Located in the right upper quadrant of the abdomen liver has different functions. An important role is the production of bile, which ensures better absorption of fats in the intestine. Salts and breakdown products from blood (bilirubin) are also transported to the intestine via the bile. The bile produced is stored in the gallbladder via the bile ducts in the liver. The liver also produces important proteins that the body needs. This includes cholesterol, protein components for hemoglobin (the substance that carries the oxygen in the blood), proteins that are required for blood clotting and antibodies. Also, glycogen is also stored in the liver, an essential fuel for many processes in the body.
Liver transplantation is indicated for all liver diseases that have a significant negative impact on life expectancy and/or quality of life, that can be resolved permanently or permanently through transplantation and for which there are no effective or less invasive treatments.
Cost of liver transplant in India
Liver transplant cost in India would include the cost of the surgery as well as postoperative treatment in hospital for 6-8 weeks. There are two main types of transplants – from living donors and from deceased donors. The cost can vary from USD 20,000 to USD 35,000 depending on the hospital chosen and the transplant team. Up to 30% of all liver transplants in India happen to foreign patients.
The cost of the transplant operation itself is no more than USD 12,000 but extended hospital stay is required to oversee the recipient’s physical reaction to the transplant and that pushes up the liver transplant cost in India.
Who does the transplant?
The transplant team consists of gastroenterologist, hepatobiliary surgeon, physician assistant, anesthesiologists, a dietitian, a physiotherapist. Various medical disciplines are represented on a consultation basis. The primary task of the team members is to care for patients before, during and after the transplant. The gastroenterologist doctor is the pivot in the treatment team. As such, this doctor monitors and coordinates the care of the liver transplant patient. For each phase of the transplant, there are set moments for consultation in which the policy for the individual patient is determined. This implies a joint responsibility for the treatment policy regarding a patient, whereby the gastroenterologist physician is the primary practitioner. At certain moments in the care process, other specialists naturally have the final responsibility; the transplant surgeons and anesthetists during the transplant; the intensivist in the postoperative phase in the intensive care unit. In addition, many others are involved to a greater or lesser extent in work related to the transplant.
Operation
During the operation, the diseased liver is removed and replaced with a donor’s liver. The operation takes 6-12 hours on average. The operating time may differ per person. The procedure starts with the removal of the diseased liver. For this, a cut is made under both ribs. Then comes a period when the patient is without a liver. The blood vessels that supplied blood to the diseased liver or drained the blood are prepared for connection to the new liver. During the implantation phase, the new liver is connected to blood vessels, and blood circulation is restored by the new liver. The bile duct is also attached.
When the operation is almost finished, a number of drains are usually inserted to drain the wound fluid. The wound is then closed with stitches.
A blood transfusion takes place during the operation. From the blood that you lose, the blood cells are recovered and, if necessary, returned to you. This is also called autologous blood transfusion.
After the transplant, you stay for a few days in the intensive care department of the hospital. You then return to the regular nursing ward.
Complications and risks of a liver transplant
There are many complications, and they can be of different severity: in a small percentage of cases the transplanted liver may not work, or the patient may have a thrombosis or an occlusion of the hepatic artery. After transplantation the main cure is based on immunosuppressive drugs: cyclosporine and tacrolimus are the main ones
Less severe complications may be acute or chronic rejection, infections, variable renal insufficiency, post-operative bleeding, biliary complications and rarely, tumors at a distance from the transplant. The original disease could recur, even though many antiviral drugs have come today to help hinder this possibility.
