Living donor liver transplantation in India

TLDR

Liver transplantation is a lifesaving therapy for end‑stage liver disease, and while living donor liver transplantation (LDLT) has advanced in Asian centres, only 22 Indian centres—14 of which have performed at least one LDLT—have adopted this resource‑intensive approach. At our centre, 140 LDLT procedures—including 13 emergency cases—demonstrate that a high‑volume LDLT program with superior advantages over deceased donor transplantation is feasible in India.

Abstract

The world over, liver transplantation has emerged a panacea for thousands of patients suffering from end-stage liver disease. The strides made in living donor liver transplantation (LDLT) by Asian centres particularly in Japan, Korea, Hong Kong and Taiwan made many Indian centres realise that in order to sustain liver transplant activity in the country, a similar solution had to be found. Even though LDLT is very resource intensive and requires skilled multidisciplinary manpower, 22 centres in India have performed liver transplants, of which 14 have performed at least one LDLT procedure. 140 LDLT procedures have been performed at our centre, of which 13 have been done in emergency circumstances. LDLT has certain advantages over DDLT. It allows for adequate preparation of the patient for elective transplant and recipients are not in competition with others over the same donor organ. Major concerns with LDLT are of donor safety and biliary complications. In conclusion, establishing a high volume LDLT centre with excellent success rates is feasible in the Indian setting.