Liver Donor/Recipient Tests

Evaluation of the recipient:
A letter from a gastroenterologist/hepatologist is essential prior to accepting a patient for transplantation.
This is important, as we would like you to follow up of your hepatologist post transplant. The long-term success of liver transplant depends on how             much care is provided to you in the first year of liver transplant.
​The need for transplant will be re-assessed once the patient reaches Delhi. Whenever possible, if there is an alternative to liver transplant, that                    treatment will be recommended.
​ The recipient should have undergone the following tests:
  1.    a) CBC, LFT, BUN, Cr, Na/K, PT, INR, AFP, TSH, Blood group,
  2.    b) Urine routine/microscopy, urine protein creatinine ratio
  3.    c) Ultrasound of the abdomen and pelvis
  4.    d) CT angiography of the liver if there is no renal failure, plain MRI of the liver if creatinine is raised.
  5.    e) An Upper GI endoscopy (not necessary if done in the last 6 months)
  6.    f) Pulse oximetry and Chest X-ray
  7.    g) Echocardiogram with measurement of pulmonary artery systolic pressure.

    Tests for the donor

We recommend that all donor tests should be done here in Pakistan. We guide you in this regard. This will save you from possible rejection in India, which will save you from money and time loss.
The donor must have thesame or compatible blood group as the patient and must be a close family member without any disease. Liver donation is possible because of liver’s unique property of regeneration.
​    a) If the donor has blood group O, he or she can donate to recipient of any blood group.irrespective of the blood group.
  1.     b) Similarly if the recipient is AB, then he or she can receive liver from a donor with any blood group.
  2.     c) For patients with group A or B, their donors can be either O group or can be group specific.
  3.     d) If there is no blood group matched donor,ABO incompatible liver transplant can be done as well.
e)Swap transplant where two donors match up with two patients and donor of one family donates to the patient of the other family and vice versa.
​The donor must be between  18 to 55 years. His general fitness must be assessed by a doctor and ensure that the individual has no disease such as          high blood sugar, high blood pressure and obesity (BMI < 33). The following donor tests should be done.
  1.      a) Blood tests: CBC, LFT, BUN, Creatinine, TSH, lipid profile, HBaic, PT, APTT, anti HCV, HBsAg and HIV II and I.
  2.      b) A plain CT scan of the liver to measure the liver attenuation and index should be done. Liver attenuation should be > 45 and LAI should be  > 5.                    Once this has been confirmed, a complete contrast enhanced triple phase CT angiogram of the liver should be done.You must bring a soft copy                  (CD) of the CT scan along with your CT scan films along with you.
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