Liver and its Functions
Liver is one of the largest internal organs, located behind the rib cage on the right side. It excretes bile- a yellow digestive juice, which gets accumulated in case it stops functioning properly.
Several critical functions of the liver includes
- Making proteins that enable the blood clot
- Bile production, which in turn helps the body to absorb fat-soluble vitamins, cholesterol and fats.
- Processing, hormones, medications and nutrients
- Regulating immune responses and preventing infections
- Removing toxins like alcohol and drugs and also bacteria from the blood
The damaged or diseased liver is replaced with a healthy one by the means of a major surgical procedure that is extremely time-consuming and demanding. The liver or hepatic transplantation is performed in case of end stage liver disease or liver failure which is replaced with a healthy liver allograft. In some cases, patients also recover with treatment in specialized ICUs, but in most of the cases liver transplant is the only option to survive. Some of the reasons for liver transplant are-
- Genetic liver disease
- Fulminant viral hepatitis (A, B, C, D), hepatic thrombosis can result in Fulminant hepatic failure.
- Liver cancers like hepatic adenomas, primary hepatcellular malignancies, primary hepatocellular carcinoma and Chloangiocarcinoma.
- Last-stage Cirrhosis which mostly occurs due to primary bilary sclerosis, hemochromatosis, chronic hepatitis, alcoholic cirrhosis etc.
All about Donors
There are two types of donors in case of liver transplantation-
Living Donor transplant- Living donor is usually a close friend or someone in the family. A segment of liver is removed from the healthy living donor and is implanted into the recipient. The liver segments of both the donor and recipient grow to normal size in few weeks. Body size and blood type are critical factors in determining the appropriate donor.
Deceased Donor transplant- Majority of liver transplants makes use of the entire liver from someone who has died, particularly for adult recipients. The circumstances of death and the identity of the deceased donor are kept confidential.
Determining the critical need of the recipient
A scoring method has been set up to determine who is in a most critical need of a liver transplant.
Status 1 (acute severe disease)- The patient with recent development of liver disease and is in the ICU with a life expectancy of less than 7 days without a liver transplant, or someone who has received a liver transplant but the donor organ did not function properly.
MELD scoring- Model for End-Stage Liver Disease scoring system for 18years or older patients.
This system is based on the probability of death within 3 months without liver transplant. It is calculated on the base of laboratory data in order to be as objective as possible. The laboratory values include the patient’s bilirubin, sodium creatinine, and international normalized ratio, or INR (a measure of blood-clotting time).
PELD scoring- Pediatric End-Stage Liver Disease scoring system for patients younger than 18 years. This system is based on the probability of death within 3 months without a transplant. The PELD score is calculated on the basis of growth parameters and laboratory data. The laboratory values used are a patient’s INR (measure of blood-clotting capability), bilirubin and albumin.
Status 7- Those patients who are temporarily unsuitable for liver transplant.
According to this system liver is first offered locally to Status 1 patient and then to the patients with highest MELD or PELD score.
Liver Transplant Hospitals in India
The healthcare center in India is one of the most established in Asia, as a result more medical tourists flock to the country due to growing credibility and high success rate. As a number of vital and major surgeries are performed at comparatively lower cost.
Several multi specialty hospitals in India offer world-class specialists, advanced equipment, and top-class infrastructure. Here’s a list of top hospitals for liver transplant in India–
- BLK Hospital
- Medanta Hospital
- MAX Multi Super Speciality Hospital
- Fortis Escorts, New Delhi
- Gleneagles Global Hospital, Chennai
- Apollo Indraprastha, New Delhi
- Kokilaben Dhirubhai Ambani Hospital, Mumbai
- Apollo Health City, Hyderabad
- Apollo, Chennai
- Jaypee Hospital, New Delhi
- Columbia Asia, Bangalore
It is important to note here that medical tourists traveling for liver transplantation to India cannot have a donor from the country and should travel along with the donor. Liver transplant is an expensive procedure, but is still affordable compared to other developed countries.