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Guidelines for Live Donor Liver Transplantation ( LDLT )

Recipient’s evaluation:

1. Patients must carry a prescription or a letter from his physician/ gastroenterologist / hepatologist that suggests a Liver Transplant as the treatment of his liver disease. As we wish that you should stay under the care of your physician once you go back, this is important for us.

2. Once you reach your preferred hospital in India, the requirement of the liver transplant will be re-diagnosed and confirmed.

3. In case you wish to seek an opinion through e-mail about regarding the possibility of a Liver Transplant, you can please send a mail attaching the following reports:

  • Urine protein creatinine ratio and Urine routine/microscopy
  • Anti HCV, HIV I & II, Liver Function Tests (LFT), P time / INR, Urea ,Creatinine, CBC / Hemogram, Sodium , Potassium, AFP, HbsAg
  • Triple phase CT angiography of the liver (Patients with normal ceratinine levels, urea and no contrast allergy can get this test done safely)
  • Your Medical Summary prepared by your doctor carrying information about your past medical history / symptoms.
  • Recent Upper GI endoscopy report

All these reports are required to confirm the requirement and cost of a Liver Transplant.

Nevertheless, once the patient reaches the preferred hospital in India.The liver transplant candidate would be examined again and would have to undergo certain other essential tests such as ABG, PA pressure measurements, PFT, Stress Echo for checking his fitness before undergoing the transplant surgery.

Evaluation of Donor:

1. He/She should be a relative of the patient and should be happy to donate his liver on selfless basis.

2. It is preferable that the donor must be between the age group of 18 and 45 years. He/she should be fit, strong and have a matching or compatible blood group:

Patient blood group Matching donor groups
A+ or A- A+/ A- /O+ / O-
B+ or B- B+ / B- / O+ / O-
AB+ or AB - Any blood group acceptable
O+ or O- O+ / O

 

3. Though liver looks like a single organ but in reality it consists of 8 different lobes and thus can be separated into these lobes. Generally the donor’s right half of the liver is donated during an adult – to – adult liver transplant. Liver’s bloodless division into right and left has now become possible because of latest techniques and gadgets. A living donor can now easy donate his liver safely as the remaining left side grows back to around 80 percent of liver’s original size in few weeks and quite close to the original size within few months. The ratio of risk in liver donation is even lower than 1:200.

4. It is mandatory that the donor should be a psychologically-sound adult who is well aware to take any sort of decision. 

5. If the transplant is being done by an unrelated liver donor for financial reasons, it is illegal and punishable under Indian laws. No queries in this regard would be entertained.

6. In case, you want to start the evaluation of the donor on an immediate basis, you can get done the Level I and Level II tests in your own country and send the reports to us by mail:

Level I: Blood group HBsAg, HbA1c, Anti HCV, HIV I & II CBC / Hemogram, Creatinine, P time / INR, LFT, Urea

 After 14 hour Fasting, Serum T3, T4, Lipid profile and TSH

 If the reports are fine, go on to Level II

Level II: Triple phase CT Liver Angio (donor protocol) along with a plain scan for looking at Liver Attenuation

You can courier or mail us the reports or bring along a CD in DICOM format

This scan is a crucial part of the donor work up

Level III: MRCP

Level IV: Stress Echo, Chest X-ray, ECG, Lung Function Tests USG breast & pelvis, Mammography ( less than 40 yrs ), , CA 125, HLA tissue typing, PAP smear ( married ladies), Blood group antibody screen 

7. Tests at Level III and IV for the donor and all tests for the patient can be done within 48 hrs of arrival at a hospital in India. If the test reports are fine, liver transplant can be done quickly once permission from Government of India Transplant Authorisation Committee is taken. All this might take a week’s time.

Assistance in Visa Formalities

1. As we receive a email with patient’s and donor’s passport details, the details of up to 2 more attendants, we can get you an Invitation letter issued from the preferred hospital. Another copy of the letter would be sent to the Indian High Commission. You must apply only for a Medical Visa soon as this letter is of great help to get a Medical Visa quickly.

2. The patient would be required to stay for 2 months and the donor for 1 month. Out of these, the patient would spend 21 days and the donor would spend 10 days in the hospital. It is advisable that post-transplant, the patient should stay close to the hospital after discharge for around 4 weeks.

3. In case of queries, please send us a Email at info@mediconnectindia.com or can contact us through Skype - Medi.connect.ihpl or can simply Call us at +91 9717766080


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