Liver transplant: Purpose, Risks, Treatment & Cost

A liver transplant is a procedure involving the removal of a damaged part of the liver and replacing it with a healthy donor liver. The donor liver may be received from a living or deceased donor. The liver is one of the most vital organs as it is responsible for the filtration of the blood and removal of toxins from the body. The liver transplant surgery is the last choice of treatment for chronic liver diseases when all other treatment options have failed. 

What is the most common reason for a liver transplant?

The most common diseases that ultimately lead to the requirement of having a liver transplant are listed below:

• Chronic viral hepatitis (B, C, and D) which causes inflammation and chronic damage to the liver.
• Acute liver failure
• Auto-immune hepatitis - involves a compromised immune system and destruction of liver tissue
• Alcoholic liver disease
• Nonalcoholic fatty liver disease and nonalcoholic steatohepatitis
• Primary biliary cirrhosis
• Hepatic or liver tumors
• Metabolic and genetic disorders

Other than the aforementioned reasons, a few signs and symptoms in children can also insinuate the need for a liver transplant in children:

• Portal hypertension along with variceal bleeding
• Failure of liver functions such as decreased albumin, raise clotting time, etc. 
• Progressive jaundice
• Malnutrition
• Recurrent cholangitis
• Encephalopathy
• Severe hypersplenism associated with liver dysfunction. 

Can you live a normal life after a liver transplant?

Even though, there is a very high success rate of approximately 70-80% with a smooth recovery. However, there are always some chances of having associated risks and complications, some of which are mentioned below:

• Internal bleeding
• Clotting of blood
• Liver transplant failure
• Infection
• Rejection of donated liver
• Mental confusion 
• Seizures

These anti-rejection medications can cause a variety of side effects, including:

• Diabetes
• Headache
• High cholesterol 
• Diarrhea
• High blood pressure
• Bone thinning

The living-donor liver transplant also holds some of the risks, which are listed below:

• Leakage of bile substances - The bile juices start leaking sometimes outside the liver. This is usually rectified on itself and sometimes can be treated by doctors by inserting a tube in the liver.
• Infection - the spread of infection is another common infection at the site of the surgery. 
• Organ damage - The liver can sometimes get damaged by living-liver donation. 

What happens during a liver transplant?

The liver transplant is broadly categorized into two types:

• Deceased-donor liver transplant
• Living-donor liver transplant

Deceased-donor liver transplant is performed under general anesthesia. A long incision is made across the abdomen to get access to the liver. The blood supply and bile ducts disconnected and removed from the damaged liver. After placing the new liver in the body, the blood vessels and bile ducts are reattached. This type of surgery takes about 12 hours.

In a living-donor liver transplant, the surgeons transplant a portion of the donor’s liver in the body. The first procedure is done on the donor for the removal of the required liver part. This is followed by placement of the donated liver part into the patient’s body, then connecting the blood vessels and bile ducts to the new liver.

What to expect after the liver transplant?

• You will need to stay in the intensive care unit of the hospital for a few days where you will be monitored for any signs of complications. 
• Once your condition is stable, you will be shifted to the transplant recovery area for recovery. 
• After 5 -10 days of hospital stay, you will be discharged and asked for frequent checkups with the doctor. The doctor might recommend a few blood tests a few times every week and then less frequently. 
• You will then need to take medications for the rest of your life. Medicines such as immunosuppressants help the immune system from attacking your liver. Other drugs are advised to prevent complications from a liver transplant. 

How much does a liver transplant cost?

It has been calculated that the overall liver transplant cost in India is 50% less than that in other western countries. This is the reason why most of the international patient across the globe prefer to visit India for their treatment. Moreover, the nation is widely known for its excellent infrastructure and skilled surgeons. For instance, 

The approximate cost of liver transplant in India revolves around 38,000 USD. However, the exact cost depends upon several factors such as, 

• Fees of the liver transplant surgeon
• Cost of medications 
• Type of accommodation
• The city and the hospital
• The Complexity of the case.