Liver Transplantation

Liver transplantation is surgery to replace a failing liver with a healthy liver from a donor — either a deceased donor or a portion of liver from a living donor. India now has one of the world's largest and most experienced liver transplant programmes, with outcomes comparable to major international centres.

When it is needed

• End-stage cirrhosis — from hepatitis B or C, alcohol, fatty liver, autoimmune disease, Wilson's disease.
• Acute liver failure — sudden liver shutdown from viral hepatitis (especially E in pregnancy, A in children), drug injury (paracetamol overdose), or traditional medicine-induced injury.
• Liver cancer — selected early-stage cases that meet specific criteria.
• Biliary atresia and other paediatric liver disease.
• Certain inherited metabolic liver diseases.

Types of transplant

• Deceased donor — a whole liver from a brain-dead donor. Depends on the national organ donation system.
• Living donor — a portion of the liver from a suitable healthy relative; both portions regrow to near-normal size. This is the commoner route in India given the current donor pool.

Indian practical points

• Deceased-donor organ donation is registered through NOTTO (National Organ and Tissue Transplant Organisation). Registering as a donor, in principle, could save multiple lives.
• Transplant is available at a number of Indian teaching and specialist hospitals; cost varies widely between government, charitable and private centres.
• Several state schemes and central government support exist for eligible patients — ask the hospital's social worker or billing desk.
• Lifelong immune-suppressing medicines after transplant, regular monitoring, and strict adherence to instructions are essential.

After transplant

• Most people return to work and normal activities within a few months.
• Vaccines, hand hygiene, safe food and water matter more when on immune-suppression.
• Alcohol is off-limits for life.
• Regular clinic visits and blood tests detect rejection or side-effects early.
• Outcomes are good — 1-year survival is 85-95% at experienced centres; many people live well for decades.