With Mumbai having a waiting list of around 218 liver transplants, first live donor transplant performed at Global Hospitals, Mumbai two weeks ago highlights the need for better management of cadaver transplantation to overcome delayed referral outcomes and risk to patient's life. According to experts, there is also huge mismatch between live donor and cadaver transplants taking into consideration that 5 to 25 per cent of transplants done in the city are cadaver liver transplants.   

This is in light of the fact that a liver donated by parents of a 19 year old brain dead teenager at KEM Hospital in Parel a month ago was wasted as it could not be transplanted on time. The woman who was to receive the liver died during the procedure.

Transplant Surgeon Dr (Prof) Mohammed Rela, who is credited to have performed 2000 liver transplants on neonates and adults, attributes it to the fact that liver transplant is a technically demanding operation and around 0.3 per cent patients die on the bed in need for a liver transplant due to delayed referrals and time taken to retrieve and transplant it accordingly. "Ideally, a transplant needs to be done within 8 to 10 hours of its retrieval through a well orchestrated effort of anesthetists, hepatologists, haematologists, transplant surgeons and nurses. A team of around 50 people work towards making the operation successful, " Dr Rela explains.  

Add to it, cadaver transplants have also been mired with the risk of  failure due to diseased conditions of the donors in some cases. Experts advocate that cadaver donations require a high level of organization for the desired outcomes.

According to Dr Samir R Shah, Hepatologist and General Secretary,  National Liver Foundation (NLF), a voluntary, non-profit organization promoting awareness and prevention of liver diseases, "There is a need for public private partnership to meet the requirement of liver transplant recipients as India is home to 11 per cent of the world's people with chronic hepatitis B and the number of deaths from liver cancer or cirrhosis each year range between 100, 000 and 200, 000. It is estimated that about 2 lakh people are diagnosed with end stage liver disease per year and 25, 000 patients need transplants as compared to 1000 per annum."