Dr. Srinivas Bojanapu, Hepatologist and Liver Transplant Surgeon at Dhaara Liver Clinic, Bangalore, performs Assessment for Liver Transplantation: Indications and Patient Selection with 16+ years of specialist experience. His team performs 60+ liver transplants per year, with outcomes benchmarked against international standards.

What is Assessment for Liver Transplantation: Indications and Patient Selection

When the liver is severely damaged and no longer able to perform its essential functions, a liver transplant may be the only option for survival. This life-saving procedure involves replacing the damaged liver with a healthy one from a donor. However, not all patients with liver disease are automatically eligible for a transplant. A thorough assessment for liver transplantation is crucial to determine whether a patient is a suitable candidate and to identify the right time for the procedure.

At Dhaara Liver Clinic, located in Yelahanka, Bangalore, we have a team of highly experienced liver transplant surgeons, including Dr. Srinivas Bojanapu, who performs over 60 liver transplants per year. Our goal is to provide compassionate, expert care to patients and their families throughout the entire journey from assessment to recovery.

Who Needs This

Liver transplantation is not a decision made lightly. It is a complex process that requires careful evaluation. The following are common indications for liver transplantation:

• End-stage liver disease (ESLD) caused by chronic conditions such as cirrhosis, which may be due to hepatitis B or C, alcohol abuse, or non-alcoholic fatty liver disease (NAFLD)
• Acute liver failure, often due to drug overdose, autoimmune hepatitis, or viral infections
• Liver cancer (hepatocellular carcinoma) that has not spread beyond the liver and meets specific criteria for transplant eligibility
• Biliary atresia, a rare condition in infants where the bile ducts are absent or blocked
• Genetic liver disorders, such as Wilson’s disease or alpha-1 antitrypsin deficiency, which cause progressive liver damage

If you or a loved one is experiencing symptoms like jaundice, fluid buildup in the abdomen (ascites), confusion, or frequent bleeding, it may be time to consider a liver transplant. Our team at Dhaara Liver Clinic is here to guide you through the process with care and expertise.

What Happens Before the Procedure

Before a liver transplant, a comprehensive assessment is conducted to evaluate the patient’s overall health, the severity of liver disease, and the likelihood of success after the transplant. This process is essential for selecting the right candidates and ensuring the best possible outcome.

Initial Evaluation

• A detailed medical history is taken, including current symptoms, past illnesses, medications, and family history of liver disease
• Physical examination to assess signs of liver damage, such as jaundice, swelling, or abdominal distension
• Blood tests to check liver function, blood type, and general health
• Imaging studies like ultrasound, CT scan, or MRI to evaluate the size and condition of the liver
• Liver biopsy, in some cases, to get a closer look at the liver tissue

Psychological and Social Assessment

• A psychological evaluation to ensure the patient is emotionally prepared for the transplant journey
• A social assessment to understand the patient’s support system, living situation, and ability to follow post-transplant care instructions

Waiting List and Prioritization

• Once a patient is deemed a suitable candidate, they are placed on the transplant waiting list
• Patients are prioritized based on the severity of their condition, as determined by a scoring system such as the Model for End-Stage Liver Disease (MELD)
• The MELD score helps determine how urgently a transplant is needed and the likelihood of survival while waiting

At Dhaara Liver Clinic, our team ensures that every patient is fully informed and prepared throughout this initial phase. We understand that this is a time of uncertainty and fear, and we are here to support you every step of the way.

The Procedure Itself

Once a suitable donor liver is available, the liver transplant surgery is scheduled. The procedure typically takes between 6 to 12 hours, depending on the complexity of the case.

Types of Liver Transplants

• Whole liver transplant: The most common type, where the entire diseased liver is removed and replaced with a healthy one from a deceased donor
• Living donor liver transplant: In this procedure, a portion of a healthy liver is removed from a living donor (usually a family member or close friend) and transplanted into the recipient. The donor’s liver regenerates, and the transplanted portion grows to full size in the recipient

The Surgery Process

• The patient is placed under general anesthesia and connected to a heart-lung machine to maintain circulation during the operation
• The surgeon carefully removes the diseased liver and replaces it with the donor liver
• The blood vessels and bile ducts are connected to the new liver
• The surgery is completed, and the patient is moved to the intensive care unit (ICU) for close monitoring

At Dhaara Liver Clinic, our team of highly skilled surgeons, including Dr. Srinivas Bojanapu, is experienced in performing both deceased donor and living donor liver transplants. Our team is committed to delivering the highest standards of care and ensuring the best possible outcomes for our patients.

Recovery and Aftercare

Recovery from a liver transplant is a gradual process that requires close follow-up and adherence to a strict care plan. The initial recovery takes place in the hospital, and it typically lasts 1 to 2 weeks. After discharge, patients continue to recover at home and attend regular outpatient appointments.

Hospital Stay and Recovery

• During the hospital stay, the patient is closely monitored for infections, rejection, and complications
• Medications are prescribed to prevent organ rejection, including immunosuppressants
• Nutritional support is provided to help the body heal and recover

Home Recovery and Follow-Up

• Patients are discharged home once they are stable and able to perform basic activities
• Follow-up appointments are scheduled regularly for the first few months, and then at longer intervals
• Blood tests are conducted frequently to monitor liver function and medication levels
• Lifestyle changes are recommended, such as avoiding alcohol, eating a healthy diet, and exercising regularly

Long-Term Care

• Lifelong immunosuppressive therapy is necessary to prevent the body from rejecting the new liver
• Patients are encouraged to avoid certain medications and herbal supplements that may interact with immunosuppressants
• Regular check-ups are essential to ensure the liver is functioning well and to detect any early signs of rejection or complications

At Dhaara Liver Clinic, we are committed to supporting our patients throughout their entire recovery journey. Our team is always available to answer questions and provide guidance, ensuring that patients and families feel supported and empowered.

Risks and Outcomes

Like any major surgery, a liver transplant carries risks, but with modern medical advancements and expert care, the success rate is very high. Our team at Dhaara Liver Clinic ensures that patients are fully informed about these risks and what to expect during the recovery process.

Common Risks and Complications

• Rejection of the new liver: The body may recognize the donor liver as foreign and attack it. This is managed with immunosuppressive medications
• Infections: Due to the use of immunosuppressants, patients are at a higher risk of infections
• Bile duct complications: Such as bile leaks or strictures, which may require additional procedures
• Blood clots and bleeding: These can occur during or after the surgery
• Side effects from medications: Immunosuppressants may cause diabetes, high blood pressure, or osteoporosis

Outcomes and Long-Term Survival

• Survival rates for liver transplant recipients are very encouraging, with 5-year survival rates exceeding 70%
• Most patients are able to return to normal life, including work, school, and family activities
• With proper care and follow-up, many patients enjoy many years of healthy, active living

We understand that this is a difficult time for you and your family, and we are here to support you with compassion, care, and medical excellence. Our team at Dhaara Liver Clinic is dedicated to providing the best possible outcomes for our patients and ensuring that they and their families feel confident in the care they receive.

Conclusion

A liver transplant can be a life-saving treatment for patients with end-stage liver disease or other conditions that severely affect the liver. The process of assessment for liver transplantation is critical in determining whether a patient is a suitable candidate and ensuring the best possible outcome.

At Dhaara Liver Clinic, Yelahanka, Bangalore, we offer expert care, advanced medical technology, and a compassionate approach to every patient and their family. Our team, including Dr. Srinivas Bojanapu, who performs over 60 liver transplants per year, is committed to providing high-quality, personalized care throughout the entire transplant journey.

If you or a loved one is considering a liver transplant, we are here to guide you with trust, knowledge, and care. Together, we can navigate this challenging process and work toward a healthier future.