The Liver Transplantation and Hepatobiliary Surgery team at Narayana Health is among the most experienced in India. We offer treatment for end-stage liver disease (liver cirrhosis), unresectable liver tumour or metabolic liver disease that meets the criteria for a liver transplant. The team has extensive experience in using open and laparoscopic approaches for complex hepatobiliary (HPB) surgery for both benign and malignant diseases. We are a reputed liver transplant hospital in India, trusted by patients across the world.

Our team was the first to use the robotic surgical platform for liver resections in India, and our work is published in indexed surgical journals. We have also been actively using The da Vinci surgical system for hepatobiliary cases, including choledochal cyst resection with Roux-en-Y hepaticojejunostomy, liver cyst resection and radical cholecystectomy. Our experienced team of liver transplant and HPB surgery specialists uses state-of-the-art equipment to ensure the best outcomes for even the most complex cases.

We strive to provide world-class treatments at affordable prices for patients suffering from liver diseases, cancers and diseases of the bile duct, gallbladder and pancreas. This is why we are rated as one of the best liver transplant centres in India. These surgeries are usually recommended when the liver is damaged beyond regenerative capacity.

Reasons for Liver Transplantation

Chronic Active Hepatitis

This progressive liver disease is characterised by inflammation of the liver due to viral infections like Hepatitis B and C. If left untreated, it can lead to severe problems like liver failure, liver cirrhosis and hepatocellular carcinoma. HPB surgeons recommend liver transplantation if the functioning of the liver is severely compromised.

Hepatic Tumours

Two types of hepatic tumours – hepatocellular carcinoma (HCC) and Secondary (metastatic) liver cancer – are leading reasons for liver transplant operations. In most cases, the liver is severely damaged, and the damage has spread to the other parts of the body. Procedures could include a partial hepatectomy or total liver replacement surgery for severe cases.

Congenital Hepatic Fibrosis

This is a rare genetic disorder characterised by fibrous tissues in the liver that not only compromise liver function but also lead to portal hypertension. This condition is common in adolescents and children, often leading to liver-related complications if left untreated. If the liver is damaged beyond repair, hepatobiliary surgery replaces the fibrotic liver with a healthy donor liver.

Cystic Fibrosis

This genetic disorder affects multiple organs, including the liver. It is categorised by thick mucus blocking the bile ducts, which leads to cirrhosis, liver damage and eventually liver failure. If the disease progresses to critical stages, liver replacement surgery might be needed.

Caroli Disease

This is a congenital disorder, characterised by the dilation of the bile ducts. Although rare, it can cause stones, recurrent infections and even complete liver damage. In most cases, surgery is necessary to remove the portions of the liver that are not reparable. In severe cases, complete liver replacement might be needed.

Hemochromatosis

This genetic disorder causes the absorption and storage of too much iron in various organs in the body, especially the liver, heart and the pancreas. It can lead to various diseases, including liver cirrhosis, liver damage and, in severe cases, liver cancer. You can look for symptoms like joint pain, abdominal pain, and excessive fatigue. If the disease becomes sever, and liver transplant surgery becomes necessary, choose Narayana Health for the best outcomes.

Wilson’s Disease

This is another hereditary condition that causes the body to retain copper in excess amounts that slowly get deposited in the brain, liver and other vital organs. This not only leads to liver diseases but also manifests as neurological and psychiatric symptoms. While symptoms may exhibit from anywhere between the ages of 5 to 35, some signs you should look out for are abdominal pain, extreme fatigue, jaundice and, in severe cases, tremors.

Wolman’s Disease

This is also a rare genetic disorder caused by the deficiency of an enzyme known as lysosomal acid lipase. This leads to the accumulation of lipids in various organs and tissues, like the liver and spleen. While this condition can be diagnosed in infancy itself through symptoms like an enlarged liver or spleen, other symptoms you can keep an eye on include vomiting, failure to thrive and severe malnutrition. Rapid progression towards liver failure might necessitate liver transplant surgery.

Byler’s Disease

This is also a genetic disorder that impairs the flow of the bile, slowly leading to chronic liver disease and failure. Symptoms may include poor weight gain, failure in growth, severe jaundice and uncontrolled itching. With the progression of the disease, the functioning of the liver deteriorates till liver transplantation is the only viable option. A team of HPB surgeons from the best liver hospital can offer the best care.

Tyrosinemia

This metabolic disorder is caused by a deficiency in the amino acid tyrosine, resulting in the accumulation of substances in various organs. The symptoms manifest in infancy and early childhood as a foul body odour (categorised as cabbage-like), jaundice and hepatomegaly. Severe cases may need hepatobiliary surgery and liver transplantation.

Liver Transplant Surgery in Children

A child would need a liver transplant operation due to a condition known as biliary atresia. The bile ducts that transport bile to the gallbladder and intestine are underdeveloped in children suffering from this condition. The condition can be corrected with reconstructive surgery in the initial few months after birth. But if the problem persists, the child may require liver transplant surgery.

Another common ailment that needs liver transplantation in children is a tumour known as hepatoblastoma. It is crucial to choose the best liver transplant hospital in India with an experienced team of HPB surgeons for optimal outcomes in young children.

Liver Transplant & Hepatobiliary Services at Narayana Health

Orthotopic Liver Transplant

Orthotopic liver transplantation involves the surgical removal of the liver and replacing it with a liver harvested from a deceased donor in the same anatomic position as the original organ. During the surgery, the surgeon creates a small incision on the abdomen to remove the damaged liver and replace it with a healthy donor liver. The surgeon positions the donor liver and connects all the blood vessels and bile ducts. Once the procedure is completed, the incision is closed. The surgeon attaches drainage tubes to drain away excess fluids. After this, the patient is transferred to the ICU for further treatment and recovery.

Living Donor Liver Transplant

This surgical procedure involves taking a portion of the liver from a healthy living person and placing it on a failed liver.

The doctors first operate on the donor to remove a portion of their liver. The surgeons can remove the right or left side of the liver, depending on the age of the patient. The right lobe or right side of the liver is bigger and, hence, is recommended for adult patients. As the left lobe is smaller, it is suited for children.

The HPB surgeon makes an incision on the abdomen and removes the damaged liver. Later, the right or left lobe from the donor is placed in the right position, and the blood vessels and bile ducts are connected. The incision is closed, and the patient is shifted to the ICU for recovery and treatment.

The donor can regrow the remaining part of their liver, which can return to its normal size, volume and capacity within a few months. The transplanted liver grows to restore its size and function.

Split Donation Liver Transplant

The liver cannot be split evenly for transplantation due to its anatomy. For split donation liver transplantation, the organ is divided into two parts where 35%-40% is the left lobe and 65%-70% is the right lobe. Since the split liver halves are smaller than the whole organ, the surgery can benefit patients who weigh between 45 and 72 kgs.

To maximise the benefit of each donor organ portion, the two parts of the liver can be transplanted into two different patients. This procedure is generally used if two patients require liver replacement surgery (one adult and one child). The surgical process is the same as that of a living donor liver transplant. The transplanted liver grows to a normal size through the process of regeneration.

Liver Transplantation And Hepatobiliary Surgery