As the largest solid organ in the body, the liver performs a host of vital functions. When its functioning is impaired, a number of other organs are affected to the point that survival is affected. In such cases, liver transplants are the only hope of survival.
FORTIS LIVER CARE
Over the years, human diets have changed and put more strain on our livers and other crucial gastric organs, leading to more dysfunction. At Fortis Healthcare, we have established a dedicated unit to treat a wide range of such disorders of the liver, biliary tract, pancreas, and upper and lower gastrointestinal tracts with the latest international standard procedures. We are also fully equipped to provide emergency and critical care for patients with Acute Liver Failure and End-stage Liver Disease. Our research wing is dedicated to studying the molecular genetics of liver diseases and ex-vivo development of functional liver cells from stem cells. In the future, we intend to explore the use of robotics in Liver and Biliary Surgery.
The divisions of CASR:
- Liver Transplant and Regenerative Medicine
- Hepato-biliary and Pancreatic Surgery
- Liver Critical Care
- Upper and Lower Gastrointestinal Surgery
- Minimal Access and Advanced Laparoscopic Surgery
ABOUT LIVER TRANSPLANTS
A Liver Transplant involves replacement of patient's diseased liver with a new one from either a brain-dead donor whose heart is still beating (Cadaveric or Deceased Donor Liver Transplant or DDLT) or from a living donor (Living Donor Liver Transplant or LDLT). A liver from a cadaver is a complete liver while that from the living donor is a half or hemiliver.
The liver is a unique organ with a special capacity for regeneration. Even 75% of the organ can be safely removed without any untoward consequences because of the capacity of regeneration. The remaining part rapidly grows and restores to its full functional capacity required for the normal functioning of the body. Owing to this unique property, a part of the healthy liver can be safely removed from a voluntary donor and used to replace a diseased liver in a patient without causing any harm to either the donor or the patient. The two halves of the liver can then return to normal within 3-4 weeks.
LIVER TRANSPLANT & REGENERATIVE MEDICINE
Liver Transplants are performed by the country's most experienced and patient-friendly team of experts who have excellent records in terms of patient care and outcomes. This multidisciplinary team comprises of Surgeons, Transplant Hepatologists, Gastroenterologists, Anaesthesia and Critical Care Intensivists, Interventional Radiologists, and well trained technical and nursing staff. The unit runs evaluation centres for liver donors and patients at various Fortis hospitals across Delhi NCR and the surrounding areas, and also has a 24 hour Liver Helpline for quick and round-the-clock access in an emergency.
The Centre is experienced in performing Living Donor Transplants in both adult as well as children with utmost safety and excellent outcomes. This is the country's only centre offering Small Incision Donor Hepatectomy (SIDH) for donors. SIDH minimises recovery time and markedly decreases complications related to surgical wounds, leaving smaller, cosmetically acceptable scars compared to the conventional incisions used at other centres. In its quest to further improve donor safety and outcomes, the unit’s vision is to introduce Laparoscopy and Robotically-assisted Donor Hepatectomy. There is a dedicated wing for performing molecular level research into various liver diseases and disorders, and their genetics, with the aim of developing a therapeutic cure. The research wing is also dedicated to ex-vivo development of liver cells from human stem cells with the basic aim of developing an alternative for the treatment of liver diseases that requires a liver transplant.
LIVER CRITICAL CARE
The Liver Critical Care Division is managed by experienced Intensivists to provide world-class care to critically ill patients mainly with Acute Liver Failure or End-stage Liver Disease with acute decompensated diseases apart from providing post-operative care. The unit has a state-of-art tertiary care liver ICU fully equipped with modern equipment like the latest ventilators, high-end monitors, CRRT and Dialysis, the latest point-of-care monitors along with experienced, well trained doctors and nursing staff. The unit provides well-equipped ambulances for shifting critically ill patients with liver failure from distant places to our hospitals. We also provide an air ambulance facility for quick inter-city transfers. The complete details for availing these services are available on our 24 hour helpline.
FREQUENTLY ASKED QUESTIONS
Who requires a liver transplant?A patient of Liver Cirrhosis or End-stage Liver Failure requires a transplant. Other conditions include Acute or Fulminant Liver Failure and Liver Cancer (Hepatocellular Carcinoma).
What are the signs of liver failure?Extreme fatigue and lethargy, progressive or persistent Jaundice, abdominal distension (Ascites), altered mental functions or Sensorium (Hepatic Encephalopathy), decreased urine output or renal failure, easy bruising or recurrent Epistaxis (Coagulopathy) and/or Hematemesis, and the passing of black stool signifies presence of liver failure. Patients with any of these features need to be evaluated by a specialist to determine whether or not they require a liver transplant.
What are diseases that can lead to end-stage liver failure?Common ailments leading to End Stage Liver failure include Viral Hepatitis (Hepatitis B, Hepatitis C), Autoimmune Liver Cirrhosis, Non-alcoholic Fatty Liver Disease, Cryptogenic Liver Disease (when cause is not known) and Cholestatic Liver Diseases like Primary or Secondary Biliary Cirrhosis and Primary Sclerosing Cholangitis.
In children, congenital disorders like Biliary Atresia, Progressive Familial Intrahepatic Cholestatis (PFIC) and Congenital Hepatic Fibrosis can lead to liver failure and require a liver transplant.
What is Acute Liver Failure?Sometimes patients without any evidence of liver disease or Cirrhosis develop liver failure within a short span of time (within 2-6 weeks) and present with signs like deep and progressive Jaundice, Altered Sensorium or Liver Coma (Hepatic Encephalopathy). This disease is medically called Acute Liver Failure or Fulminant Liver Failure and is fatal unless an urgent liver transplant is performed.
What are the causes of Acute or Fulminant Liver Failure?Liver Failure can be caused by the overuse of drugs (Paracetamol) or toxins (certain herbal or Ayurvedic medications), Viral Hepatitis (Hepatitis A, E or B), or Wilson's Disease (an inborn disorder of copper metabolism). Liver failure as a result of any of these conditions is an emergency and a liver transplant has to be performed within hours.
Where is the liver for a transplant taken from?The new liver is derived either from a Cadaveric donor or a voluntary living donor.
What is the possibility of getting a Cadaveric liver?In India, Cadaveric Liver Transplantation is less popular owing to lack of Cadaveric Organ Donors. Awareness regarding sanctity of organ donation is still in its infancy not only in India but over much of the eastern part of the world, making living donor transplants more popular in these areas.
Who can be a living donor?Any person above the age of 18 can legally donate a part of his or her liver. However, in India, as per Human Organ Act 1996, liver donation is restricted to family members or close relatives. Medically, the liver donor should have a compatible blood group (same blood group as patient or O group), should not be more than 55 years of age, and should be medically fit and psychologically sound. All voluntary liver donors are evaluated thoroughly to look for medical and surgical fitness.
What is the outcome following a liver transplant?The success rate of the transplant worldwide is around 85-90%. Most patients lead normal, healthy and productive lives following the procedure. However, the individual outcome depends on factors like the cause of the disease, the degree of liver failure and the patient's general condition, and cannot be generalised.
When can the donor and patient resume work following a surgery?Donors can usually be discharged within 10 days and patients within 2-3 weeks time. The donor can resume normal activity within 3-4 weeks and resume his job within 6 weeks, and patients within 4-6 months. No special precautions are needed for the donors after 4-6 weeks and they can continue a normal life thereafter. Patients have to receive life-long immunosuppressive medication and take special care to prevent infections. There are no specific dietary restrictions. However, the consumption of uncooked food in salads and fruits with their peels (apples, grapes) has to be avoided.
- Liver, Biliary and Pancreatic Surgery for Cancers and benign disorders
- Critical Care for patients of Liver Trauma, Fulminant Liver Failure and End-stage Liver Failure.
- Non-operative management of Hepatobiliary-Pancreatic Disorders like ERCP, TACE, TIPSS and Therasphere.
- Upper and Lower Gastrointestinal surgery for Oesophageal, Stomach and Colon Cancers, or other benign conditions.
- Minimal Access & Advanced Laparoscopic Surgery for Biliary Stones, and stomach and colon diseases
Liver Patients Testimonials
Specialty: Organ Transplant
Patient Name: Rafiq Ilyasov
Country: UzbekistanView video
Specialty: Organ Transplant
Patient Name: Ubdar Hussain
Country: PakistanView video
Specialty : Organ Transplant
Patient Name : Rafiq Ilyasov
Country : Uzbekistan
Post the International OPD conducted by Fortis Healthcare in Uzbekistan, Rafiq Ilyasov travelled to India, he was diagnosed with Chronic Liver Disease which required Liver transplantation. The pre-operative tests revealed that his heart function values were low, thus increasing the risk associated with the liver transplant. Rafiq's positive attitude helped doctors to take on the challenge and post surgery the speedy recovery paved way for Rafiq to visit the Taj Mahal with his family.
To know more visit: http://www.fortishealthcare.com
Specialty : Organ Transplant
Patient Name : Ubdar Hussain
Country : Pakistan
With liver disease spreading across the world like an epidemic, it is important to know about liver disease, factors that cause it and when should one consider a liver transplant. Dr Vivek Vij provides vital insights on this and touches upon on why liver transplants requires a multidisciplinary team of experts, specialized facilities and state of the art technology which are only available at top class hospitals like Fortis. He also speaks on challenging cases like those of Ubdar Hussain and Munir Butt who came to India from Pakistan with the hope of getting a new lease of life
Ubdar Hussain discovered that he had Hepatitis C and a cancerous tumor in his liver when undergoing a routine medical checkup in Pakistan. He opted to go to Italy for medical treatment but met with disappointment when the doctors diagnosed that the cancer had spread and liver transplant was not possible. Faced with rejections from experts in France and Germany, Ubdar turned to Fortis where the transplant team realized that there was a threat to Ubdar's life and performed a lifesaving liver transplant.
Weighing in at 128 kgs at more than 6 feet tall, Munir Butt's size and fame meant that it would require a liver of massive propositions for the transplant to be successful. This brought challenges in terms of finding a matching donor with similar proportions or even the prospect of having to source the liver from multiple donors. However, using technological advances, the transplant team at Fortis was able to use a much smaller liver (donated by his daughter) and perform a successful liver transplant.
Fortis Centre of Excellence for Organ Transplants conducts a comprehensive Liver Transplant program, including medically challenging liver transplant surgeries like paediatric liver transplants. Medically advanced laboratories and ICUs offer excellent pre- and post-op care for recipients and donors ensuring high success rates.