Abstract

Objective: Living donor liver transplant (LDLT) is the mainstay of liver transplants (LT) in India. Data on transplant referrals and their outcomes is lacking from the subcontinent. This study is aimed to elucidate the reasons for eligible LT candidates not being able to undergo liver transplant and impact on mortality for such patients.

Methods: We analyzed 500 referrals to the LT surgery team between November 2018 to July 2019. Patient particulars, diagnosis, MELD score and plan as advised by the team was noted. A questionnaire was answered individually by each patient or primary caretaker after a minimum waiting period of 4 weeks from the clinic or inpatient visit.

Results: LT was advised in 476 (95%) patients. 34 (7%) patients were lost to follow up.58 out of 442 (12%) eventually underwent LT. Of the 57 patients transplanted at our center there was no inpatient mortality. 306/442 (69.2%) patients did not agree for evaluation. 74 patients died during the period of study out of which 34/74 (45.9%) had no donors, 25/74 (33.7%) had no finances and 15/74 (20.2%) lacked both donor and finances. 30/442 (6.7%) patients improved on follow up and did not require LT.

Conclusion: We conclude that lack of finances and living/deceased donors are the major impediments for LT in the developing world.

Keywords: Organ-Shortage; Waitlist-Mortality; Liver Transplantation

References

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Citation

Citation: Ashish K Mishra, Ashish Bansal, S Soundappan, Raghuram Reddy and P Kumaraswamy. “Analysis of 500 Referrals to a Liver Transplant Surgery Unit at a Tertiary Care Center in India: Are We Saving Enough Lives?". Acta Scientific Gastrointestinal Disorders 3.11 (2020): 04-08.

Copyright

Copyright: © 2020 Ashish K Mishra. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.