Deceased donor is a person who is declared “brain dead” but who can donate other organs of his body as the blood supply to these organs is maintained. The organs of a brain dead person can be used for transplantation if the next-of-kin give consent. Donor should be blood group compatible.
Patient evaluation - Patient undergoes an evaluation for the cause of end-stage liver disease and for the fitness for a major surgery like liver transplantation. As end stage liver disease has adverse effects on other organs of the body, a multidisciplinary team (including Hepatologist, Transplant surgeons, Anesthesiologist, Cardiologist, Chest physician, Dental surgeon, Psychiatrist, Gynaecologist for female recipient) evaluates the patient and then he/she is placed on the waiting list for deceased organ.
The waiting time apart from the availability of organ (shortage of donors), depends on the general medical condition of the patient. Hundreds of people die each year while waiting for a cadaveric liver to be offered. Organ donation after “brain death” is still in infancy in India. However, it is slowly and steadily making a place in the transplant program, which to a large extent at the moment is living related.
Patient preparation after the organ is available - Once the transplant team gets information regarding organ availability, the recipient on the waiting list for cadaveric liver transplant is contacted and admitted to the hospital. Simultaneously the retrieval team gets involved in the organ procurement while the patient is prepared for the surgery. Liver once retrieved is transported to the recipient hospital in a cold preservative solution.
Operation - The operation involves removal of the diseased liver and replacing it with a healthy liver from the deceased donor. The whole new liver with the conduits (arteries, veins and bile duct) are joined to the corresponding structures in the patient. This operation of liver transplantation usually lasts for 6-8 hours.
Post-transplant care - Patient usually stays in hospital for 2-3 weeks depending on the pre-transplant condition and his/her recovery. Post-transplant patient is started on medications (immunosuppressants) to prevent the individuals own body reacting to the new liver and rejecting it. These medications which are three in the initial part, is continued for life-long, however the number of medications get reduced to single or at the most two which are continued in a small dose. After transplantation patients have a good quality of life and most of them lead a comfortable and healthy life.
Blood group compatibility chart
Can donate liver
Can receive a liver
O, A, B, AB
A, B, AB, O
At Sir Ganga Ram Hospital, till date 13 deceased donor liver transplants have been performed.
In 2011 two deceased donor liver transplants have been done. The donors also donated their kidneys, eyes, heart and heart valves. The heart transplant was the first at Sir Ganga Ram Hospital.
In 2012, the Chairman, Board of Trustees, Sir Ganga Ram Hospital died of a brain hemorrhage. He had expressed his desire to donate his organs after death and his family readily agreed to donate his organs. His liver was transplanted into a patient from Punjab who had cirrhosis due to hepatitis B. Both kidneys were also transplanted. At 88 years of age he was the oldest liver donor in India. The liver recipient recovered uneventfully and is doing well.