Orthotopic Liver Transplant in Gurgaon, India

What is an Orthotopic Liver Transplant? 

An orthotopic liver transplant is a surgical procedure in which a diseased or failing liver is removed and replaced with a healthy donor liver in the same anatomical position. It is one of the most effective treatments for advanced liver disease, offering patients a chance to regain normal liver function and long-term health. The procedure is carefully planned, highly specialized, and supported by a multidisciplinary medical team to ensure the best possible outcome. 

Types of Liver Transplants 

1. Deceased Donor Liver Transplant (DDLT)

In this type, the liver is obtained from a donor who has been declared brain-dead but whose organs remain functional through life support. The entire liver is transplanted into the recipient. This is the most common form of liver transplantation and is typically based on waiting-list priority, medical urgency, and organ compatibility. DDLT is ideal for patients with advanced liver failure, acute liver injury, or end-stage liver disease requiring complete organ replacement. 

2. Living Donor Liver Transplant (LDLT) 

Here, a healthy individual—usually a relative or emotionally connected donor—donates a portion of their liver. Since the liver has a unique ability to regenerate, both the donor’s remaining liver and the recipient’s transplanted portion grow back to normal size within weeks. LDLT offers several advantages: shorter waiting time, planned surgery, and improved survival rates due to healthier donor organs. It is particularly beneficial in regions with limited deceased-donor availability. 

3. Split Liver Transplant 

In this technique, a single deceased donor liver is divided into two functional grafts. One smaller segment is transplanted into a pediatric recipient, and the larger segment goes to an adult recipient. Split transplantation allows one donor liver to save two lives and is especially useful for critically ill children. However, it requires precise surgical expertise and carefully selected donors to ensure both grafts function safely. 

Eligibility and Pre-Transplant Evaluation

Eligibility for an orthotopic liver transplant is determined by the severity of liver disease, overall health status, and the potential to benefit from transplantation. Candidates typically include individuals with end-stage liver disease, advanced cirrhosis, acute liver failure, certain metabolic disorders, or select liver cancers that fall within transplant criteria.

Once considered for transplantation, patients undergo a comprehensive pre-transplant evaluation that includes blood tests to assess liver and kidney function, infection screening, coagulation markers, and compatibility studies.

Imaging tests such as ultrasound, CT scan, MRI, and sometimes elastography help evaluate liver structure, blood vessels, and the presence of tumors. Cardiac evaluation, pulmonary tests, nutritional assessment, and psychological readiness are also essential components to ensure safe surgical outcomes. 

Several factors can delay or prevent transplantation. Uncontrolled infections, active substance abuse, severe heart or lung disease, metastatic cancer, and poor nutritional status may compromise post-transplant recovery.

Lack of social or caregiver support, non-compliance with medical care, or insufficient financial resources may also affect candidacy. Optimizing these factors through medical management, rehabilitation, and counseling is crucial before patients can be safely placed on the transplant waiting list. 

Procedure of Orthotopic Liver Transplantation

Before surgery, the team confirms donor–recipient compatibility, reviews recent imaging, and evaluates cardiac and pulmonary fitness. Patients are optimized medically with nutritional support, infection control, and fluid–electrolyte stabilization. Consent, blood availability, and ICU arrangements are finalized. Once a donor organ becomes available, the surgical team coordinates timing so the retrieval and transplant procedures align seamlessly. Preoperative preparation also includes marking operative sites, administering prophylactic antibiotics, and ensuring vascular access for intraoperative monitoring. 

1. The surgery begins with placing the patient under general anesthesia and initiating continuous hemodynamic monitoring. 
2. A long incision is made across the upper abdomen to access the liver and surrounding structures. 
3. The surgeon divides ligaments and frees the liver from its anatomical attachments to fully mobilize it. 
4. Key vessels—the hepatic artery, portal vein, and hepatic veins—are carefully clamped and divided to detach the liver. 
5. The non-functioning liver is lifted out, leaving space prepared for the donor graft. 
6. The donor liver is placed into the abdomen and aligned for vascular reconnection. 
7. The surgeon reconnects vessels starting with the inferior vena cava or hepatic veins, then proceeds to the portal vein. 
8. Once the portal vein is unclamped, blood flows into the new liver, allowing it to perfuse and begin functioning. 
9. The arterial supply is restored by attaching the hepatic artery to the graft. 
10. The bile duct is reconstructed to ensure proper bile drainage from the transplanted liver. 
11. The surgeon verifies stable blood flow, controls bleeding, and evaluates graft function. 
12. Surgical drains may be positioned, and the incision is closed in layers to complete the procedure. 

The surgery typically lasts 6 to 12 hours, depending on the patient's anatomy, complications, and surgical approach. Patients are shifted to the ICU for close monitoring of liver function, hemodynamics, coagulation, and infection risk. The average hospital stay ranges from 10 to 20 days, with early recovery focusing on graft function stabilization, mobility restoration, and immunosuppressive therapy initiation. Discharge occurs once the patient is stable, mobile, tolerating food, and showing healthy graft performance. 

Postoperative Recovery and Rehabilitation

After an orthotopic liver transplant, recovery begins in the ICU, where liver function, vital signs, and fluid balance are closely monitored. Patients can expect gradual improvement in energy levels as the new liver starts functioning efficiently. Immunosuppressive medications are started immediately to prevent rejection, and regular blood tests track liver enzymes, clotting profile, and electrolyte balance. Pain and discomfort around the incision are common but manageable with prescribed medication. As days progress, patients shift from the ICU to the ward, begin sitting up, walking short distances, and learning wound-care routines. Preventing infection becomes a key priority, so strict hygiene, handwashing, and avoiding sick contacts are essential during early recovery. 

Diet and lifestyle slowly advance as the body strengthens. A high-protein, nutrient-dense diet is recommended to support healing, while low-salt meals help control fluid retention. Hydration is important, and raw or unhygienic foods must be avoided to reduce infection risk. Gradual physical activity—starting with short walks—helps rebuild stamina, improve circulation, and protect long-term graft health. Heavy lifting, strenuous exercise, smoking, and alcohol are strictly avoided. Over the next few weeks, daily routines can be reintroduced with caution, while long-term lifestyle modifications such as maintaining a healthy weight, regular follow-up visits, medication adherence, and balanced nutrition ensure the liver graft remains healthy and functional for years. 

Risks and Possible Complications of Orthotopic Liver Transplantation

Every major surgery carries some risks, and liver transplantation is no exception, but most complications can be managed effectively with careful monitoring and timely treatment. Common risks include infection, which may occur due to immunosuppressive medicines, and bleeding, since the liver is a highly vascular organ. Patients are closely observed in the ICU to detect and treat these issues early, and antibiotics, sterile care, and controlled mobilization help keep recovery safe. 

Another important aspect is graft rejection, which simply means the body’s immune system may try to attack the new liver because it recognizes it as foreign. Rejection is not unusual and, in most cases, is mild and treatable. Regular blood tests, follow-up visits, and strict adherence to immunosuppressive medications help prevent this. With proper care, monitoring, and timely medical guidance, most patients recover well and enjoy long-term, healthy liver function. 

Why Choose Artemis Hospitals for Orthotopic Liver Transplantation? 

Artemis Hospitals offers comprehensive and high-quality liver transplant care supported by: 

• Multidisciplinary liver transplant team combining hepatologists, transplant surgeons, anesthesiologists, and critical-care experts for coordinated treatment. 

• Advanced ICU and postoperative facilities equipped for continuous monitoring, infection control, and early recovery support. 

• Personalized rehabilitation and long-term care, including nutrition guidance, physiotherapy, medication management, and regular follow-up to ensure lasting graft health. 

This integrated approach ensures safer surgery, smoother recovery, and long-term well-being for every patient. 

How to Book a Consultation for an Orthotopic Liver Transplant?

Booking a consultation at Artemis Hospitals is simple and convenient. Patients or caregivers can connect directly through the dedicated liver transplant helpline at +91 98004 00498 for appointment scheduling and guidance. You may also visit the hospital’s official website or outpatient department to register for an in-person or virtual consultation. The transplant team ensures timely evaluation and seamless support throughout the process.