Brain Death is a condition in which a person suffers an irreversible catastrophic brain injury. In this the brain stops functioning but the heart is still beating. The patient can be in this condition for hours or days but there is no chance of recovery. A person is pronounced Brain Dead by a team of doctors after performing certain bedside clinical procedures. Once a person has been determined as Brain Dead, the family of the person is contacted by the hospital authorities whether they wish to donate the organs of the person to be transplanted in patients who are in the waiting list. If the family agrees then organs like Heart, Lungs, Liver, Kidneys, Cornea, Pancreas and Small Intestine can be retrieved and transplanted. Liver from a Cadaveric Donor can be preserved for 12-18 hours within which it has to be transplanted in the recipient.
Cadaveric Liver Transplant in India is done for the patients who have significant complications due to end-stage chronic liver disease. Liver transplant may also be a treatment option in rare cases of sudden failure of a previously healthy liver. As per the organ transplant act 1994, the cadaveric donor liver transplant can be done only for Indian citizens and this facility is normally not available for international patients. The International patients can get Living Donor Liver Transplant Surgery in India.
India is currently doing around 2500 Liver Transplant Surgeries every year of which only about 10% are Cadaveric Donor Liver Transplant. In the developed countries more than 90% of the transplants are Cadaveric Organ Transplant. The low numbers are due to lack of information about Organ Donation and also due to the religious beliefs.
In order to get a cadaveric liver transplant, the patient has to be registered with an approved Liver Transplant Hospital in India. The hospital will upload the details of the patient on the web portal www.notto.gov.in. On this portal, each hospital will have their own waiting list and the deceased donor liver will be given to the hospitals by rotation. The liver which has been retrieved at a Government hospital in India will be given to the government hospitals and if the liver has been retrieved at a private hospital then it will be allocated to a private hospital. Metro Hospital at Faridabad is the latest addition to the list of private hospitals in India which have been approved for Liver Transplant. The waiting list of recipients at Metro hospital is therefore short and the chances to get a deceased donor liver transplant are much higher if the patient gets registered at Metro Hospital, Faridabad.
Once a deceased donor liver is available, the patient who is highest in the wait list will get a call to come immediately to the hospital. Pre surgery test would be carried out after admitting the patient to the hospital. During the surgery, Liver transplant surgeon will give a long incision on the abdomen and remove the diseased liver and place the donor liver the body of the patient. The liver is then attached to bile ducts and blood vessels are connected. The surgery would take 8-10 hours and a team of liver transplant surgeons, anaesthetists and specially trained ot techs would assist the Chief surgeon.
Once the liver has been placed and connected, the surgeon will close the incision using stitches or staples. The patient is shifted to the ICU after the surgery. The hospital stay of the patient for Liver Transplant Surgery would be 25-30 days.
After the surgery, the patient is kept in intensive care unit (ICU) for 5-7 days for better care and continuous monitoring. Blood tests are carried out regulary to check your health parameters including the functioning of the new liver. Once all the health parameters are stable, the patient is shifted to the room. The stay in the room could be anywhere from 5 days to 25 days depending upon the speed of your recovery. Most of the patients who have been waiting for a long time for liver transplant do not have a good health so their recovery takes more time than those who get Living Donor Liver Transplant. Once you are discharged from the hospital, you will continue to recover at home. You would be required to get some blood tests while you are recovering. You will have to take several medicines during the recovery period which normally lasts for 6 months. Some medicines called immunosuppressents have to be taken lifelong. These medicines will suppress your immune system and prevent the rejection of the new liver by the body. However since these immunosuppressents reduce the immunity of your body, you will be more susceptible to other infections. You will therefore have to take much more care of your health as compared to other people who have not undergone such a surgery.
The cost of hospitalization, tests, surgery and medicines during your hospital stay would be Rs. 20 – 25 Lacs or USD 40-50 thousand for International patients. If you have to stay in a hotel after discharge from the hospital then that cost would be extra. Cadaveric Liver Transplant surgery has a good success rate and 5 year survival after the surgery is close to 70% at most of the centres in India. Dr. Ankur Garg has been the Chief Liver Transplant Surgeon at Nanavati Hospital before joining Metro Hospital, Faridabad.