Liver transplant
Liver transplant is a lifesaving surgery for patients with end-stage liver disease, acute liver failure, or some genetic liver diseases. The liver is a special organ that can regenerate, and thus, transplantation can be done using a deceased donor or a living donor. Although both methods have pros and cons, knowing the contrast between them will enable patients and their families to make an educated choice.
Deceased Donor Liver Transplant (DDLT)
What is a Deceased Donor Liver Transplant?
A deceased donor liver transplant involves transplanting a liver from a person who has been declared brain dead but whose organs are still functional. The organ is retrieved from the donor and preserved before being transplanted into the recipient.
Pros of Deceased Donor Liver Transplant
- No Risk to a Living Donor: Since the liver is obtained from a deceased person, no healthy individual is subjected to the risks associated with surgery.
- Entire Liver Transplantation: The recipient typically receives a whole liver, which may result in better long-term outcomes compared to a partial liver transplant.
- Availability for Complex Cases: Patients with severe liver disease, anatomical complications, or large tumors often require a full liver, which is only available through deceased donors.
- No Need for a Compatible Living Donor: Some patients do not have a willing or compatible living donor. In such cases, a deceased donor liver is the only viable option.
Cons of Deceased Donor Liver Transplant
- Long Waiting Period: Due to the shortage of deceased donor livers, patients often remain on the transplant list for months or even years, increasing the risk of deterioration.
- Higher Risk of Organ Damage: The liver must be preserved and transported before transplantation, which can sometimes lead to ischemic injury, affecting post-transplant recovery.
- Potential for Organ Rejection: Since the donor liver comes from an unrelated person, the risk of rejection is higher, requiring lifelong immunosuppressive medication.
Living Donor Liver Transplant (LDLT)
What is a Living Donor Liver Transplant?
A living donor liver transplant involves transplanting a portion of a healthy person’s liver into the recipient. The donor’s liver regenerates over time, returning to nearly full function.
Pros of Living Donor Liver Transplant
- Shorter Waiting Time: Since the transplant is planned, patients do not have to wait for an available deceased donor organ, reducing disease progression.
- Better Organ Quality: The liver is taken from a healthy, living person, ensuring better function and reducing the risk of ischemic injury.
- Higher Success Rates: Studies indicate that patients undergoing living donor transplants often experience better survival rates compared to those receiving deceased donor livers.
- Immediate Transplantation: The surgery can be scheduled at an optimal time for the patient, improving preparation and outcomes.
Cons of Living Donor Liver Transplant
- Surgical Risk for Donor: The donor must undergo major surgery, which carries risks such as infection, bleeding, and complications related to anesthesia.
- Size Matching Required: The donor liver portion must be sufficient to support the recipient while still allowing regeneration in the donor.
- Ethical and Emotional Considerations: The decision to donate a liver portion can be emotionally and psychologically challenging for the donor and their family.
- Post-Surgical Recovery for Donor: The donor will need several weeks to recover, which may impact their work and daily activities.
Which Option is Better?
Each has its advantages, and the selection is based on specific situations. For those in need of an urgent transplant, living donor transplantation provides a more rapid and more certain answer. But for others who lack an available living donor or need an entire liver transplant, a deceased donor transplant is the only available option.
Liver Transplant in India: Cost, Hospitals, and Success Rates
India is a leading destination for liver transplants due to its advanced medical facilities and cost-effective treatment options. The cost of a liver transplant in India varies between $25,000 and $45,000, depending on the hospital and the type of transplant. Some of the best hospitals for liver transplants in India include Medanta, Apollo Hospitals, and Max Super Specialty Hospital. The liver transplant success rate in India is approximately 85–90%, making it one of the preferred choices for patients worldwide seeking quality and affordable liver transplant procedures.
Dr. Nishant Mittal is a highly accomplished researcher with over 13 years of experience in the fields of cardiovascular biology and cancer research. His career is marked by significant contributions to stem cell biology, developmental biology, and innovative research techniques.
Research Highlights
Dr. Mittal's research has focused on several key areas:
1) Cardiovascular Development and Regeneration: He studied coronary vessel development and regeneration using zebrafish models1.
2) Cancer Biology: At Dartmouth College, he developed zebrafish models for studying tumor heterogeneity and clonal evolution in pancreatic cancer.
3) Developmental Biology: His doctoral work at Keio University involved identifying and characterizing medaka fish mutants with cardiovascular defects.
4) Stem Cell Research: He investigated the effects of folic acid on mouse embryonic stem cells and worked on cryopreservation techniques for hematopoietic stem cells.
Publications and Presentations
Dr. Mittal has authored several peer-reviewed publications in reputable journals such as Scientific Reports, Cardiovascular Research, and Disease Models & Mechanisms1. He has also presented his research at numerous international conferences, including the Stanford-Weill Cornell Cardiovascular Research Symposium and the Weinstein Cardiovascular Development Conference.
In summary, Dr. Nishant Mittal is a dedicated and accomplished researcher with a strong track record in cardiovascular and cancer biology, demonstrating expertise in various model systems and a commitment to advancing scientific knowledge through innovative research approaches.
