Liver Transplant FAQ

What is liver transplant?

A liver transplant is a surgical procedure by which a surgeon replaces a dysfunctional or damaged liver with a healthy one. Either a part of liver or whole liver is transplanted, according to the indication of the transplant. Since liver is the only organ in the body which can regenerate to increase its size, a part of liver when transplanted in the body rebuilds to the normal size liver within few weeks.

What are the indications for liver transplant?

The indications for liver transplant include:

• Liver Cirrhosis (with complications of liver cirrhosis) - loss of healthy liver cells, replaced by scar tissue
• Ascites
• Encephalopathy
• Liver cancer
• Portal hypertensive gastropathy
• Hepatopulmonary syndrome
• Portopulmonary syndrome
• Hepatorenal syndrome
• Metabolic diseases of liver
• Liver cancer - which has not spread beyond liver
• Biliary Duct Atresia - Abnormal/absence of bile ducts

What are the complications of liver transplant?

• Bleeding
• Infection
• Blood vessel blockage
• blockage of bile ducts
• New liver may not function properly for some time after the transplant
• Rejection of new liver by the body

What is the cost of liver transplant?

The cost of liver transplant in India varies from 12 lakhs to 30 lakhs

Am I eligible for liver transplant?

The patients suffering from the above mentioned diseases are usually the candidates for liver transplant. However, there are many contraindications also for the transplant. Some of the contraindications are -

• Active cancer outside the liver
• Uncontrolled infection
• If the patient is an alcoholic
• Heart Diseases
• Brain death
• Advanced age
• Portal Vein Thrombosis
• HIV Infection
• Psychiatric illnesses

Who performs the liver transplant?

The team that performs a liver transplant comprises two or more surgeons, hepatologist, anaesthesiologists, trained paramedical staff (transplant nurses & support staff). The team of doctors & trained paramedical staff (nurses, dietician, and psychologist) attends to various needs of the patient after the transplant.

What is the expected duration of the procedure?

The liver transplant procedure is a long procedure of approximately 5-8 hours. It may extend beyond 8 hours also.

How should I prepare for the liver transplant?

After the patient is declared as the candidate for liver transplant, he has to undergo few tests.

Finding a compatible donor is the most important thing to do before liver transplant.

The decision of liver transplant is not an easy decision to make. Financial issues, support by the family/friends, stress management is crucial for the patient & his family.

Some blood tests, Xrays, USG are done to assess the overall fitness of the candidate.

Alcohol & smoking should be avoided before the procedure.

What should I expect before the procedure?

After the fitness is assessed by the surgeon, anaesthetic checkup is done to assess the fitness of the patient for anaesthesia.

The doctor will explain the procedure & give you a consent form (which contains information about the procedure). Signing this consent form means your written permission for the surgery. Read the form carefully before signing it & ask questions if you have any doubts.

You will not be given anything by mouth 8-12 hours prior to the surgery; instead, you will be given fluids intravenously (with the help of IV drip).

You will be given few medications to relax you prior to the surgery.

What should I expect during the procedure?

• The patient will be asked to wear the gown & intravenous lines are placed.
• Before the surgery starts, the patient is made comfortable by engaging in a conversation by the surgeon & the anaesthesiologist.
• The anaesthesia is given via intravenous catheter.
• A tube is inserted into the lungs & connected to the ventilator to assist respiration.
• After cleaning the area, incision is made & surgery is started.
• It takes 5-8 hours for the surgery.
• The damaged liver is replaced with the new liver.
• After the procedure, the incision is closed and shifted to the ICU for further observation.

What should I expect after the procedure?

• Patient is closely observed in the ICU - Pulse, blood pressure, respiratory rate, temperature, oxygen saturation, etc are monitored at regular intervals. Blood tests are done to ensure the post surgery recovery of the patient.
• The tube in the lungs is removed after few hours or few days. The other tubes in the throat, urinary bladder are also removed after few days.
• You will be allowed to take clear fluids after your condition stabilize, followed by soft diet & normal diet.
• After the initial observation & stabilization of the patient in the ICU, he is shifted to the normal room.
• Patients are advised to get out of bed soon & move and walk around the room in the first few days.
• Before the patient is discharged, the team of doctor, dietician, psychologist, physiotherapists tell the patient about taking care at home.

What precautions should I take after the surgery?

You should take the medications as prescribed.

You should notify your doctor for any of the new signs/symptoms appearing in your body. These may be due to graft rejection.

• Fever
• Redness
• Swelling in the body
• Nausea/vomiting
• Tiredness
• Bleeding from incision site
• Abnormal discharge from incision site
• Pain in abdomen
• You should avoid consumption of alcohol
• You should avoid pregnancy for the first two years after the transplant