The Essential Guide to Liver Transplants in India

Liver Transplant Procedure

1. Anaesthesia: Before the surgery starts, the patient is given general anaesthesia to make sure they're completely asleep and feel no pain during the operation. It's like being in a deep sleep that helps keep them comfortable and safe.

2. Incision: Once the patient is under anaesthesia, the surgeon makes a large cut in the upper part of the abdomen. This cut allows them to reach the liver easily. It's usually shaped like a “J” or an inverted “T” to give them good access while causing as little disruption as possible to other parts of the body.

3. Removal of Diseased Liver: With access to the liver, the surgeon carefully disconnects the diseased liver from its blood vessels and bile ducts. This is done very carefully to avoid hurting any nearby organs.

4. Implantation of Donor Liver: After removing the diseased liver, the healthy donor liver is placed in the same spot. The surgeon makes sure it fits well and attaches it securely. This new liver will now take over the job of the old, diseased liver.

5. Connecting Blood Vessels: One of the most important parts of the surgery is connecting the blood vessels of the new liver to those of the patient. This involves carefully stitching or connecting the hepatic artery, portal vein, and hepatic veins. It's crucial because it allows blood to flow properly to the new liver, giving it the oxygen and nutrients it needs to work.

6. Connecting Bile Ducts: Another critical step is connecting the bile ducts from the donor's liver to the patient’s bile ducts or the small intestine. Bile is a fluid made by the liver that helps with digestion. Connecting these ducts ensures that bile can flow out of the new liver correctly.

7. Closure: Once everything is connected and working well, the surgeon closes the cut in the abdomen. They use stitches or staples to carefully bring the skin and muscle back together. This helps the surgical area heal properly.

Throughout the procedure, the surgical team works very carefully to make sure everything goes smoothly. Afterwards, the patient will be closely watched to make sure the new liver is working well and to check for any problems. A successful liver transplant not only depends on the surgery itself but also on careful planning and looking after the patient afterwards.

Duration and Phases of the Surgery

The liver transplant surgery typically lasts between 6 to 12 hours and involves several important phases:

1. Before Surgery: The patient is given general anaesthesia to ensure they are completely asleep and pain-free. They are carefully positioned on the operating table to prepare for the procedure.

2. Removing the Diseased Liver: The surgeon begins by carefully disconnecting the diseased liver from its blood vessels and bile ducts. This part of the surgery focuses on controlling any bleeding and ensuring the patient remains stable.

3. Temporary Without a Liver: There’s a crucial moment when the old liver has been removed, and the patient temporarily doesn’t have a liver. During this short period, surgeons work quickly to prepare for the next step.

4. Connecting the New Liver: The new liver, donated by a living or deceased donor, is then meticulously connected to the patient’s blood vessels and bile ducts. This phase restores blood flow to the liver and allows bile, a fluid essential for digestion, to drain properly.

5. After Surgery: Once the new liver is securely in place and functioning, the surgeon closes the incision. The patient is then moved to the Intensive Care Unit (ICU) for close monitoring. In the ICU, medical staff carefully watch over the patient’s recovery and ensure the new liver is working as expected.

Throughout the entire procedure, the surgical team works with precision and care to give the patient the best chance for a successful transplant. Post-surgery, ongoing monitoring and specialized care in the ICU help support the patient’s recovery and address any potential issues promptly.

Best Hospitals for Liver Transplant in India

1. Apollo Hospitals, Chennai:

Specialties:

• Oncology: Offers comprehensive cancer care, including medical oncology, surgical oncology, radiation oncology, and advanced therapies like proton therapy (first in South Asia) and bone marrow transplant.
• Cardiology: Renowned for advanced cardiac surgeries, minimally invasive procedures, interventional cardiology, and electrophysiology services.
• Gastroenterology: Provides a full spectrum of gastroenterological services, including diagnostic and therapeutic endoscopy, liver disease management, and advanced GI surgeries.
• Orthopedics: Specializes in joint replacement surgeries, sports medicine, spine surgery, and pediatric orthopaedics.
• Neurology: Offers comprehensive neurological care, including stroke management, epilepsy treatment, neurodegenerative disease management, and brain tumour surgery.

Technology:

• Cutting-edge imaging facilities like PET CT scan, 3 Tesla MRI, and high-resolution CT scan.
• Advanced robotic surgery systems (e.g., Da Vinci) for minimally invasive procedures.
• Telemedicine services for remote consultations and patient monitoring.
• A well-equipped cath lab for advanced cardiac procedures.
• Modern radiation therapy equipment, including linear accelerators and brachytherapy units.

Patient Services:

• International patient services team to assist with travel arrangements, visa applications, and language translation.
• Personalized care coordinators to guide patients through their treatment journey.
• Comfortable and well-equipped patient rooms with various accommodation options.
• Support services like nutrition counselling, physiotherapy, and psychological counselling.

2. BLK Super Speciality Hospital, New Delhi:

Specialties:

• Joint Replacement Surgery: Renowned for joint replacement surgeries using advanced techniques and computer navigation.
• Bariatric Surgery: Offers a comprehensive weight loss surgery program, including laparoscopic and robotic bariatric procedures.
• Organ Transplant Program: Provides liver, kidney, and heart transplants with a high success rate.
• Oncology: Offers medical, surgical, and radiation oncology services, including advanced cancer therapies.
• Cardiology: Provides advanced cardiac care, including minimally invasive procedures, interventional cardiology, and cardiac electrophysiology.

Technology:

• Advanced diagnostic tools like PET CT scan, 3 Tesla MRI, and high-resolution CT scan.
• Robotic surgical systems like Da Vinci Xi for minimally invasive surgeries.
• Cutting-edge cath labs for complex cardiac procedures.
• Advanced radiation therapy equipment for precise cancer treatment.

Patient Services:

• International patient services team to assist with travel arrangements and medical visa applications.
• Dedicated patient care coordinators to guide patients throughout their treatment journey.
• Comfortable and well-equipped patient rooms with a range of accommodation options.
• Support services like physiotherapy, nutritional counselling, and psychological counselling.

3. Max Smart Super Speciality Hospital, Saket

Max Super Speciality Hospital, Saket is one of the leading multispecialty hospitals in India, located in the heart of South Delhi. It is part of the Max Healthcare brand, which has a network of hospitals and healthcare facilities all over India.

Here's a summary of the Max Super Speciality Hospital, Saket:

• Established: 2006
• Number of beds: 530+
• Accreditations: JCI, NABH, NABL
• Specialities: Over 38 specialities including Cardiology, Oncology, Neurology, Neurosurgery, Nephrology, Urology, Transplant services (Heart, Lung, Liver, Kidney, Bone Marrow), Metabolic and Bariatric Surgery, Obstetrics and Gynaecology, Aesthetics & Reconstructive Surgery, and many other ancillary medical services.

Here are some of the reasons why Max Super Speciality Hospital, Saket is considered one of the best hospitals in India:

• Advanced diagnostic and therapeutic technologies: The hospital is equipped with the latest technologies for diagnosis and treatment, including several first-in-India and Asia machines.
• Team of experienced doctors: The hospital has a team of highly qualified and experienced doctors from various specialities.
• Comprehensive care: The hospital provides comprehensive care for a wide range of medical conditions, from simple to complex.
• Focus on patient care: The hospital is committed to providing quality care to its patients and has a patient-centric approach.

Explore more top hospitals for liver transplants in India.

Top Liver Transplant Surgeons in India

1. Dr. Arvinder Singh Soin (Medanta - The Medicity, Gurgaon):

• Expertise: Dr. Soin is a pioneer in liver transplantation in India. He has performed the highest number of liver transplants in the country, exceeding 3500, including a significant number of pediatric transplants.
• Focus: He is known for his expertise in both deceased donor and living donor liver transplants (LDLT), with a high success rate.
• Recognition: Dr. Soin is internationally recognized for his work and has received the prestigious Padma Shri award for his contributions to the field.

2. Dr. Vivek Vij (Fortis Hospital, Noida):

• Expertise: Dr. Vij is a renowned liver transplant surgeon with extensive experience in adult and pediatric liver transplantation.
• Focus: He has a special focus on complex liver transplant surgeries, including re-do transplants and surgeries for patients with high-risk factors.
• Recognition: Dr. Vij is known for his commitment to patient care and his use of advanced surgical techniques to achieve optimal outcomes.

3. Dr. Mohammed Rela (Global Hospitals, Chennai):

• Expertise: Dr. Rela is a highly skilled liver transplant surgeon with a strong background in both adult and pediatric liver transplantation.
• Focus: He has a particular interest in minimally invasive liver transplant techniques and robotic surgery for improved patient recovery.
• Recognition: Dr. Rela is actively involved in research and development in the field of liver transplantation and has published extensively in peer-reviewed journals.

Explore more top doctors for liver transplants in India.

Risks Associated with Liver Transplants

Liver transplant surgery involves inherent risks that patients should be aware of:

• Surgical Risks: Potential complications include bleeding and infections.
• Rejection: The body may reject the new liver, requiring lifelong immunosuppressive medications.
• Medication Side Effects: These can include infections, diabetes, hypertension, and kidney problems.
• Biliary Complications: Issues like leaks or strictures in bile ducts may occur.
• Recurrence: Underlying liver diseases may return post-transplant.

Post-Transplant Care and Recovery

After a liver transplant, recovery is a crucial journey that involves several key aspects:

1. Monitoring: You'll need regular check-ups to make sure your new liver is functioning well and to adjust your medications as needed to prevent rejection.

2. Medications: It's really important to take your prescribed immunosuppressants exactly as directed. These medications help your body accept the new liver and prevent it from being rejected.

3. Infection Prevention: Keeping up good hygiene habits and staying current on vaccinations will help lower your risk of infections. This is especially important because your immune system will be weaker after the transplant.

4. Nutrition: Eating a balanced diet is essential for healing and staying healthy. A dietitian can help you plan meals that support your recovery and the health of your new liver.

5. Activity: You'll start with light activities and gradually increase them under your doctor's guidance. Building up your strength and stamina is important as you recover.

6. Support: It's normal to have emotional ups and downs after such a major surgery. Having support from family, friends, and maybe even a counsellor can be really helpful during this time.

7. Lifestyle: Avoiding alcohol and not smoking are crucial for your liver's health and your overall well-being. Living a healthy lifestyle with regular exercise and good nutrition will support your long-term recovery.

8. Long-term Care: You'll have follow-up appointments with your transplant team to monitor your progress and check the health of your new liver. These visits are important for catching any issues early and adjusting your treatment plan as needed.

Taking care of yourself in these ways will help ensure the best possible outcome from your liver transplant and support your overall health for years to come.

Liver transplantation is a lifesaver for people with severe liver conditions. In India, you’ll find world-class medical facilities and highly skilled surgeons with impressive success rates. The whole process involves detailed pre-transplant evaluations, specialized surgery, and attentive post-operative care. Both living and deceased donor transplants have their pros and cons. Looking ahead, advancements like robotic surgery and regenerative medicine offer a lot of hope. Raising awareness about organ donation can shorten waiting times and save more lives. Staying informed, choosing the right hospitals, and living a healthy lifestyle are crucial for a successful transplant and a healthier future.