Understanding Liver Transplant Surgery
Liver transplant surgery replaces a severely damaged or failing liver with a healthy liver or a suitable portion of a donor liver. It may be considered for patients with advanced chronic liver disease, decompensated cirrhosis, selected liver cancers or acute liver failure when the liver is unlikely to recover with medical treatment. Depending on the clinical situation and organ availability, transplantation may involve a living donor liver transplant or a deceased donor liver transplant.
A transplant decision involves more than assessing liver function alone. The underlying disease, severity of liver failure, other medical conditions, cancer status where applicable, nutritional condition and overall suitability for major surgery all need to be evaluated before listing.
Dr. Chetan Kalal: Expertise in Liver Transplant Care
Dr. Chetan Kalal is a DM Hepatologist with 15+ years of experience in managing advanced liver disease and transplant-related care. Recognised as Maharashtra’s first DM Hepatologist, he completed his DM Hepatology training at ILBS, New Delhi, under Prof. S. K. Sarin. He currently serves as Associate Director, Hepatology & Liver Transplant at Gleneagles Hospital, Mumbai.
15+ Years of Experience
Extensive experience managing complex liver and transplant cases.
First DM Hepatologist in Maharashtra
Advanced specialist training in hepatology from ILBS, New Delhi.
Transplant Medicine Expertise
Experience evaluating patients before and after liver transplantation.
26 Peer-Reviewed Publications
Research contributions across national and international medical journals.
Your Liver Transplant Evaluation Starts With One Important Question
Not every patient with liver disease requires a transplant. The decision depends on the severity and progression of liver disease, complications, overall health and the likelihood that transplantation will provide meaningful benefit. The initial evaluation focuses on:
When Does a Liver Transplant Become Necessary?
Liver transplantation may become relevant when the liver can no longer maintain adequate function or when complications of advanced liver disease become difficult to control. Transplant evaluation may be considered in patients with:
Liver Transplant Surgery in Mumbai: Understanding Your Transplant Options
There are two main sources of liver grafts used for transplantation. The appropriate option depends on the patient’s medical condition, donor availability and transplant programme requirements.
When Does a Liver Transplant Become Necessary?
Liver transplantation may become relevant when the liver can no longer maintain adequate function or when complications of advanced liver disease become difficult to control. Transplant evaluation may be considered in patients with:
- Decompensated cirrhosis - Recurrent or progressive complications despite appropriate treatment.
- Refractory ascites - Abdominal fluid that remains difficult to control with standard treatment
- Recurrent variceal bleeding- Repeated bleeding despite appropriate medical and endoscopic management.
- Persistent hepatic encephalopathy- recurrent or difficult-to-control changes in brain function.
- Acute liver failure - Sudden severe liver dysfunction with limited likelihood of spontaneous recovery.
Transplantation is not a single operation but a process that begins well before surgery. The pre-transplant phase focuses on determining suitability, reducing avoidable risks and preparing the patient and donor where applicable.
The severity of liver disease is assessed using clinical findings, laboratory investigations and established scoring systems to determine transplant need and urgency.
Kidney, heart, lung and other organ function are assessed because transplantation is a major procedure requiring adequate overall medical fitness.
Patients are evaluated for active infections and, where relevant, liver cancer is assessed to determine whether transplantation is an appropriate treatment option.
Malnutrition and muscle loss are common in advanced liver disease. Nutritional assessment and appropriate intervention can help prepare the patient for transplantation.
Potential living donors undergo detailed medical and anatomical evaluation to assess liver health, compatibility and whether donation can be performed safely.
Patients and families are counselled about immunosuppressive medicines, follow-up visits, infection precautions and the long-term monitoring required after transplantation.
When Is a Second Opinion for a Liver Transplant Useful?
A transplant decision can involve several complex factors, particularly when there are questions about timing, donor suitability, transplant eligibility or the expected benefits of surgery. A specialist second opinion may help when:
Transplant Has Been Recommended
Donor Suitability Is
Unclear
The Timing of Transplant Is Uncertain
The Case Is Medically
Complex
Frequently Asked Questions About Liver Transplant Surgery
Who needs a liver transplant?
A liver transplant may be considered for patients with advanced liver failure, decompensated cirrhosis, selected liver cancers or acute liver failure when the liver is unlikely to recover with medical treatment.
What is a living donor liver transplant?
A living donor liver transplant uses a suitable portion of a healthy donor’s liver to replace the recipient’s diseased liver. The donor and recipient both undergo detailed evaluation before transplantation.
What is a deceased donor liver transplant?
A deceased donor liver transplant uses a suitable liver from a deceased donor. The organ is allocated to an appropriate recipient through established transplant allocation processes.
Does everyone with cirrhosis need a liver transplant?
No. Many patients with compensated cirrhosis can be managed medically and monitored for complications. Transplant evaluation becomes relevant when liver function deteriorates or complications become difficult to control.
How is a patient evaluated before transplantation?
Evaluation includes liver disease severity, other organ function, infection screening, cancer assessment where relevant, nutritional status and overall ability to undergo major surgery and follow long-term post-transplant treatment.
What happens after a liver transplant?
Patients require lifelong follow-up, regular liver function monitoring and immunosuppressive medicines to reduce the risk of rejection. Monitoring also focuses on infections, kidney function, metabolic health and other long-term effects.
