Liver Transplantation - ECAB book cover

Liver Transplantation - ECAB

Liver Transplantation (LT), until recently the ‘forbidden fruit’, is the newest, the sexiest, the most controversial and arguably, the most technically challenging subspecialty of Surgical Gastroenterology to have mushroomed in India. In a journey spanning 12 years, 28 centers and 1500 liver transplants, we imagined there would be a gripping story to tell. It was only appropriate then, that we chose to inaugurate the series with an overview of Liver Transplantation. In the last 2 decades, the field has seen rapid progress with 1- and 5-year patient survival improving from 80% and 50% to 90% and 80%, respectively, owing to technical refinement, and better immunosuppressants, intensive care, and patient monitoring. Despite being a relatively new entrant into the field, India can now boast of at least some islands of excellence that have caught up with the "best in the west". This means the evolution of LT in these centers has been fast-forwarded up a steep curve. We have come a long way from the point of every LT being considered an experimental procedure with much media and public hype to one where it is accepted as a successful and durable panacea for all liver failure. The popularity of teams running successful programs in India has swung from being ostracized when the chips were down, to being celebrated and envied when the going became good. The focus has shifted from immediate to long-term survival, from surgical heroism to building multidisciplinary teams, from anecdotal to hard data and from media reports to scientific publications. ‘Fly-by night’ operations are on the decline as realization of their futility dawns on new centers and transplant teams. They are now happier to take the longer route of developing trained in-house teams. After spending a good part of the last decade honing the technique of living donor liver transplantation, we are becoming more sensitive to the morbidity and mortality risks to the living liver donor. We want to minimize the liver volume removed from the donor, and want to develop techniques of minimal access. More importantly, we want to train our guns back on pushing donation after brain or cardiac death. We have begun to maintain databases, are getting into audit mode and want a National registry. We want standardized treatment guidelines and training curricula. We want to take part in multicenter trials and further meaningful clinical and laboratory research. As a community, the liver transplant doctors of India are on a warpath of progress. We want it all and we want it now! The first step to the march into the future is to size up the past and the present. That is what we have attempted to do in this volume.

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Published: January 2013

Imprint: Elsevier

ISBN: 978-81-312-3247-7

Contents

  • How to Set up a Liver Transplant Center in India?

    Liver Transplantation in India

    The History

    Individual Center Experiences: Present Status

    Our Journey of Liver Transplantation at Sir Ganga Ram and Medanta Hospitals: A Rewarding Decade of Trials and Tribulations

    The Apollo, Delhi Journey

    Experience at Amrita Institute of Medical Sciences, Kochi, Kerala

    Experience at Apollo, Chennai

    The Cadaver Transplant Scenario in South India: The Global Hospital Experience

    Deceased Donor Liver Transplantation in the Indian Armed Forces: Current Status

    Liver Transplantation in India - The Way Forward

    Liver Transplantation for Hepatocellular Carcinoma

    Liver Transplantation for Acute Liver Failure

    Postoperative Complications after Liver Transplant

    Technical Advances in Liver Transplantation

    Split Liver Transplantation

    Pediatric Liver Transplantation

    Laparoscopic Live Donor Hepatectomy

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