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About “Liver Transplant”

Liver Transplant

Liver transplantation has been one of the most successful revolutions in the healthcare industry in the last few decades. At present, this medical treatment is in its golden age in India due to numerous surgical procedures and the latest technologies that appeared in the last few decades.

The first successful living donor liver transplant together with a deceased donor liver transplant happened in November 1998 after some unsuccessful attempts. With advancements in the medical field, there were 1200 liver transplants in 2014.

In addition to these statistics, Indian medical personnel keeps up with the latest developments in the healthcare industry. India has become one of the most popular medical tourism destinations in the world.


Liver Transplant – A Gift Of Life!

A liver transplant is also known as a hepatic transplant. It is the process of replacing a diseased liver with a healthy one that is donated by another person. Curing end-stage liver failure has a number of benefits.


Health Conditions That May Lead To Liver Transplantation

When you have final-stage liver disease and you do not have any effective medical treatment, you undergo a liver transplant. Some of the signs of liver disorders. It may include:

  • Hepatitis B
  • Hepatitis C
  • Alcoholic liver disease.
  • Fatty liver disease or non-alcoholic steatohepatitis.
  • Autoimmune hepatitis.
  • Wilson’s disease.
  • Previously failed liver transplant.
  • Polycystic disease.
  • Alpha1 Antitrypsin deficiency.
  • Hemochromatosis.
  • Liver cancer.
  • Primary biliary cirrhosis.
  • Acute liver disease.
  • Then, he/she has to undergo a liver transplant.


Types Of Liver Transplant Procedure Options Available In India

Liver transplants boost the quality of life and help you to live a long life.

More than 80 percent of living donor liver transplants are carried out in India compared to western countries where 90 percent of liver transplants are from deceased donors.

More than 80 percent of live donor liver transplants take place in India as compared to western countries where approximately 90 percent of transplants are from deceased donors. 

There are mainly two types of liver transplantation in India and they are:

  • Deceased Donor Transplant:

    – When a patient dies due to a brain disorder, his liver is ready for transplantation after his body is examined.

    – After matching the blood group and size of the deceased donor, the liver is transplanted to the patient who comes first on the shortlist.

    – As the liver is regenerable, sometimes it is divided into two parts, and transplantation is done on two patients at a time – a child and an adult.

A deceased donor can provide eight lifesaving organs and various beneficial tissues.

  • Living Donor Transplant:

    – The transplant of a portion of the liver by a living donor to replace a diseased organ is called a living donor transplant.

    – The donor should be a relative of a patient such as parents, siblings, children, spouse, or grandparents.

    – The liver can regenerate or regrow to its normal size and this procedure begins as soon as the liver is divided or transplanted.

    – It takes about 2 – 3 months for the whole process of the liver to regrow to its normal size.

In order to be eligible for surgery, patients must have a liver that equals 0.8 – 1 percent of their body weight. This was correlated with the right portion of the liver in adults, the left portion of the liver in teenagers, and the left sideward segments in children.


Requirements And Evaluation: Live Liver Donor

Liver donation is an organ donation. Therefore, both the donor and the recipient should adhere to the rules and regulations of the Indian Government. For organ donation, the donor and the recipient should follow some rules:

  • All liver transplants require early approval of the Competent Authority/Hospital-based Authorization Committee/ State Authorization Committee.
  • Only licensed hospitals have the authority to organize liver transplants.
  • Cadaver transplants should be performed on those who are brain dead.
  • In the case of a brain-dead person, if tissues, organs, or both are to be removed, it is mandatory to take permission from the board of medical experts given by the Act and the Rules under it.
  • Near relatives are advised to make living donations more often than distant relatives.
  • Both the donor and the recipient must be approved by the State Authorization Committee or Hospital-based Authorization Committee if they are close relatives and either is a foreign native.
  • A Coordination Committee is organized by the State Committee to manage all transplant-related issues that require the presence of both parties.
  • If the donor is not related to blood, then there should be no commercial angle beyond the donation, as understood by the authorized committee properly appointed by government authorities.


Documentation Process For Liver Donation In India

When you bring a donor with you, you are required to bring some documents as well:

  1. Send the letter through the Processing Consultant.
  2. Authorization Committee Agreement Letter.
  3. Approval Certificate from the Embassy/ District Hospital.
  4. An affidavit on stamped paper accompanied by an attested photo of the recipient’s signature from the SDM/DM/Embassy.
  5. HLA/DNA typing results show the relationship between parents and siblings.
  6. Donor and Recipient Performance.
  7. Form 1 (Related to the donor).
  8. Form 2 (Spousal Donor), and
  9. Form 3 (Not related to the donor) is filled out by the patient and signed by the Notary Public.
  10. Form 4 (Psychiatric Estimation of the donor) must be reviewed by the Processing Consultant and the Surgeon.
  11. In the case of a spouse donor, form 6 should be completed by the appropriate authority.
  12. Whether the donor is related or not, Form 11 (joint transplant request by the donor and recipient) must be filled out and stamped by the Processing Consultant.
  13. Medical Visa.
  14. Document proof of relationship photo identity Card/Ration Card/Passport/ Selection Card/Income Tax/ PAN Card/ Driving License/ Government identity card or Certificate together with attested photographs from the Superintendent of Police/ District Magistrate/ Deputy Commissioner of their area.

Proof of income of the donor and recipient. All documents should be numbered. If any error is found in the document, it deceives the authorization committee and breaks the law.


Pre-Operative Evaluation Process For Liver Transplantation

As liver transplantation is a major procedure, one must adopt a positive attitude before treatment. The assessment is done step by step and starts with the recipient’s evaluation. If the patient is eligible for transplantation, the search for family donors depends on their blood groups.

If a donor is found, it requires approval of the authorization committee to take further steps, and transplantation is generally undertaken around 2 – 3 weeks.

Step 1: Pre-transplant Recipient Evaluation

  • After the diagnosis of a patient with end-stage liver disease and the requirement for a transplant, the transplant team performs tests such as blood tests, CT scans, and other tests to observe the function of the heart, lungs, and other major organs.
  • Tests are performed to determine the underlying cause of cirrhosis, the severity of liver disease on other organs, and whether liver tumors are present. In addition, they are performed to evaluate the condition of other major organs. The evaluation normally takes 7 – 10 days for an outpatient procedure.

Step 2: To Decide The Donor

Deciding on a donor is the most crucial part of the whole process. The donor has to meet some criteria:

  • A family member related by blood as stated in the Act.
  • If the donor is not related to blood, then it requires an assessment from the government-appointed authorization committee together with the clarification that there is no commercial angle included.
  • An age group between 18 and 55 years old with a normal weight.
  • In order to donate the required number of segments, the donor liver should be of sufficient size.
  • The recipient must have the appropriate blood group.

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