What is a liver transplant and who is a suitable candidate?
A liver transplant is a surgical procedure in which a diseased or failing liver is replaced with a healthy liver from a deceased or living donor. Suitable candidates are patients with end-stage liver disease, acute liver failure, or certain liver cancers whose condition cannot be managed by other treatments. Lilavati International in Mumbai offers comprehensive Gastroenterology and liver transplant evaluation services for patients requiring advanced hepatic care.
Tip: A liver transplant is considered only after all other medical and surgical options have been exhausted. Early evaluation is key to securing a place on the transplant waiting list.
Candidacy is determined through a structured evaluation process that assesses the severity of liver disease, overall health status, and the absence of contraindications. The MELD score (Model for End-Stage Liver Disease) is the primary tool used to prioritise patients on the transplant waiting list.
What conditions require a liver transplant?
A liver transplant is indicated when the liver can no longer perform its essential functions and the patient's life is at risk. The following conditions are among the most common reasons a transplant is recommended:
- Cirrhosis — advanced scarring of the liver caused by chronic hepatitis B or C, alcohol-related liver disease, or non-alcoholic fatty liver disease (NAFLD/NASH)
- Acute liver failure — sudden, severe loss of liver function, sometimes caused by drug toxicity or viral hepatitis
- Hepatocellular carcinoma (HCC) — primary liver cancer meeting specific transplant criteria (e.g., Milan criteria)
- Biliary atresia — a condition in children where bile ducts are absent or damaged
- Primary biliary cholangitis (PBC) and primary sclerosing cholangitis (PSC)
- Wilson's disease and haemochromatosis — inherited metabolic disorders affecting the liver
- Autoimmune hepatitis unresponsive to medical therapy
A gastroenterologist or hepatologist will assess whether the underlying condition meets transplant criteria before referral for surgical evaluation. To explore Gastroenterology services at Lilavati International, use the booking form on this page.
What are the criteria for being a suitable liver transplant candidate?
Not every patient with liver disease qualifies for a transplant. Suitability is determined through a multi-disciplinary evaluation covering medical, surgical, and psychosocial factors.
General inclusion criteria:
- Diagnosis of end-stage liver disease or acute liver failure with no alternative treatment
- MELD score typically 15 or above (higher scores indicate greater urgency)
- Hepatocellular carcinoma within accepted transplant criteria
- Adequate cardiac and pulmonary function to tolerate major surgery
- Absence of active systemic infection or uncontrolled sepsis
- Commitment to post-transplant medication adherence and follow-up
- Abstinence from alcohol or substance use (with documented sobriety period where applicable)
Conditions that may exclude a candidate:
- Active or metastatic malignancy outside the liver
- Severe, irreversible cardiopulmonary disease
- Uncontrolled psychiatric illness affecting treatment compliance
- Active alcohol or substance dependence without rehabilitation
- Severe, irreversible brain damage
Warning: Candidacy criteria vary between transplant centres and are reassessed throughout the evaluation process. A formal multi-disciplinary team review is required before any decision is made.
What is the MELD score and why does it matter for a liver transplant?
The MELD score (Model for End-Stage Liver Disease) is a numerical scale used to assess the severity of chronic liver disease and to prioritise patients on the deceased-donor transplant waiting list. It is calculated using three blood test values.
| Parameter | What It Measures |
|---|---|
| Serum Bilirubin | Liver's ability to process waste products |
| Serum Creatinine | Kidney function, often impaired in advanced liver disease |
| INR (Prothrombin Time) | Blood clotting ability, reflecting liver's synthetic function |
MELD scores range from 6 to 40. A higher score indicates more severe disease and a greater short-term risk of death without a transplant. Patients with a MELD score of 15 or above are generally considered for transplant listing. Scores are recalculated regularly as the patient's condition changes.
Liver function tests, including those used to calculate the MELD score, are available through Liver Function Tests at Lilavati International.
Can a living donor provide part of their liver for transplant?
Yes. A living donor liver transplant (LDLT) involves surgically removing a portion of a healthy donor's liver and transplanting it into the recipient. The liver has a unique ability to regenerate — both the donor's remaining liver and the transplanted segment grow to near-normal size within weeks.
Who can be a living donor?
- A blood relative or emotionally related individual (spouse, close friend)
- Aged typically between 18 and 55 years
- In good general health with no significant medical conditions
- Compatible blood group with the recipient
- Willing to undergo a thorough medical, surgical, and psychological evaluation
- Free from liver disease, diabetes, or conditions that increase surgical risk
Living donor transplants can reduce waiting time significantly compared to deceased-donor transplants, which is particularly relevant in India where deceased-donor availability remains limited. The evaluation process for both donor and recipient is conducted by a multi-disciplinary team.
Tip: Donor evaluation is completely independent of the recipient's evaluation. A donor is never pressured to proceed and may withdraw at any stage without affecting the recipient's care.
How long does liver transplant surgery take and what is the recovery time?
Liver transplant surgery is a major operation performed under general anaesthesia. The duration and recovery period depend on whether the liver comes from a deceased or living donor, and on the recipient's overall health.
| Phase | Typical Duration |
|---|---|
| Surgery (recipient) | 6 to 12 hours |
| ICU stay post-surgery | Several days, depending on stability |
| Hospital stay (total) | 2 to 4 weeks typically |
| Return to light activity | 3 to 6 months |
| Full recovery | 6 to 12 months |
After discharge, recipients require lifelong immunosuppressant medication to prevent organ rejection, along with regular follow-up appointments, blood tests, and imaging. Adherence to the post-transplant care plan is essential for long-term graft function.
Risks associated with liver transplant include:
- Organ rejection (acute or chronic)
- Infection due to immunosuppression
- Bile duct complications (leaks or strictures)
- Vascular complications (hepatic artery thrombosis)
- Recurrence of the original liver disease
- Side effects of long-term immunosuppressant medications
When should you seek a liver transplant evaluation?
Consult a hepatologist or gastroenterologist promptly if you or a family member experiences any of the following, particularly if symptoms persist or worsen over days to weeks:
- Jaundice (yellowing of skin or eyes) that does not resolve
- Persistent abdominal swelling (ascites) not responding to diuretics
- Repeated episodes of hepatic encephalopathy (confusion, disorientation)
- Vomiting blood or passing black, tarry stools (signs of variceal bleeding)
- A diagnosis of cirrhosis with deteriorating liver function tests
- Hepatocellular carcinoma confirmed on imaging
- Acute liver failure developing over days with no identifiable reversible cause
Early referral for Liver Transplant Evaluation allows the medical team to assess candidacy, optimise the patient's condition before surgery, and — where applicable — identify a suitable living donor in time.
Warning: Acute liver failure is a medical emergency. If a patient develops sudden jaundice, confusion, or bleeding alongside known liver disease, seek emergency care immediately. Lilavati International's emergency department at Bandra West, Mumbai is available 24/7, including holidays, with no appointment required. Emergency: 022-69318063 / 64. Ambulance: +91 97692 50010.
How does Lilavati International support liver transplant patients in Mumbai?
Lilavati International in Bandra West, Mumbai is a JCI- and NABH-accredited quaternary-care hospital with the infrastructure to support complex hepatic care across every stage — from initial liver function testing and endoscopy through to transplant evaluation and critical-care management.
The hospital's facilities relevant to liver transplant care include:
- Round-the-clock access to CT, MRI, ultrasound, and a full diagnostic laboratory — including Liver Function Tests
- Endoscopy services for assessment and management of varices and biliary conditions — see Endoscopy at Lilavati International
- Dedicated ICU, ICCU, SICU, and PICU for post-operative critical care
- Multiple operation theatres equipped for major abdominal surgery
- Blood bank, pathology, and dialysis facilities on-site
- International patient-care support for patients travelling to Mumbai for treatment
- 24/7 emergency department with dedicated trauma and resuscitation services
The hospital holds Joint Commission International (JCI) Accreditation – 8th Edition, NABH Hospital Accreditation, and NABL Accreditation, reflecting its commitment to clinical standards and patient safety.
To speak with a specialist or begin the liver transplant evaluation process, use the booking form on this page or contact the team directly.
Book a consultation at Lilavati International
Use the booking form on this page, or reach out directly:
Call: 022 69318050
WhatsApp: 022 69318050