The Department of Liver Transplant and Hepatobiliary Surgery at Columbia Asia Referral Hospital – Yeshwanthpur, Bangalore offers a variety of options for those afflicted by liver diseases. The team of consultants are highly qualified and experienced to provide total solutions to liver and biliary diseases and perform transplantation of the liver when necessary.
The mission of the team is to provide state-of-the-art services using evidence-based guidelines and international protocols, at an affordable cost. It is one of the few centres in the country where deceased as well as living donor’s liver transplantation, along with comprehensive treatment for hepatobiliary and pancreatic diseases, are being offered to patients under one roof.
Multi-disciplinary approach is the hallmark to manage successful liver transplantation. The hospital has the support of specially trained nurses, interventional radiologists, cardiologists, anaesthesiologists, intensivists and others to manage the intricate care these patients require. A well equipped, laboratory, radiology and imaging services and a contemporary transplant ICU complement the team.
What is liver transplantation?
Liver transplantation is a surgical procedure to replace a failing or damaged liver with a healthy, well functioning one. The most commonly used technique is orthotopic liver transplantation, in which the entire liver is removed and replaced by the donated liver.
Liver transplantation is universally the standard of care for treatment of end-stage chronic liver disease or cirrhosis and is a life-saving operation for acute liver failure patients. Donated liver can be from a living donor or a deceased (brain-dead, cadaveric) donor.
Which diseases need liver transplant?
In adults, the most common reason for a liver transplant is end stage liver disease (ESLD) or cirrhosis, which is caused by:
- Long-term infection due to hepatitis C or hepatitis B virus
- Excessive alcohol consumption, over many years
- Fatty liver, obesity or high cholesterol levels
- Biliary diseases (damage or blockage to bile ducts inside the liver) like primary biliary cirrhosis and primary sclerosing cholangitis
- Autoimmune liver diseases (immune system attack against the liver)
- Hereditary diseases such as Wilson's disease where copper deposition and hemochromatosis where iron accumulation leads to liver failure
- Liver cancer
- Biliary artesia is the most common reason for transplant, where the bile ducts are missing, damaged or blocked by birth. Thus, bile accumulates in the liver and causes cirrhosis.
- Metabolic diseases where some enzymes made by the liver are deficient at birth
Signs and symptoms of liver disease and results of some blood tests are commonly used to determine severity of liver disease, which in turn determines the treatment required. Patients with advanced diseases having severe symptoms need an early transplant. Patients who have secondary effects of liver disease on other organ systems, such as kidneys (hepato-renal syndrome), lungs (hepato-pulmonary syndrome) and brain may also need an early transplant.
Patients with liver cancer are often diagnosed on routine screening tests such as ultrasound, CT scan or MRI. They might require an early transplant even without severe underlying liver disease. Patients with acute liver failure generally have a normal (non-cirrhotic) liver and therefore have the potential for regeneration and recovery. However, beyond a certain degree of damage, recovery is unlikely.
Some patients might have an irreversible liver disease but not worse enough to warrant a transplant, whereas others might be too sick to benefit from a transplant. This assessment can best be made by doctors who specialise in liver diseases i.e. liver transplant surgeons and hepatologists. Transplantation will be offered only if the benefits of a liver transplant outweigh its risks.
Liver transplant is not offered to patients with current alcohol abuse problems, those with uncontrolled active infections, widespread cancer or severe, untreatable diseases of the brain, heart or lung.
Treatments and Procedures
- Liver transplantation surgery