Overview
Most liver transplant candidates are put on a waiting list until a healthy liver becomes accessible. The need to put on a waiting list is because more individuals require liver transplants than there are liver donors.
The waiting time can vary based on factors such as the patient’s blood group. For instance, individuals with blood group AB may have a shorter waiting time than those with blood group O. Read how long the average waiting time is for a liver transplant.
What is a Liver Transplant? 1
A liver transplant is a procedure where a healthy liver replaces a diseased one. It is possible to transplant the entire liver or simply a part of it.
A healthy liver is usually taken from a recently deceased organ donor or a living person. A living donor should preferably be a first or a second degree-relative.
Need for a Liver Transplant 2
Nobody can survive without a healthy liver. A liver transplant may save a life if the liver is damaged, i.e. the patient has end-stage liver disease (chronic liver failure).
The following conditions require a liver transplant:
- Cirrhosis,
- Biliary Atresia,
- Acute Hepatic Necrosis,
- Metabolic Diseases,
- Autoimmune Hepatitis, etc.
Liver Transplant Evaluation Process 3
Comprehensive testing is required for liver transplant candidates. The patient interacts with the transplant coordinator, hepatologist, surgeon, counsellor, and nurse instructor, among other members of the transplantation team.
For the examination for a liver transplant, the patient must bring all medical documents. It includes X-rays, liver biopsy, and a list of all their prescription drugs. The group of professionals may carry out tests such as:
- Blood tests examine the patient’s blood and determine how well their liver functions. The patient will also have tests for hepatitis, Epstein-Barr, herpes, and HIV.
- Chest X-rays and CT scans will also examine the heart and lungs.
- Doppler ultrasound determines whether the liver’s blood arteries are open.
- Checking the patient’s heart with an echocardiogram.
- Pulmonary function tests mainly evaluate the efficiency of oxygen and carbon dioxide exchanges in the patient’s lungs.
The interdisciplinary liver transplant team next reviews the case and decides if the patient qualifies for a transplant.
Waiting Period for a Liver Transplant 4
The recipient has to register for organ donation at the National Organ and Tissue Transplant Organization (NOTTO) registration website. The typical waiting period for a liver transplant is approximately 6 to 12 months. The waiting period for a liver transplant can vary depending on certain factors. It includes:
- Variable Waiting Time: The waiting period for a liver transplant is not fixed and can vary from patient to patient. It depends on factors such as the severity of the patient’s liver disease and the availability of suitable donor organ.
- Priority and Severity: Patients with more severe liver disease are given higher priority on the transplant list. Those critically ill or with advanced liver failure may have a shorter waiting time.
- Organ Availability: The availability of donor organ is a significant factor in determining the waiting time. The number of donors and the compatibility between donor and recipient play a crucial role.
- Geographic Location: The waiting time can also be influenced by the geographic location of the transplant centre. Different regions may have varying numbers of potential donors and patients on the waiting list.
- Ongoing Communication: Patients and their families are encouraged to communicate openly with the transplant centre and healthcare team. Regular updates on the waiting time and the patient’s condition are essential for optimal preparation.
- Preparation for Transplant: While waiting, patients undergo thorough evaluations and medical assessments to ensure they are in the best possible condition for the transplant surgery.
What to do While Waiting? 5
When the patient is on the waiting list, they should do as much as possible to keep themselves healthy. Some of the things a patient can do to stabilise the situation are:
- Eat a balanced diet.
- Exercise regularly (if they can).
- Check that all of the required vaccinations are valid and up to date.
- Maintain frequent dental examinations.
- Plan arrangements with the people they can go with to the transplant centre immediately after they get the phone call.
- No smoking and drinking.
- Use birth control to prevent pregnancy.
- Set up a hospitalisation pack to bring to the hospital on short notice.
What to Do When Liver Becomes Available? 6
When a liver becomes available for a transplant, it is crucial to act promptly and follow the necessary steps to ensure a successful transplant process.
- Contact from Transplant Center: The transplant centre will notify the patient or their designated representative when a suitable liver becomes available for transplantation.
- Immediate Response: Patients must be ready to respond quickly to the transplant centre’s call. Any delays can result in the liver being offered to another patient.
- Medical Assessment: Once notified, the patient must immediately go to the transplant centre for further medical assessments. This will help to determine their current health status and suitability for the transplant.
- Preparation for Surgery: If deemed suitable for the transplant, the patient will be prepared for the surgery. This may include blood tests, imaging scans, and other evaluations.
- Consent and Paperwork: The patient or their attendant must give informed consent for the surgery.
- Surgical Procedure: The liver transplant surgery will occur as soon as possible after the liver becomes available. The surgical team will replace the diseased liver with a healthy donor liver.
Risks and Complications of the Liver Transplant 7
The general success rates of liver transplantation have increased over time. However, a liver transplant still has risks as it is a complex procedure:
- Surgical Complications: As with any major surgery, a liver transplant carries the risk of surgical complications such as bleeding, infection, and blood clots. The surgical team and medical staff typically manage these risks.
- Organ Rejection: The body’s immune system may recognise the transplanted liver as foreign and attempt to attack it. The patients are prescribed immunosuppressant medications to reduce the risk of organ rejection.
- Infection: Immunosuppressant medications can weaken the body’s ability to fight infections, making transplant recipients more susceptible to various illnesses.
- Bile Duct Complications: Problems with the bile ducts (it carries bile from the liver to the intestine) can occur after a liver transplant. These complications may require further medical intervention.
- Blood Vessel Complications: Issues with the blood vessels that supply blood to the new liver may arise, leading to potential complications that require additional treatment.
- Side Effects of Medications: The medications used to prevent organ rejection can have side effects, including weight gain, bone thinning, high blood pressure, and an increased risk of certain cancers.
Liver Transplant Cost 8
The starting price for a liver transplant in India is ₹ 15,00,000. A liver transplant cost, on average, ₹ 19,00,000. Up to ₹ 24,000,000 may be the maximum cost of a liver transplant. The following are a few variables that could impact the liver transplant cost in India:
- Pre-workup and Tests (Donor and Patient Matching)
- Available Donor (Living, Deceased or ABO Incompatible)
- Surgery Technique (Orthotopic, Laparoscopic or Robotic)
- Hospital Stay
- Medications
- Recovery after surgery
Takeaway
The liver is essential for the body’s metabolic process and produces proteins crucial for blood coagulation. A liver transplant can address chronic liver impairment.
The best approach to learning more about liver transplants, waiting lists, and costs is to contact HexaHealth. It assists patients throughout their surgical journey, starting with selecting the best surgeon and facility. Therefore, make sure to get started and book your consultation today!
References:
- https://my.clevelandclinic.org/health/treatments/8111-liver-transplantation
- https://www.mayoclinic.org/tests-procedures/liver-transplant/about/pac-20384842
- https://www.webmd.com/hepatitis/digestive-diseases-liver-transplantation, https://www.beaumont.org/conditions/liver-transplant-evaluation-process
- https://aasldpubs.onlinelibrary.wiley.com/doi/pdf/10.1002/lt.24459, https://www.niddk.nih.gov/health-information/liver-disease/liver-transplant/preparing-transplant#:~:text=The%20waiting%20period%20for%20a,to%20more%20than%205%20years.&text=How%20long%20you%20will%20wait,you%20need%20a%20new%20liver.
- https://www.nhs.uk/conditions/liver-transplant/waiting-list/
- https://my.clevelandclinic.org/health/treatments/8111-liver-transplantation
- https://www.nhsbt.nhs.uk/organ-transplantation/liver/benefits-and-risks-of-a-liver-transplant/#:~:text=Infections%20and%20bile%20duct%20complications,liver%20doesn’t%20work%20properly
- https://www.adotrip.com/medical-tourism/hepatology/liver-transplant-cost-in-india