The document discusses liver transplantation and living donor liver transplantation. It describes the surgical procedure for liver transplantation, noting that an incision is made to expose the liver and the donor's liver is split into two parts with one part removed for transplant. It notes potential complications of the surgery can include bleeding, infection, or bile duct damage. The recovery process is also outlined, with donors typically staying in the hospital for 4-7 days and a full recovery taking around 4 weeks. Living donor transplantation is advocated for due to long waitlists, with extensive medical evaluation and testing required to ensure the safety of both donor and recipient.

1. Institute of Liver, Pancreas Diseases
& Organ Transplantation
Know the facts...
Liver Transplantation
What happens during the operation?
What are the potential complications of surgery?
An upper abdominal incision, in the shape of an
inverted 'L' is made to expose the liver. The liver
anatomy is re-checked, and an X-Ray of the bile ducts
obtained (cholangiogram) to ensure patient safety. The
donor's liver is split into two parts. One part is removed
for the transplant. The wound is then closed with suture
or staples.
Donors stay in the hospital from 4 to 7 days after
surgery, longer if problems occur. The first night after
surgery is usually spent in the intensive care unit (ICU).
The next day, the patient may be moved to the general
surgical floor where nurses have experience caring for
liver donors. The nurses will encourage one to get out of
bed and sit in a chair the day after surgery and to walk
as soon as able.
As with any major surgery, there are risks. There is a 10
to 25% chance a donor could have complications from
the surgery. A donor may develop some problems
during or right after the operation; they might also
experience problems later. Surgical problems include
bleeding, infection, bile leaks, or damage to the bile tree
(the ducts that run through the liver). Other risks can
come from anesthesia and general surgery.
Living Donor
(Modified from the American Society of Transplantation
information brochure)
You may also want to talk to a donor who has already
gone through the surgery and can talk about his or her
experiences.
You may be in hospital for a week, if all is well. It takes
about 4 weeks to recover from surgery. Most donors
recover fully after the operation and can do normal
activities within a few months after the surgery. The liver
team will tell you when it is safe to return to normal life.
How long does recovery take?
Global Hospitals
6-1-1070/1to4, Lakdi-ka-pul,
Hyderabad - 500 004.
Ph: +91 40 2324 4444 (10 lines)
Aware Global Hospitals
Sagar Road, L.B.Nagar,
Hyderabad - 500 035,
Ph: +91 40 2411 11
Hyderabad | Chennai | Bengaluru | Mumbai
Emergency: 040 2324 4444
Specialties:
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Liver Diseases
Neurosciences
Medical Gastroenterology
Therapeutic Endoscopy
Bariatric Surgery
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Hepatobiliary Surgery
Oncology
Critical Care
Minimal Access Surgery
And other services
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Cardiac Sciences
Multiorgan Transplantation
Surgical Gastroenterology
Endocrinology
Pancreatology
www.globalhospitalsindia.com
Prof. Mohammed Rela, MBBS, MS, FRCS (Edinburgh)
Head of Multi-organ Transplantation and HPB Surgery
Global Hospitals Group
THE HYDERABAD TEAM
Dr. Dharmesh Kapoor (Transplant Hepatologist)
Dr. Balbir Singh (Transplant and HPB Surgeon)

2. Why Living Donor Liver Transplantation?
What are the advantages of a live organ donation?
By knowing facts about liver transplants, you can make
an informed decision about being a donor.
Approximately 20,000 patients need liver transplants in
India every year, yet less than 600 patients actually
receive a transplant.
Many adult patients
cannot survive the
wait times for a
deceased-donor liver.
Because there is a
long waiting list for
t h o s e n e e d i n g
transplants, 1 out of 4
patients who need a new liver will die before one
becomes available. When considering facts about liver
transplants, remember that the liver is one of the few
organs that will grow back if a portion of it is removed.
Ÿ Living donor liver transplantation is now an
accepted method, used more commonly because
of the severe lack of livers from recently deceased
donors.
Ÿ The live donor procedure also allows greater
flexibility for the patient because the procedure may
be done for people who are in the lower stages of
liver disease.
Ÿ A living-donor transplant means a patient can have
a transplant before their liver failure gets worse. It
means a shorter wait time for a liver.
Ÿ Because the surgery can be planned in advance,
the chance for a successful transplant is better.
Ÿ The quality of the liver may be better, because living
donors are usually young, healthy adults who have
gone through a complete medical evaluation.
Ÿ With a living-donor transplant, the preservation time
(the time when the liver is outside the body) is
shorter.
· The donor may be a family member, such as a
parent, sister, brother, or adult child. The donor can
also be a husband or wife.
· It is against the law for people to sell their body parts.
In general, liver donors must:
• Be at least 18 years old
• Be in good health with no major medical or mental
illnesses
• Be a non-smoker for at least 4 to 6 weeks before
surgery
• Be able to understand and follow instructions before
and after surgery
• Have a compatible blood type
• Have an emotional tie with the recipient
• Not have a selfish motive for donating
• Have a similar body size
• Be able to go through certain medical tests like
blood work, radiology studies, and a liver biopsy
• A person should feel no pressure to donate part of
his or her liver; nor should any money be given or
received.
Who can donate?
What are the tests needed for evaluation of a living
donor?
People who want to donate their liver go through a
complete medical exam to make sure their liver is
healthy and that it is safe for them to donate. Safety is
important for both the donor and the recipient
Medical evaluation is done
a) To make sure the donor does not have any health
problems, like diabetes or heart conditions, that
could increase the risks of problems during and
after the surgery.
b) To make sure the donor liver that is the right size for
the recipient.
The general tests performed as part of the evaluation
include:
Physical examination. A complete physical
examination is performed as part of the evaluation.
Did you Know?
The Liver is the only organ
that can regenerate itself
Blood tests
• Donor's blood type (it should match the recipient's
blood type.)
• Liver and kidney function tests
• Red cell, white cell, and platelet counts
• The donor is also tested for viruses such as hepatitis
B, hepatitis C, and HIV
Ultrasound/MRI/CAT scan. These tests are done to
get images of the liver to make sure the donor's bile
ducts, arteries, and veins are the right fit for the intended
recipient. These tests also measure the volumes of the
liver that will go to the recipient, and make sure that it is
adequate. Additionally, they are used to assess the
piece of the liver that will remain in the donor to ensure
that it is sufficient..
Chest X-ray and EKG. These are standard tests done
before any major operation to check for lung or heart
problems.
Consultation. Every donor will meet with a medical
physician for a complete assessment. All donors will
also have a comprehensive psychosocial assessment
to talk about their reasons for donating a liver and to
make sure they are in a stable mental condition for the
surgery.