The liver is an organ located in the right side of the abdomen below the ribs. The liver has many vital functions. It is a powerhouse that produces varied substances in the body, including (1) glucose, a basic sugar and energy source; (2) proteins, the building blocks for growth; (3) blood-clotting factors, substances that aid in healing wounds; and (4) bile, a fluid stored in the gallbladder and necessary for the absorption of fats and vitamins. As the largest solid organ in the body, the liver is ideal for storing important substances like vitamins and minerals. It also acts as a filter, removing impurities from the blood. Finally, the liver metabolizes and detoxifies substances ingested by the body. Liver disease occurs when these essential functions are disrupted. Liver transplants are needed when damage to the liver severely impairs a person's health and quality of life.

In Globe Health Tours, we encourage Living Donor Related Transplants. Avoiding a long wait is possible if a person with liver disease has a living donor who is willing to donate part of his or her liver. This procedure is known as living donor liver transplantation. The donor must have major abdominal surgery to remove the part of the liver that will become the graft (also called a liver allograft, which is the name for the transplanted piece of liver). As techniques in liver surgery have improved, the risk of death in people who donate a part of their liver has dropped to about 1%. The donated liver will be transplanted into the patient. The amount of liver that is donated will be about 50% of the recipient's current liver size. Within 6-8 weeks, both the donated pieces of liver and the remaining part in the donor grow to normal size.

Recipients of a living donor liver transplant go through the same evaluation process as those receiving a cadaveric liver (a liver from someone who has died). The donor also has blood tests and imaging studies of the liver performed to make sure it is healthy. The living donors, as with the deceased donors, must have the same blood type as the recipient. They must be aged 18-55 years, have a healthy liver, and be able to tolerate the surgery. The donor cannot receive any money or other form of payment for the donation. Finally, the donor must have a good social support system to aid in emotional aspects of going through the procedure.

People who have liver disease or alcoholism are not allowed to donate part of their liver. Those who smoke chronically or who are obese or pregnant also cannot make such donations.

The donation is entirely safe and teh half liver regenerates quickly in both the donor and recipients in 3 weeks.

In the first few days after operation even when regeneration is not complete, the half liver is enough to maintain normal donor functions due to the immense reserve in the liver.

To donate

• The person must donate of his/her own free will
• The person should be between 18-55 years and weigh between 50-85kg
• The person must be a close relative
• The donor and recipient blood group must match
• The donor liver structure / function, as well as the other systems must be normal
• Half of the donor liver must be enough in volume for the recipient

The suitability in the above respects and some other technical points is determined by the Transplant Team in Pre-transplant donor evaluation which normally takes 2-3 days.

Facts about liver donation surgery

Modern liver cutting techniques using CUSA have made it safe and blood less

Normal liver has immense reserve - nearly 70% of liver can be safely removed although much less is removed
Normal liver grows back very quickly - it can be restored to normal size after removal of half the liver in just 2 weeks

For Liver Transplantation, patient needs to have a blood group compatible donor from family (donor has to be between 18 to 65 yrs) as required by the human transplant act of our country. The donor and recipient will have to undergo detailed tests, which could take 7-15 days (depending on the reports of investigations) prior to transplantation. Transplantation can be done only after the Authorization Committee approves the donor. The Embassy in Delhi will certify all the proofs of certificates and documents of relationship between the Donor and the Recipient.

Blood Group of donor should be matched as given below:

Recipient (Patient) Blood Group Donor Blood Group

A A or O
B B or O
AB Any blood Group
O O

The package for liver transplant (includes 1 day pre-operative and 4 weeks post-operative for the Recipient) is approximately US$ 52,000 which includes donor admission and surgery and 10 days post operative period. Average donor stay in hospital is about 10-12 days. This package isn't applicable for patients with Hepatitis B and with additional kidney failure/ problems. The cost of preoperative investigations will be approx. US $ 2500.

Post discharge from hospital, the donor needs to stay in Delhi for 10 days and can resume his regular work after 6 weeks. The recipient needs to stay in Delhi post discharge for 1 month with twice a week follow up in OPD.