"The success rate of transplants with living donors is higher than with brain-dead donors.' Unlike in western countries where cadaver donor transplantation is predominant, in India there has been a rise of living liver donors". Living donors or liver transplant (LDLT) can save patients with locally advanced liver cancer and acute liver failure though deceased donor liver transplant (DDLT) in not suitable for most patients. LDLT can be done as soon as a family member is found fit to donate a part of the liver, while DDLT requires waiting in India for 6-18 months." Dr. S.K. Sarin, Director, Institution of Liver and Biliary Science, said, "A deceased donor is mostly preferred because of the risks to a living donor. But when the requirement is for, say 2,000 donors, we get just 300-400 deceased donors. But even with non-living donors, there are challenges, often even people aged 35 are obese or consume alcohol in large amounts. More than 60% of the donors are wives or mothers".
As per government rule, the donor has to be a first degree relative of the recipient, that is a husband, wife, brother, sister, father, mother, son or daughter. A healthy living donor can donate up to 60% of the liver, which grows back to normal size in 4-6 weeks.
"In north India, DDLT constitutes 3-4% of transplants, while in South India, it is higher at 10-15 %. Overall, 92% of recipients recover well, said Dr. Neerav Goyal of Apollo Hospitals. "The recipient goes on long term immuno-suppressant medications, usually life-long." Liver transplants do have some risks. "A thrombus may form in the blood vessels during the surgical process. The liver can also be rejected by the patient's body", pointed out Dr. Bhushan Bhole, senior consultant, GI surgery and liver transplantation, PSRI Hospital "A donated organ acts as a foreign organ and the body may not accept it."
Liver failure occurs due to non-alcoholic cirrhosis, alcoholic liver diseases, Hepatitis B and Hepatitis C. Another factor is acute liver failure in a short time due to Hepatitis A and E drug toxicity due to anti-TB medicines.
Post-transplant care involves regular blood tests and lifelong administration of medicines to prevent transplant rejection. These costs around Rs. 5,000 a month. But despite the need for long-term medication and regular follows ups, liver transplant recipients have an excellent quantity of life and a normal life expectancy. "More than 250 patients I know have lived 15-25 years after transplant, some of the little kids we transplanted have now become doctors, lawyers and sportspersons got married and have children of their own." smiled Arvinder Soin.