Center for Liver Restoration

Living Donor Liver Transplant (LDLT)

Liver failure is not the end; it is a signal for renewal. Living Donor Liver Transplant (LDLT) is the gold standard for treating end-stage liver disease in India. By using a partial liver from a healthy relative, we bypass the long waiting lists and perform surgery before the patient becomes too critical.

95% Success Rate Zero Waiting List

The Donor: Safety is Absolute

The first rule of transplant is: The Donor Must Be Safe. A healthy person is volunteering to save a life, and their safety is our moral and legal priority. Global studies confirm donor mortality risk is less than 0.2%.

Who Can Donate?

  • Age: 18 to 55 Years.
  • Relation: Close relative (Wife, Son, Daughter, Sibling, Parents).
  • BMI: Ideally < 28 (Not obese).
  • Blood Group: Compatible (or ABO-Incompatible protocol).

Who Cannot Donate?

  • Active Infection (HIV, Hepatitis).
  • Diabetes or Heart Disease.
  • Pregnant Women.
  • Fatty Liver > 20% (Determined by Biopsy).

Blood Group Matching

Historically, blood groups had to match perfectly. Today, we have options.

O Universal Donor
(Gives to A, B, AB, O)
A / B Can donate to
Same Group or AB
ABO-I Incompatible Swap
(Requires Desensitization)
ABO-Incompatible Transplant (ABOi): If you do not have a matching donor, we can still perform the transplant. We use a special protocol (Rituximab + Plasmapheresis) to "clean" the recipient's antibodies so they don't reject the new liver.

The Science of Matching

It is not just about blood groups; it is about Volume. The liver piece must be big enough to keep the recipient alive, but small enough to leave the donor safe.

GRWR (Graft-to-Recipient Weight Ratio):
This is the "Golden Number." The donated liver piece must be at least 0.8% of the recipient's body weight.
Example: If the patient is 80kg, they need at least 640 grams of liver. We measure this precisely using CT Volumetry software before we ever enter the operating room.

The Legal Process (Authorization Committee)

India has strict laws (THOA Act) to prevent organ trade. Every LDLT case must be cleared by a government-appointed Authorization Committee.

  • Phase 1: Medical Fitness clearance.
  • Phase 2: DNA matching (HLA) to prove relationship.
  • Phase 3: Committee Interview (Video recorded) to ensure donation is voluntary.

The Procedure

LDLT involves two simultaneous surgeries in adjacent operating theaters.

Donor Surgery

We typically remove the Right Lobe (60-65% of liver) for adult recipients. For children, we take the smaller Left Lateral Segment.
Safety Tech: We use CUSA (Ultrasonic Aspirator) to cut the liver without bleeding. The gallbladder is also removed.

Recipient Surgery

The diseased liver is removed completely (Hepatectomy). The new healthy graft is implanted. We connect:
1. Hepatic Vein (Outflow)
2. Portal Vein (Inflow)
3. Hepatic Artery (Oxygen)
4. Bile Duct (Drainage)

The Miracle of Regeneration

Patients often ask: "How can the donor live with half a liver?"

The liver is the only organ in the human body with the superpower of Hyperplasia. It does not just stretch; it grows new cells.

1 Week

Rapid growth begins immediately. Liver enzymes will be temporarily high.

4 Weeks

60-70% of the volume is restored. Donor feels energetic again.

3 Months

Near-complete regeneration (90%+). Function is normal.

Recovery Timeline

For the Donor

  • Hospital Stay: 5 to 7 days.
  • Pain: Epidural analgesia means minimal pain.
  • Work: Back to desk jobs in 3-4 weeks.
  • Scars: We use cosmetic "sub-cuticular" stitches (dissolvable).

For the Recipient

  • ICU Stay: 3 to 5 days for monitoring.
  • Hospital Stay: 12 to 15 days total.
  • Quarantine: Must avoid crowds for 3 months (Immunosuppression).
  • Life: Normal quality of life resumes by Month 3-6.

Patient FAQ

Hover over the questions below to reveal the answers.

1. Can a diabetic person be a liver donor?
Usually, No. Diabetes can affect liver quality. However, if it is pre-diabetes controlled strictly by diet with no medication, we might consider them after a biopsy.
2. Will the donor have to take medicines for life?
No. The donor takes painkillers for a few weeks and maybe iron/vitamins for 3 months. After that, they take zero medication related to the surgery.
3. Can a female donor get pregnant later?
Yes. We recommend waiting at least 1 year after donation to allow the body to fully recover strength. The liver regeneration itself does not affect fertility.
4. What if the donor's liver is Fatty?
If fat is >20% (Macro-steatosis), we cannot use it immediately. We often put the donor on a strict diet/exercise plan for 4 weeks to reverse the fat, then re-evaluate.
5. Is the surgery covered by insurance?
Yes. The Recipient's insurance usually covers the Donor's surgery costs as part of the transplant package. However, donor evaluation tests are sometimes out-of-pocket.
6. How big is the surgical scar?
For donors, we often use a "Mercedes Benz" incision or a midline incision. In Robotic donor surgery, the main cut is much smaller (just to remove the organ), located low like a C-section scar.
7. Can I drink alcohol after donating?
We strongly advise zero alcohol for at least 6 months while the liver regenerates. After that, social drinking is allowed, but heavy drinking is discouraged.
8. What is the success rate of LDLT?
In experienced centers, the 1-year survival rate for recipients is over 90-95%. The risk to the donor is extremely low (<0.2%).
9. How long does the legal approval take?
For close relatives (parents/children/spouse), it takes about 1 week. For distant relatives or unmatched names (requiring DNA tests), it may take 2-3 weeks for committee meetings.
10. Can I donate if I have had gallbladder surgery?
Yes! Since we remove the gallbladder during donation anyway, having it previously removed is not a problem at all.