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Liver Transplant in Bangladesh

A liver transplant is a surgical procedure to remove a diseased liver and replace it with a healthy liver (whole or part) from a donor. Liver transplant operations use livers from deceased donors or from living donors. Liver transplant is a treatment option for people who have end-stage liver failure that can’t be controlled using other treatments. Two specialized team of liver transplant surgeons work simultaneously in two equipped operation theatres. In case of living donor liver transplant, one team for donor operation for retrieval of part of donor liver and another team for removal of damaged (cirrhotic/cancer liver) and finally implantation of donated liver (allograft)to the recipient. In case of deceased donor liver transplant the retrieval of liver may be done in other centre and the liver is transported as quickly as possible to the recipient surgery theater.   Liver diseases are common in Bangladesh. Prevalence of HBV is 4-7% & HCV is 1- 3%, other viral & non viral conditions ( NAFLD) lead to cirrhosis & liver failure. Hundreds of patients need liver transplant every day. Starting of liver transplant was long time due in Bangladesh. Deficient infrastructure, extreme shortage of trained manpower, equipments & facilities were the problems for starting liver transplant. in Bangladesh Prof. Mohammad Ali started the first Dept. Hepato-Biliary-Pancreatic Surgery of Bangladesh at BIRDEM hospital in 1999 with aim of starting liver transplant in Bangladesh. Manpower developed in this field, equipments arranged and organized facilities for starting liver transplant. Segmental dissection of interior anatomy of liver was made at the Dept. of Anatomy of Dhaka Medical College. Vascular anastomosis of cow’s liver & sheep’s liver and Porcine Model (Pig to Pig) was made at BIRDEM hospital & Gastro liver Hospital & Research institute, Dhaka for technical expertise. Recipient and donor evaluation of many end stage liver disease patients were made in Bangladesh and their liver transplants were successfully arranged in abroad. Academic discussions, collaboration with overseas centers, awareness programmes in the different electronic and print media was continuously made.Information leaflet on liver transplant was distributed to public and appeal made for coming forward for donation of part of liver of as life saving gesture (gift) to his or her relative. Multidisciplinary liver transplant team was made at BIRDEM Hospital, headed by Prof. Mohammad Ali

Liver Transplant Cost in Dhaka

 

Liver Transplant Cost in Bangladesh Cost in Bangladesh Taka (Tk)
Dhaka 45,00,000৳
BSMMU 45,00,000৳
National Liver Foundation of Bangladesh 45,00,000৳
Bangladesh 45,00,000৳
BIRDEM 45,00,000৳

Liver Transplant in Dhaka

 

What is Liver Transplantation?

Liver transplantation is the surgical removal of a diseased liver and its replacement with a healthy one.

Who needs a liver transplant?

Anyone with a long standing (chronic) or sudden (acute) liver failure due to severe liver diseases needs to be considered as a candidate for a liver transplantation. The common diseases requiring transplant are advanced liver disease (Cirrhosis) due to Hepatitis C, Hepatitis B, Primary sclerosing cholangitis, Primary Biliary cirrhosis, Biliary atresia in children and Metabolic diseases. Acute hepatic failure due to acute viral, drug induced or alcohol-induced hepatitis may also need transplantation. Liver transplant is also done for primary liver cancers in certain circumstances.

When a patient needs liver transplant?

Those with end-stage chronic liver disease complicated by tiredness, fatigue, weight loss, repeated attacks of blood in the vomit or stool, low serum albumin or prolonged prothrombin time. Repeated hospitalization for intractable ascitis, infection in the ascitis, attacks of excessive drowsiness, mental confusion (encephalopathy) or coma are considered for liver transplant as life saving measure.

Where does the donor liver come from?

Donor liver comes from two sources a) Deceased Donor Liver Transplant (DDLT): This liver is taken from a brain dead person (where there is no chance of survival after withdrawal of life support). b) Living Donor Liver Transplant (LDLT): A living person donates a part of his/her liver (right or left lobe) to one of his/her relative dying from liver failure.

Who can be a living liver donor?

A live liver donation is a precious gift from a living person. Any healthy person aged 18-65 years who is of matching blood group with the recipient can be a living liver donor. Eligibility of a person for liver donation is judged after detailed examination and tests by the transplant team, where donor safety is considered first.

How the Liver Transplant surgery done?

Two team of experienced surgeons work at a time in two well equipped operation theaters. One team removes the diseased (cirrhotic) liver. The blood that flows into the liver will be blocked or sent through a machine to return to the rest of the body. Another group removes a part of healthy liver from a donor and then prepares it. The surgeons put the healthy liver (Graft) in place and reconnect to the blood vessels and bile ducts. It allows blood flow to start in the new liver. Liver transplantation time is about 12 to 14 hours.

What happens to the donor liver after the donation?

The donated part of the liver regrows (regenerates) from the remaining liver, which completes after 6-12 weeks of donation.

What happens to the recipient after the transplant?

The donated liver (graft) grows quickly in the recipient’s body and performs the functions as new liver (central organ) according to the metabolic demand of the body.

What is rejection and how it is prevented?

Defense system (immune system) of our body keeps us healthy by fighting against the substances that don’t belong to individual’s body. After a transplant our defense system fight against the new liver from other person and try to destroy it by a process called rejection. Rejection is prevented by anti rejection drugs (immunosuppressants) after the transplant. The common drugs are steroids, cyclosporine, tacrolimus, sirolimus and mycophenolate mofetil.

What is the success of living donor liver transplant?

Successful living donor liver transplant recipient survive 01 year 85%, 05 years 69% and 10 years 61%. The success rate is better in children than adult population.

What are the problems after liver transplant?

Recipient can get infections more easily. He will need to stay away from people who are the probable sources of infections. Avoid to get infected by hepatitis B & C virus. The immunosuppressants and other drugs may also increase the chance of getting infections. It also causes increase of blood pressure, weight gain, rise in cholesterol level, diabetes, bone weakness and kidney damage.

Can one go back to daily activities after liver transplant?

Yes, after a successful liver transplant most people can go back to their normal daily activities. Getting your strength back will take some time though depending on how sick you were before the transplant.

Immunosuppresion after Liver Transplant?

Immunosuppressive drugs are started immediately after liver transplant to prevent rejection. It must be maintained for the rest of the life. Initial cost is high for first few months, but subsequently reduces to one or two medicine at the end of the year and single medicine in 2-4 years time, which needs to be taken life long. Liver functions and drug level also needs to be evaluated repeatedly.

Liver transplantation at BIRDEM Hospital

BIRDEM hospital is a specialized tertiary care hospital of Dhaka. It has many subspecialties specially, the department of Hepato-Biliary-Pancreatic Surgery, which deals the complex surgery of the liver, biliary system and pancreas. This organized unit in co-ordination with other specialties has successfully performed the first two liver transplants of Dhaka at BIRDEM hospital. The department is working hard to make a full-fledged Liver transplant centre at BIRDEM, so that our patient with end stage liver disease will continuously get the liver transplant services in their own country.

Cost of liver transplant in abroad and Dhaka?

In European and other advanced countries it is about two (02) crore taka. In neighboring country it is about 30 to  40  lacs taka. In Dhaka, Bangladesh we are planning to do the liver transplant in minimum cost considering the socio-economic status of our people, which will be lowest in any centre of the world.

Bangladesh First Liver Transplant

  The liver transplantation was performed under the care of Dept. of Hepato-Biliary-Pancreatic Surgery, BIRDEM with active participation of other departments. The liver transplant was lead by Professor Mohammad Ali, the Chief liver transplant surgeon of BIRDEM. His eight member surgical team includes Prof. S.M. Abu Zafar, Dr. Md Mamunur Rashid, Dr.Mohd. Mustaque Hossain, Dr. Hashim Rabbi, Dr. A H M Tanvir Ahmed, Dr. Kazi Mahbuba Akhtar & Dr. Hasina Alam. The surgical team was co-operated by chief liver transplant surgeon of Indraprastha Apollo Hospitals New Delhi Dr. Subash Gupta, Dr. Vivek Vij and Dr. Neerav Goyal. Team of Anesthetists lead by Dr. Col (Rtd.) Hamidur Rahman, Prof. Nur Nabi Chowdhury,Dr. Mahbub Hasan Munir & Dr. Kawsar Shardar were cooperated by Dr. Sanjeev Aneja. Prof. Md. Omar Faruq, Dr. A H M Areef Ahsan (Critical Care Medicine) and their team were cooperated by Dr. Pankaj Lohia. Team of Gastroenterology-Hepatobiliary-Pancreatic Disorders (GHPD) department was lead by Prof. M. Anisur Rahman, associated by Dr. Mohsin Kabir and Dr. Golam Azam. Dr. Haider Ali performed the Doppler study of the transplanted liver. The first liver Transplant was done on 3rd June 2010 in the operation theatre of Ibrahim cardiac hospital and research institute. The recipient was Mr. Kazi Ershad Ahmed from Comilla. He had been suffering from liver Cirrhosis for a long time and received various treatments at home & abroad. In spite of all efforts he had reached End stage liver failure. His maternal uncle Mr. Khaled Abdullah donated his right lobe of liver as the last resort to save his life. The liver transplant started on 3rd June 2010 at 7.30am and ended at 12.30am on 4th June (17 hours), at the two adjoining operation theaters. Professor Mohammad Ali returned to Bangladesh after getting training in various liver transplant centers in abroad for starting liver transplant in the home country. He started the first Department of Hepato-Biliary-Pancreatic Surgery of Bangladesh at BIRDEM in 1999. Simultaneously, this department started organizing for starting liver transplantation and finally successfully completed the first liver transplant in Bangladesh. Successful completion of the first liver transplantation at BIRDEM hospital is a milestone in the medical history of Bangladesh. To make this liver transplantation possible in BIRDEM hospital, participation and active cooperation of many departments and institutions were involved. Actively participated Departments and organizations are Ibrahim Cardiac Hospital and Research Institute, Organ transplant unit of BADAS, Dept. of Anesthesiology , Dept. of Critical Care Medicine, Gastroenterology-Hepatobiliary-Pancreatic Disorders (GHPD), Dept of Surgery, Laboratory services, Radiology and Imaging Services, Transfusion Medicine, Dept of Immunology, Administration and Logistic Dept. and Dept. of Nursing. Different Private and public institutions have supported this liver transplantation programme. Specially, Dutch Bangla Bank Foundation,Armed forces Institute of Pathology, National Heart Foundation of Bangladesh, Gastroliver Hospital and Research Institute and Popular Diagnostic Centre .  

Liver Transplant cost in Dhaka, Bangladesh is ৳ 45,00,000.

Bangladesh Second Liver Transplant

  The recipient Mr. Reazul Islam (35 yrs.), diabetic, College teacher, Golachipa, Potuakhali. He had been suffering from Hepatitis B virus infection since 2002 and developed Cirrhosis of liver. He developed end stage liver disease with repeated episodes of encephalopathy and refractory ascites and hyperspleenism since 2008. He received treatment in different centers, home and abroad. During this period he was treated at BIRDEM Hospital on several occasions and finally was advised liver transplant as the last hope of survival. The donor, Mr. Kium Azad (38 yrs), a maternal uncle of the recipient came forward to donate part of his liver as a life saving measure. The transplant was organized by the Dept. of Hepato-Biliary-Pancreatic Surgery, BIRDEM. The Liver transplant team was headed by the chief Liver transplant Surgeon, Prof. Mohammad Ali. The liver transplant team of Prof. Subash Gupta of Indraprastha Apollo Hospital, New Delhi, India helped in the transplant. The department of Gastro Intestinal Hepato-Biliary- Pancreatic Disorder (GHPD), Surgery, Anesthesiology, Critical Care Medicine, Transfusion Medicine, Radiology & Imaging Services, Laboratory & Immunology Services, Nursing Services of BIRDEM & ICHRI ,Organ transplant Unit & Administration of BADAS took active part in the transplant. The operation theatre facilities, Dept. of Anesthesiology, Laboratory services & Administration of Ibrahim Cardiac Hospital & Research Institute (ICHRI) actively participated and extended all cooperation. The transplant was done on August 6, 2011 at two well equipped operation theaters of ICHRI. Two teams of twenty five members performed the operation, starting from 9 AM till 01:30 AM, next day (about 16 hours). Right lobe of the donor liver (weighing 735 gram) was retrieved. The cirrhotic liver of the recipient was totally removed and the donated right lobe (Graft) was implanted to the recipient at the same site. The recipient and donor left hospital without any problem and passing normal life. Dutch Bangla Bank Foundation made generous contribution to the liver transplant facilities. ICHRI provided their operation theater complexes and other facilities for the transplant. Armed Forces Institute of Pathology, Gastro liver Hospital & Research Institute & Popular Diagnostic Centre extended their support in the transplant. It may be mentioned here that, the first ever liver transplant of Bangladesh was successfully performed at BIRDEM on June 03, 2010. Both the recipient and the donor are doing well. They are back to their normal life and activities. The first successful Liver transplant at BIRDEM received wide spread national and international appreciation. Bangladesh has been enrolled as one of the liver transplant country in the world since 2010.We believe that the 2nd successful liver transplant at BIRDEM will reinforce the dimension of advancement of medical science and technology of Bangladesh . The liver transplant team : Surgical : Prof.Mohammad Ali, Prof. S M Abu Zafar, Dr. Md. Mamunur Rashid, Dr. Muhd. Mustaque Husain, Dr. Hashim Rabbi, Dr. Kazi Mahabuba Akhter, Dr.A.H.M. Tanvir Ahmed, Dr. Hasina Alam and Dr. Ashim Kumar Dutta, Anaesthesia : Prof. A K M Nur Nabi Choudhury, Dr. Col (Rtd) Hamidur Rahman, Prof. M A Salam Khan, Dr. Mahbubul Hasan , Dr. Kawsar Sardar, Dr. Basudeb Saha, Dr. Md. Nazmul Hakim, Dr. Md Mushfiqur Rahman and Dr.Md. Hamidur Rahman, Critical Care : Prof. Mohammad Omar Faruque, Dr. A S M Arif Ahsan, Dr. Kaniz Fatema and Dr. Fatema Ahmed, GHPD : Prof. M Anisur Rahman, Dr. Mohsin Kabir, Dr. Golam Azam and Dr. Arif Mahmud, Organ Transplant :- Prof. Md. Abul Mansur and Dr. Polash , Radiology and Imaging: Prof. A S Mohiuddin, Prof. Raihan Hussain, Dr. Nasreen Sultana and Dr. Muhitul Alam, Laboratory and Transfusion medicine: Prof. Shubagato Choudhury, Prof. M Sirajul Islam and Dr. Tashmim Farhana Dipta, Nursing team , headed by chief nurse of Operation theatre, Joefphin Rozario. Team from abroad: Prof. Subash Gupta, Dr. Neerav Goyal, Dr. Sanjeev Aneja, Dr. K V Ramarswamy and Dr. Ramdip Roy.  

Liver Transplant Cost in National Liver Foundation is 45,00,000 Tk

What is Liver Transplant cost in Bangladesh?

Liver Transplant cost starts from 45,00,000 BDT in Dhaka, Bangladesh

Where can I get Liver Transplant done in Bangladesh?

Liver Transplant is done at BIRDEM Hospital, Dhaka

Can I get Liver Transplant done in Bangladesh?

Yes, if all conditions are satisfied.

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