Liver transplant, perhaps one of the most complex of medical procedures, has now come to the city. Meet Prof. Tom Cherian, a stalwart in this line of work.
While it’s difficult to quantify the importance of a single organ, here is an important fact to consider: The human body can work for days on a ventilator even after brain death. The work of the heart, lungs or kidneys can be substituted by machines. However, survival beyond 48 hours is difficult if the liver stops functioning. This is an organ, so complex, that to date no machine has been made to successfully duplicate its functions. Dr. Tom Cherian, Group Director for HPB Surgery and Liver transplantation at CARE Hospitals, is an expert in the field. With a sixteen year long career spanning different countries, he has performed over 450 transplants, of which over 150 have been since relocating to India 3 years ago. Since the last year he has set up, refined and delivered liver transplantation services here in Vizag. In an interview with the Yo! Vizag team, he throws light on the process of liver transplantation as he and his team have done 15 transplants up until now, in this city.
When do you consider a liver transplant? Is it the last resort?
Most definitely. Many people including some medical professionals feel that transplant surgeons will do transplants the first time they see patients with liver disease. However we carefully assess all patients who come to us, ensure that all other treatment options have been exhausted, discuss the case with a panel of specialist doctors before we decide. So there have been cases of patients where I have modified treatments rather than opt for immediate transplants.
How safe is the transplantation process?
Well, no surgical procedure where an entire organ is replaced is risk free, on average, 90-92% of our patients survive the procedure and go home. This is after all the last resort, and is performed only if the patient faces high risk of death through liver failure. In fact, the average predicted risk of death within one year among my patients without a transplant, will be over70%! So, LT actually reduces that risk from 70% within 1 year, to less than 10%.
How much time does recovery take?
Patients are out sitting within 3 days of a normal transplant, and walking by day 5. If all has gone well, we would expect them to be discharged in 2 weeks and back to normal activity by 2-3 months. There is no special diet or precautions for these patients post-transplant, except some medication that they’d need to continue.
How can donors donate their liver?
A living donor transplant (LDLT) is considered if the waiting list for livers is long and the recipient too sick. This is a more complicated procedure than a standard transplant and something I hesitate to do if the patient is very stable. However 70-80% of liver transplants done in India are LDLT, due to the shortage of organs. The outcomes of LDLT are excellent, made possible by the amazing regeneration capabilities of the liver.
What steps can one take to maintain a healthy liver?
Liver health doesn’t require any special attention. A good diet, exercise to prevent obesity (a little paunch can be harmful too), refraining from excessive or regular alcohol, good sugar control and vaccinations from viruses like Hepatitis B are important. I often find that patients often come to me a little too late, after they’ve become very sick. So if you do have liver disease, regular visits to a liver surgeon as well as a gastroenterologist, are very important for the best results.