor is put in the same place. The donor liver can be from a deceased person where usually the whole liver is transplanted or more commonly it is from a family member who donates part of his or her liver. Although we only have one liver in our body, it can be safely divided into 2 parts, so that one part can be taken out for transplantation and the remaining liver is sufficient for the donor. Both these portions can regenerate quickly to the liver’s original size within 4-6 weeks, though the shape will become different.

Who Needs a Liver Transplant?

Liver transplant is advised in the following scenarios:

If a person has a diseased liver where the liver cannot function to its optimum ability (known as end-stage liver disease) he/she is advised to go for Liver Transplant.

If a previously healthy liver fails acutely (known as acute liver failure) then one needs to get transplant done.

Liver cancer is another reason for the transplant. In cadaveric transplant, the wait can be unpredictable and some patients will die while waiting for a donor liver. On the other hand, living donor liver transplant can be done whenever a donor is medically fit and when the entire team is available as it is a planned operation.

What Causes Liver Failure? 

Liver failure can occur rapidly, in a matter of weeks (acute liver failure) in a previously healthy liver, or it can occur slowly over months and years (chronic liver failure). There are different causes for liver failure such as chronic viral infection with B and C virus, diabetes, alcoholism, fatty liver, bile duct abnormalities (primary biliary cholangitis, primary sclerosing cholangitis and biliary duct atresia). Hepatitis B and C are the two most common infections across the world. Luckily there is an effective vaccine for hepatitis B and cure by drugs for hepatitis C. Primary Liver Cancer develops in chronically diseased livers and sometimes spreads rapidly so that no treatment is possible. Liver transplant can be curative for patients with liver cancer (subject to certain criteria).

Eligibility for Liver Transplant

Eligibility for a liver transplant is determined based on a thorough evaluation of a patient's medical condition, overall health, and specific criteria established by the specialists at transplant centers. While the exact eligibility criteria may vary between institutions, here are some common factors considered when evaluating a patient for a liver transplant:

• Liver disease severity: The primary factor in determining eligibility is the severity of the liver disease. Typically, patients with end-stage liver disease or irreversible liver failure are considered for transplant. This is often indicated by a low Model for End-Stage Liver Disease (MELD) score, which assesses the severity of liver dysfunction.
• Underlying diagnosis: The specific cause of liver disease, such as liver cirrhosis, hepatitis, alcoholic liver disease, autoimmune conditions, or metabolic disorders, is considered. Some underlying conditions may affect eligibility.
• Absence of contraindications: Certain medical conditions or factors, known as contraindications, may disqualify a patient from a liver transplant. These may include severe heart disease, active infections, and certain types of cancer.
• Sobriety and substance abuse: Patients with a history of substance abuse, particularly alcohol or drug addiction, may be required to demonstrate a period of sobriety and commitment to maintaining abstinence.
• Psychosocial evaluation: A psychological and social evaluation is conducted to assess the patient's ability to cope with the stress of the transplant process and to adhere to the necessary post-transplant lifestyle changes, including medication regimens.
• Support system: Having a strong support system is important. Patients should have family or caregivers who are willing and able to assist with post-transplant care, as recovery can be challenging.
• Age and general health: Age is not an absolute barrier to liver transplantation, but the patient's overall health, and ability to tolerate surgery and recover post-transplant are considered.

Note: The evaluation process for a liver transplant is complex and individualized, and not all patients with end-stage liver disease may be eligible.

Liver Transplant Process

1. Pre-Transplant Evaluation

• Medical history and testing: The patient undergoes a comprehensive medical evaluation, including blood tests, imaging, and diagnostic tests to assess the severity of their liver disease.
• Psychosocial assessment: Patients and their support system are evaluated to ensure they can cope with the emotional and psychological aspects of the transplant process.
• Financial counselling: The financial feasibility of the transplant is reviewed to ensure the patient can cover the costs or has adequate insurance.

2. Organ Matching and Donor Selection

• Placement on the waiting list: If the patient is deemed eligible, they are placed on a national or regional waiting list for a deceased donor liver. Priority is determined based on the Model for End-Stage Liver Disease (MELD) score.
• Living donor option: For living donor transplants, potential living donors (typically a family member) undergo medical and psychological evaluations to ensure compatibility and willingness to donate.
• Organ allocation: When a suitable deceased donor liver becomes available, it is allocated to the most suitable recipient based on blood type, size match, and MELD score.

3. Surgery

• Recipient surgery: The recipient is prepared for surgery. The transplant surgery is performed under general anaesthesia and typically takes 8-10 hours. The damaged liver is removed, and the healthy donor liver is implanted.
• Donor surgery (if applicable): In the case of a living donor transplant, the donor undergoes surgery to remove a portion of their liver. The recipient's new liver is then transplanted using this living donor graft.

4. Post-tTansplant Care

• Immediate recovery: After surgery, the patient is closely monitored in the intensive care unit (ICU).
• Immunosuppression: Patients must take immunosuppressive medications to prevent rejection of the transplanted organ. These medications are carefully managed to balance the need to suppress the immune system while minimizing the risk of infections. The patient needs to be on these medicines lifelong.
• Follow-Up appointments: Regular follow-up appointments are essential to monitor the patient's progress and make any necessary adjustments to medications or treatment plans.
• Lifestyle changes: Patients are advised to maintain a healthy lifestyle, which includes diet, exercise, and abstaining from alcohol or substances that may harm the liver.

5. Success Rates and Patient Outcomes

• Survival rates: Max hospital ensures that the patient receives the intense care during and after the surgery. Currently, the success rate of Liver transplant is over 95% and 10-year survival is over 80%.
• Quality of life: Many transplant recipients experience a significant improvement in their quality of life, as the new liver allows them to resume normal activities and alleviate symptoms of liver disease.
• Complications: While liver transplant is successful for many, there can be complications, including rejection, infections, and side effects from immunosuppressive medications. These risks are carefully managed by the medical team.

If you or a loved one needs specialized medical care in the field of liver transplant and biliary sciences, you can count on the expertise and care provided by Max Hospitals. With a commitment to healthcare excellence, cutting-edge technology, and a team of renowned  Liver transplant specialists, Max Healthcare is ideally positioned to offer patient-centered care, with our exceptional success rates in liver transplants making us a top choice for those seeking liver transplant in India. Begin your journey toward better health with a consultation at Max Hospitals, where world-class medical care paves the way for a brighter, healthier future.

Frequently Asked Questions about Liver Transplant

Q. What are the signs and symptoms of a sick liver?

Common signs and symptoms of liver disease include jaundice (yellowing of the skin and eyes), fatigue, abdominal pain, swelling in the abdomen, unexplained weight loss, dark urine, pale stools, itchy skin, nausea, and vomiting.

Q. Is liver transplant safe?

Liver transplant is considered a safe and effective treatment for end-stage liver disease when performed in a reputable medical center by an experienced transplant team. Like all surgeries, there are risks, but the benefits often outweigh them for suitable candidates.

Q. Can one live a normal life after a liver transplant?

Yes, many liver transplant recipients go on to lead normal and fulfilling lives after their recovery. They can resume work, engage in regular activities, and enjoy an improved quality of life.

Q. What is the age limit for liver transplant?

There isn't a strict age limit for liver transplant. The eligibility for transplant is determined based on overall health and the ability to withstand the procedure. Older individuals may be considered if they are otherwise healthy.

Q. Is liver transplant a major surgery?

Yes, liver transplant is a major surgical procedure. The surgery is performed under general anesthesia and can take several hours.

Q. How long is liver transplant surgery recovery?

The initial hospital stay following a liver transplant is typically about 2 to 3 weeks. Full recovery may take several months to a year, depending on the patient's overall health and the success of the transplant.

Q. Which is the best hospital for the liver transplant in India?

There are several excellent hospitals in India known for their liver transplant programs. The choice of the best liver transplant hospital may depend on your specific needs and location.

Q. How can I book an appointment with a liver specialist at Max Hospitals?

You can book an appointment with a liver transplant specialist at Max Hospitals through our official website, or can also contact the hospital directly. All of our hospitals have a patient services department that can assist you with the appointment process.

Review

Reviewed by Dr. Rajesh Dey, Associate Director - Liver Transplant and Biliary Sciences, Robotic Surgery, Paediatric Liver Transplant on 16-Jan-2024.