Best Liver transplant In Bangalore
Best Liver Transplant In Bangalore
It is a procedure wherein a patient’s native liver is taken out and replaced with a healthy liver. It involves the greatest amalgamation of various specialties- Hepatobiliary surgeons, Hepatologists, Radiologists, Intensive care specialists, and Anaesthetists.
The usual indications for liver transplantation are decompensated chronic liver disease, acute liver failure, and liver cancer.
All patients with chronic liver disease/ cirrhosis do not need transplantation, though they should be aware of the same.
Decompensation/end-stage disease in such patients like the development of intractable ascites, high bilirubin, bleeding tendencies, kidney dysfunction, gastrointestinal bleeding, encephalopathy, and progressive disease with increasing MELD (Model for End-stage Liver Disease) scores need a transplant. There are many scoring systems available to assess the severity of liver disease, the most used ones are the CTP score and MELD score. CTP and MELD score calculators are easily available on Google and one may calculate theirs from home. Though most patients under a MELD score of 14 or CTP score of 9 may be followed up, few of them still require a transplant, indicating even these scores do not include all aspects of assessing disease severity. The most common causes of chronic liver disease in adults in Indian settings are Hepatitis B/C and alcoholism. In children, common causes are Biliary atresia and errors of metabolism. If found early and advice followed, most of them may not progress to end-stage disease.
If you are searching for the best liver transplant in Bangalore then you are in the right place.
Acute liver failure is a condition in which liver functions deteriorate rapidly in a previously healthy liver. Some of them end up requiring emergency liver transplants based on clinical criteria followed in the transplant unit. The usual causes for acute liver failure are Hepatitis A/E (common)/B/C (less common), and alcoholic or drug-induced hepatitis (paracetamol/ TB medicines/ some Ayurvedic ones).
Liver cancers usually develop in previously damaged/ cirrhotic livers, though they may also develop in healthy native livers. Primary liver cancers in the cirrhotic liver are best treated by transplantation since it would also address dysfunctional liver.
There are generally 2 broad types of liver transplantation- Living/ brain dead donation. Though there have been discussions on the superiority of one over the other, both are equally good and serve their purpose, provided patient has time to wait. A living donor is usually a close relative (spouse/ parents/ children/ siblings), 18-55 years of age, of same blood group as patient/ O group, with no significant medical problems. He/ she would be extensively worked up to assess his/ her candidacy for donation, including the adequacy of liver volume in donor as well as the patient. Usually, the right lobe of the liver is harvested from the donor and it makes up approximately 60-70% of liver volume. One-fourth of normal healthy liver is sufficient to take care of bodily functions, 35-40% is left behind as remnant liver in donors for safety purposes. Moreover, liver has excellent regenerative capacity. It is a very safe procedure (but a major one) since the donor is healthy with normal liver and no significant medical problems. Donors are favorites of surgeons (and the community) since they voluntarily risk their lives for getting their loved ones healthier. The risk to life in donor operation is about 1 in 300 (0.3%). Other common complications are bleeding/ bile leaks requiring tube insertion.
If you are searching for the best liver transplant in Bangalore then you are in the right place.
Best Liver Surgeon In Bangalore
Brain dead donation involves taking whole livers from brain dead, blood group matching donors. It involves legal work and is managed/ coordinated by government appointed committee, called Jeevasarthakathe in our state. Patients need to get registered with them for organ donation. Liver may or may not be split before transplantation, depending on scenario.
Unlike most surgical procedures, Liver transplantation is not a one hit procedure- like removal of gallbladder/ hernia repair, where both patient and doctor forget each other after some time of treatment period. It needs life long follow up and build up of relation between healthcare provider and patient is very important.
Liver transplantation is a supra-major complex surgery with inherent risks of complications. The procedure involves joining of many blood vessels and bile ducts- either of which may get blocked or may leak and they need urgent rectification by either surgery or other means. It requires close monitoring in dedicated Liver ICU for first 2-4 days after surgery. The usual risks after surgery are need of prolonged ICU care/ ventilation since most patients are sick to begin with, rejection, risk of infection as all are put on immunosuppressors (to prevent rejection of implanted organ) and side effects of those medicines.
On an average, risk to life due to procedure is about 5-10 %. This means if 100 undergo liver transplant, 90-95 are likely to walk out of hospital after procedure. Another 10% would lose lives in next one year for reasons as recurrence of earlier disease/ rejection/ infections. Loss of life after that period is rare and about 75% are likely to survive 5 years.
For a consultation, you can visit Dr. Raghavendra Nagaraja who is the best surgeon for liver transplants in Bangalore.
Best Hernia Operation In Bangalore
Non-Cirrhotic Portal Hypertension- Shunt surgeries
It encompasses a group of disorders characterised by normal liver functions and structure but symptoms of portal hypertension, usually bleeding or bile duct blockage. The most common ones in clinical practice are EHPVO (Extra hepatic portal venous obstruction) and NCPF (Non-Cirrhotic portal fibrosis). Since liver structure and functions are normal, these do not require liver transplantation. They usually need treatment for gastrointestinal bleeding/ bile duct blockage. Many are asymptomatic and are incidentally found when being evaluated for some other illness and they may or may not need treatment depending on clinical scenario. The initial treatment would include endoscopic ones- for esophageal/ gastric varices or biliary stents for jaundice. Presence of symptomatic spleen enlargement/ problematic hyperfunctioning spleen with low platelet and white cell counts/ GI bleeding inspite of endoscopic treatments/ presence of ectopic varices beyond stomach/ bile duct blockage need surgical treatment. The usual surgical treatment is Splenectomy +/_ porto-caval shunts (common ones are spleno-renal or meso-caval shunt). Here, splenic vein from high pressure system is joined to kidney veins which are low pressure ones. This would reduce pressures in portal vein and reduce risks of bleeding and/ or bile duct blocks.