Liver Transplant Treatment in India

A liver transplant is a complex surgical procedure where a diseased or failing liver is replaced with a healthy liver from a deceased or living donor. It is a life-saving treatment for end-stage liver disease and acute liver failure when no other treatments are effective. The procedure involves removing the damaged liver and connecting the donor liver to the patient's blood vessels and bile ducts. Performed by a specialized liver transplant surgeon, this major operation requires a multidisciplinary team and is followed by lifelong immunosuppressive medication to prevent organ rejection. It offers a chance for a significantly improved quality of life and long-term survival for eligible patients.

A liver transplant is recommended for people whose liver can no longer function properly and when no other effective treatments remain. It is typically considered when advanced liver disease threatens life or significantly impacts quality of living.

Candidates Who May Benefit From a Liver Transplant

1. End-Stage Liver Disease (ESLD)

ESLD is the most common reason for transplant. It occurs after long-term liver damage leads to liver failure. Common causes include:

• Cirrhosis from chronic hepatitis B or C
• Alcohol-related liver disease
• Non-alcoholic fatty liver disease (NAFLD / NASH)

2. Acute Liver Failure

Sudden, severe loss of liver function — often caused by infections, medication toxicity (such as acetaminophen overdose), or autoimmune disease — may require urgent transplantation.

3. Certain Liver Cancers

A transplant may be an option for patients with hepatocellular carcinoma (HCC) or other liver tumors that meet specific medical criteria.

4. Genetic or Metabolic Disorders

Inherited or metabolic conditions that damage the liver may require transplantation, such as:

• Wilson’s disease
• Hemochromatosis
• Alpha-1 antitrypsin deficiency

5. Pediatric Liver Conditions

Children with congenital or early-onset liver diseases — including biliary atresia and metabolic disorders — may also be candidates for liver transplant.

Who Is Not Typically a Suitable Candidate?

A liver transplant may not be recommended for individuals with:

• Active, uncontrolled infections
• Untreated alcohol or substance dependency
• Severe, irreversible heart or lung disease
• Cancer that has spread outside the liver

How Candidates Are Evaluated

Before joining the transplant waiting list, patients complete a thorough evaluation that may include:

• Blood tests and imaging (CT, MRI, ultrasound)
• Assessment of heart, lung, and kidney function
• Psychosocial evaluation and support system review
• Consultations with transplant specialists

Preparing for a liver transplant involves completing medical evaluations, making lifestyle changes, organizing support, and understanding what to expect before and after surgery. Proper preparation helps improve outcomes and recovery.

1. Complete the Transplant Evaluation

Before being placed on the transplant waiting list, every patient undergoes a detailed medical evaluation. This ensures the surgery is safe and appropriate.

• Blood tests and lab work
• Imaging scans (CT, MRI, ultrasound)
• Heart and lung assessments
• Cancer screenings
• Dental evaluation to prevent infection
• Meetings with the hepatologist, transplant surgeon, social worker, psychologist, and dietitian

2. Follow All Medical Instructions

Your transplant team will provide specific steps to prepare your body for surgery and maintain stability while waiting.

• Take medications exactly as prescribed
• Manage chronic conditions (blood pressure, diabetes, infections)
• Stay up to date with vaccinations
• Attend all scheduled appointments
• Notify your care team of any new symptoms

3. Make Lifestyle Changes

Healthy habits reduce surgical risks and improve long-term transplant success.

• Stop alcohol use completely
• Stop smoking or vaping
• Avoid all illegal or non-prescribed substances
• Follow a liver-friendly diet (low sodium, balanced nutrition)
• Maintain or work toward a healthy weight
• Exercise regularly as tolerated

4. Prepare Emotionally and Mentally

A liver transplant is a major life event. Emotional readiness supports better healing and long-term adherence to care.

• Consider counseling or support groups
• Talk to previous transplant recipients
• Involve family or close friends early
• Learn what to expect before, during, and after surgery

5. Organize Your Support System

Most transplant centers require patients to have reliable support before and after surgery.

• Identify a caregiver to help with appointments and recovery
• Arrange transportation for clinic visits
• Plan help with daily tasks during early recovery
• Ensure someone can assist with medications and follow-up care

A liver transplant is a major surgery, and while it can be life-saving, it also carries certain risks and potential complications. Understanding these helps patients and families prepare and know what to watch for during recovery.

Surgical Risks

• Bleeding during or after surgery
• Blood clots that may form in major vessels
• Bile duct complications, such as leaks or blockages
• Injury to surrounding organs during the procedure

Infection Risks

The immune-suppressing medications needed to protect the new liver can increase infection risk.

• Bacterial, viral, or fungal infections
• Wound infections after surgery
• Opportunistic infections due to weakened immunity

Rejection of the New Liver

The body may see the transplanted liver as foreign and attempt to attack it. Rejection can happen early or even years later.

• Acute rejection (common, especially within the first months)
• Chronic rejection (less common, slower progression)
• Need for medication adjustments or additional treatment

Complications From Immunosuppressant Medications

• Increased risk of infections
• High blood pressure
• Kidney problems
• Weight gain or metabolic changes
• High cholesterol or diabetes

Other Potential Complications

• Delayed graft function (slow start of the new liver)
• Hernias near the incision site
• Fluid buildup in the abdomen or chest
• Long-term fatigue or muscle weakness

While these risks are real, transplant teams closely monitor patients before, during, and long after surgery to reduce complications and ensure the best possible outcome.