The growth of liver transplants in India over the last two decades has been phenomenal. This growth has been mainly confined to the private sector with only a handful of government hospitals developing a sustainable and viable transplant program. This does lead to problems with equity in a country like India where the out of pocket expenses for healthcare means limited access to such transplants to the less affordable population.1

The first successful deceased donor and living donor liver transplants took place in 1998.2 Early attempts in 1995, with deceased donor liver transplants were unsuccessful. It was another decade before the liver transplant numbers became significant and by 2014 India had become a major hub for liver transplants in this part of the world with around 1400 transplants performed.3 At present, it is estimated that more than 1800 liver transplants are performed in India. Although these are done in 90 - 100 registered hospitals, 60% of all such transplants are performed by only about five hospitals in the country.4

It is estimated that 70 to 80% of livers come from living donors (80% are male recipients) and 20 to 30% from deceased donors. There are significant regional variations with the south and west having more deceased donors compared to North India, where the majority are living donors.

The high volume centres also attract many trainees from other countries to learn the techniques for safe living donor liver transplants. The growth of liver transplants has also meant that the deceased donation program has more support when it comes to retrieval of organs and because of the cost implications and return, the senior hospital managements are supportive to help with the growth of deceased donation.

The current issue of ITN carries the international and national data on liver transplants. The data is derived mainly from the WHO-Global Observatory website.

References

1. Sunil Shroff, John S. Gill. Bold policy changes are needed to meet the need for organ transplantation in India. American Journal of Transplantation. 14 Feb 2021. https://doi.org/10.1111/ajt.16537

2. Poonacha  P,  Sibal  A,  Soin  AS,  et  al.  India’s  first successful pediatric liver transplant. Indian Pediatric 2001;38:287-91.

3. Narasimhan G. Living donor liver transplantation in India. Hepatobiliary Surg Nutr. 2016 Apr;5(2):127-32. doi: 10.3978/j.issn.2304-3881.2015.09.01. PMID: Statistics Donor Story Workshops Anudaan Invited Article 27115006; PMCID: PMC4824736.

4. Choudhary NS, Bhangui P, Soin AS. Liver Transplant Outcomes in India. Cl