The Journey of a Patient: From Nigeria to India for a Life-Saving Liver Transplant

A liver transplant is a surgical operation in which a diseased liver is transplanted with a healthy liver from a donor. It is a life-saving procedure for individuals suffering from liver failure, liver cancer, or liver cirrhosis. Unfortunately, the healthcare system in Nigeria is not equipped to handle complex surgeries like liver transplant, which often forces patients to seek medical treatment abroad.

Background

A 50-year-old man from Nigeria, Mr. Johnson, was suffering from liver cirrhosis, a condition where the liver is damaged and unable to function properly. His condition worsened over time, and he started experiencing symptoms like fatigue, jaundice, and abdominal pain. His doctor recommended a liver transplant, but the patient was hesitant as he was not aware of the healthcare system in Nigeria and the available options.

Overview of Healthcare System in Nigeria

Nigeria has a public healthcare system that provides basic medical facilities to the population, but it lacks the necessary infrastructure and expertise to handle complex surgeries like liver transplant. Most of the government hospitals are overcrowded and understaffed, making it difficult for patients to receive proper treatment. Moreover, there is a shortage of medical equipment, medicines, and specialists in the country, which affects the quality of care provided to patients.

Reasons for Seeking Medical Treatment Abroad

Due to the limitations of the healthcare system in Nigeria, patients with serious medical conditions like liver cirrhosis often seek medical treatment abroad. Mr. Johnson was no exception, and he decided to travel to India for a liver transplant. India has a robust healthcare system and is known for providing quality medical treatment to patients from across the world.

Reasons for choosing India

India is one of the top medical tourism destinations in the globe, drawing tourists from all around.

The primary reasons for choosing India for a liver transplant are:

• Availability of advanced medical facilities: India offers some of the world’s most cutting-edge medical facilities, equipped with the latest technology and equipment. Patients can access a range of treatments, including liver transplantation, at an affordable cost.
• Expertise of Indian doctors: Indian doctors are highly skilled and experienced in performing liver transplants, with many of them having received training from some of the world’s leading medical institutions. The expertise of Indian doctors in liver transplantation has made India one of the leading destinations for patients seeking liver transplantation.
• Affordable costs: The cost of a liver transplant in India is significantly lower compared to other countries, making it an attractive option for patients who are seeking affordable medical treatment.

Types of liver transplant available in India

India is a leading country in liver transplantation, and it offers several types of liver transplant options to patients, including:

Deceased donor liver transplant: In this type of transplant, the liver is taken from a donor who has recently died.

Living donor liver transplant: In this type of transplant, a portion of the liver is taken from a living donor and transplanted into the recipient.

Split liver transplant: In this type of transplant, a single liver is split into two parts, and one part is transplanted into two different recipients.

The Cost of the liver transplant in India

The cost of a liver transplant in India varies depending on the hospital, the type of transplant, and the condition of the patient. However, on average, the cost of a liver transplant in India ranges from $30,000 to $50,000, which is significantly lower compared to other countries like the US, where the cost of a liver transplant can be as high as $150,000.  This was a major factor in Mr. Johnson’s decision to travel to India for the transplant.

Facts about liver transplant in India

India has emerged as a popular destination for medical tourism, especially for liver transplant. According to the Indian Society of Organ Transplantation (ISOT), India has one of the largest liver transplant programs in the world, performing more than 5000 transplants each year. The success rate of liver transplants in India is over 95%, making it one of the best destinations for liver transplant.

Finding a Match: The HLA Typing Test

Liver cirrhosis is a condition that can rob a person of their health, vitality, and even their life. For Mr. Johnson, this was exactly what was happening. The local hospital in Nigeria recommended a liver transplant as the only viable option for Mr. Johnson’s treatment. The doctors told him that his only hope was a liver transplant, and someone from his family would have to be the donor.

The first step in Mr. Johnson’s journey towards a liver transplant was to determine which family member would be the best match for him. The doctors in Nigeria recommended an HLA typing test to see if there was a suitable donor within his family. The family underwent HLA typing tests in Nigeria to determine the compatibility between the donor and the patient. The test results showed that one of Mr. Johnson’s family members was a suitable match.

With a suitable donor in place, Mr. Johnson and his family set their sights on India for the liver transplant. However, before they could travel, they had to apply for an Indian Medical Visa.

Liver Transplant Medical Visa process for Nigerian Patients

For patients who are seeking medical treatment in India, obtaining an Indian Medical Visa is an essential step. The medical visa allows patients to enter India for medical treatment and stay in the country for a specified period of time.

The first step in the process of obtaining an Indian Medical Visa is to submit passport copies of both the patient and the attendant. Once the passport copies have been submitted, the next step is to receive a medical visa invitation letter from the Indian Embassy in Nigeria. The letter will be issued to the patient and the attendant and will serve as proof of their eligibility for a medical visa.

The processing time for a medical visa can vary, so it is important to check with the embassy for an estimated processing time. Once the medical visa has been processed and approved, the patient and the attendant will receive their visas and will be able to travel to India for medical treatment.

With all the necessary documents in place, Mr. Johnson and his family embarked on their journey to India.

Liver Transplant FRRO Registration

Once you arrive in India, the hospital team will take care of the FRRO registration process for you. They will provide you with all the necessary documents and information required for the registration, and will assist you in completing the process.

The hospital team is well-versed in the FRRO registration process and will ensure that everything is done smoothly and efficiently. This takes the stress of the FRRO registration process away from the patient and their family, allowing them to focus on their recovery and treatment.

Liver Transplant Video Consultation from Top Liver transplant surgeons

Mr. Johnson, who was seeking a liver transplant, wanted to have a video consultation with top liver transplant surgeons in India. He was worried about the procedure and wanted to clarify all his doubts before coming to India. With the help of medical tourism companies, he got in touch with the best liver transplant surgeons in India and had a video consultation with them.

During the video consultation, he asked all his questions related to the procedure, post-operative care, and recovery time. The doctors answered all his queries and provided him with the information he was seeking. They explained the procedure in detail and assured him that he would receive the best possible care in India. He was happy that he could have a consultation with top doctors without having to travel to India, saving him time and money.

Liver Transplant Success Rate in India

Liver transplantation in India has a high success rate with reputed transplant surgeons leading the way. With state-of-the-art facilities and well-trained medical teams, the procedure is carried out with precision and care, ensuring a positive outcome for patients. In India, the success rate of liver transplant is comparable to international standards, making it a viable option for those seeking medical attention. With a focus on patient safety and outcomes, reputed transplant surgeons in India are committed to delivering the best possible results to their patients.

Best Hospital for Liver Transplant in India: Mr. Johnson’s Journey

Mr. Johnson, in search of the best hospital for a liver transplant in India, reached out to four leading institutions: Apollo Hospital, Medanta Hospital, Manipal Hospital, and Max Hospital. He first contacted Apollo Hospital and spoke with their liver transplant team to gather information on the surgeon details, cost estimates, success rates, and recovery process.

Next, Mr. Johnson reached out to Medanta Hospital and had a similar discussion with their liver transplant team. He learned about their approach to liver transplant surgery and what sets them apart from other hospitals.

Moving on to Manipal Hospital, Mr. Johnson spoke with their liver transplant specialists and learned about their facilities and resources for liver transplant patients.

Finally, Mr. Johnson reached out to Max Hospital and discussed their liver transplant services with their team. He gained insights into their surgical process, patient care, and post-operative support.

However, when Mr. Johnson reached out to AIIMS Hospital, Safdarjung Hospital, Tata Memorial Hospital, and King Edward Memorial Hospital, he was disappointed with the information he received. The waiting time for international patients was long, the cost was similar to private hospitals, the success rate was not sure, the liver transplant surgeon details were not provided, the services were not good, and the post-transplant recovery time and follow-up plan were not given.

Given the lack of information and unsatisfactory services offered by these hospitals, Mr. Johnson decided to go with one of the top 4 hospitals he had contacted initially. He chose the hospital that best suited his needs and was confident that he would receive the best care and support.

Donor Selection Criterion

Mr. Johnson and his family were given a clear understanding of the criteria that need to be met in order for a potential donor to be considered for the procedure. These include:

• Compatibility: The patient must arrange for a blood group-compatible related donor from the family.
• Relation: The donor must be a relative of the patient.
• Blood Group: The blood group of the donor must be compatible with the patient, either the same blood type or type O. The Rh factor (positive or negative) does not impact donor suitability. Patients with blood group AB can receive blood from any blood group.
• Age: The donor must be between the ages of 18 to 50 years.
• Physical Health: The donor should not be excessively overweight and there should not be a significant difference in height and weight between the recipient and the donor.

Stay of the Recipient and the Donor

Here are the details of the stay:

• The donor will be in India for 4-5 weeks, while the recipient will stay for 6-8 weeks.
• Following arrival, the donor and patient will be assessed, and the legal committees’ consent will be sought. These take about 10 to 14 days to complete.
• The hospital stay for the recipient will last around 21 days, while the hospital stay for the donor will be 8 days.
• The transplant recipient must remain in India for at least 3–4 weeks after the procedure, and the donor for at least 2–3 weeks.

Liver Transplant Package in India

Mr. Johnson was impressed with the comprehensive Liver Transplant Package in India that he was offered, which included the following benefits:

Thorough Work up and Investigation: The package included an initial workup and investigation for the recipient and one donor.

Inpatient Stay: The package offered a 21-day stay for the recipient and an 8-day stay for the donor during treatment, guaranteeing comprehensive care and monitoring.

Inclusive Transplant Surgery Cost: The package included the liver transplant surgery cost, which covered surgeon fees, anesthetist fees, and OT and anesthesia charges, giving Mr. Johnson financial peace of mind.

Gastroenterology & LTP Team Consultation: The package also provided access to consultations with a gastroenterology team and a liver transplant team, ensuring holistic treatment.

Physiotherapy: The package included physiotherapy, which Mr. Johnson saw as an essential part of the healing process post-surgery.

Pharmacy & Consumables: The package also covered pharmacy and consumables, reducing the financial burden for Mr. Johnson and his family.

Blood Products: The package provided blood products, a crucial resource for liver transplant patients.

Investigations: Lastly, the package included investigations, ensuring that any complications were detected early and treated promptly.

Documents required for Liver Transplant

Before a Liver transplant surgery can take place in India, there are several legal requirements that must be fulfilled. The liver transplant committee in the hospital overseeing the surgery requires a specific set of documents to ensure that the transplant is conducted in accordance with legal and ethical guidelines. The list of documents required for successful approval by the committee are as follows:

Documents for Liver Transplant Recipient

1. ID Proofs: Passport, National ID
2. Family Photos with Donor, Parents, Brothers and sisters – 10 to15 (color copies)
3. Passport size photos recent – 15 copies
4. Relationship certificate/Marriage certificate
5. School Documents

Documents for Liver Transplant Donor

1. ID Proofs: Passport, National ID
2. Passport size photos recent – 15 copies
3. Birth Certificate of Donor
4. Educational Certificate of donor

Documents for Liver Transplant Consent

1. ID Proofs: Passport, National ID
2. Passport size photos recent – 04 copies
3. Form-21 for NOC (Embassy)

*HLA Report

*Psychiatric Clearance

*Blood Group Donor & Recipient

*Carry all original documents

Liver transplant technologies in India

Mr. Johnson was given a detailed explanation about the different types of liver transplant technologies available in India, including laparoscopic liver transplant, robot-assisted liver transplant, and minimally invasive liver transplant.

Laparoscopic Liver Transplant: In this minimally invasive surgery, the liver transplant is carried out using a laparoscope, a short, illuminated tube with a camera at one end. The laparoscope allows the surgeon to perform the transplant with small incisions, reducing the risk of postoperative complications and shortening the recovery period.

Robot-Assisted Liver Transplant: This is a state-of-the-art procedure that uses robotic technology to perform the liver transplant. The surgeon operates the robot arms that carry out the transplant while seated at a console. The robot provides a 3D view of the surgical field, improving the precision and accuracy of the procedure.

Minimally Invasive Liver Transplant: This is a procedure that uses advanced technology to perform the liver transplant with minimal incisions, reducing the risk of postoperative complications and shortening the recovery period. The procedure is performed through a single incision or a few small incisions, making it less traumatic for the patient.

Mr. Johnson was impressed with the advanced medical technology available for liver transplant in India and was confident that he would receive the best possible care. He decided to proceed with his liver transplant in India and traveled to the country with his family.

The Journey

Mr. Johnson’s journey from Nigeria to India was not an easy one, but it was worth it in the end. He had to undergo several tests and evaluations to determine his eligibility for the transplant. Once he was cleared, he was put on a waiting list, and after a few weeks, he received a call that a liver was available.

Pre-Transplant Preparation

Before traveling to India, the patient had to undergo a series of medical tests to determine their eligibility for transplantation. This included a series of blood tests, X-rays, and other diagnostic procedures. Financial arrangements were also made, including arranging for travel and accommodation in India. The visa process was also a key part of the pre-transplant preparation, as the patient had to apply for a medical visa to enter India for their treatment.

Arrival in India

The patient’s journey to India was a long and challenging process. After arriving in India, they were taken to the hospital where they would receive their transplant. The patient was immediately taken into the care of the transplant team, who assessed their condition and prepared them for surgery. The patient had to adjust to a new environment, which was made easier by the support of the hospital staff and the patient’s family.

Transplant process

The next step was to undergo a series of tests to determine if he was a suitable candidate for the transplant. These tests included blood tests, a liver biopsy, a heart and lung evaluation, and a psychological evaluation. After all the tests were completed, the results were evaluated and it was determined that Mr. Johnson was a good candidate for the transplant.

The transplant surgery was scheduled, and Mr. Johnson was admitted to the hospital. The surgery lasted approximately 8 hours and was performed by a team of experienced surgeons. The donor liver was carefully removed and carefully transplanted into Mr. Johnson’s body. The surgery was successful, and Mr. Johnson was placed in the intensive care unit for close monitoring.

Post-operative care and recovery

After the transplant, Mr. Johnson was taken to the intensive care unit (ICU) where he was closely monitored. He was given pain medication and antibiotics to prevent any infections. He was also put on a special diet to help his body adjust to the new liver.

Over the next few days, Mr. Johnson’s condition improved, and he was gradually moved out of the ICU. He was encouraged to move around and do light exercises to help with his recovery. He was also given regular check-ups and tests to monitor his liver function and the success of the transplant.

Follow-up care

Once Mr. Johnson was discharged from the hospital, he was advised to come back for regular check-ups and follow-up appointments. These appointments included blood tests, liver function tests, and other evaluations to monitor the success of the transplant.

Mr. Johnson was also put on a long-term medication regimen to help prevent rejection of the new liver and to keep it functioning properly. He was advised to make significant lifestyle changes, such as avoiding alcohol, eating a healthy diet, and exercising regularly, to maintain a healthy liver.

Return to Nigeria

Before leaving India, Mr. Johnson was given a comprehensive medical check-up to ensure that he was fit to travel. To ensure a smooth transition back to Nigeria, Mr. Johnson’s medical team in India worked closely with his doctors in Nigeria to transfer his medical records and ensure that he received the necessary follow-up care.

Impact of Liver Transplant on the Patient’s Quality of Life

The liver transplant has had a significant impact on Mr. Johnson’s quality of life. He no longer experiences the symptoms of liver failure and is now able to perform daily activities. His energy levels have increased, and he is able to lead a much more fulfilling life.

Conclusion

Mr. Johnson’s journey to India for a liver transplant was a long and challenging one, but he was successful in receiving the life-saving procedure he needed. Despite the challenges he faced, he is grateful for the opportunity to receive a transplant and is now enjoying a much healthier life.

For other patients considering medical treatment abroad, Mr. Johnson’s advice is to do your research, familiarize yourself with the medical system and culture of the country you will be visiting, and have a good support system in place. It is also important to understand that the process will not be easy, but with the right preparation and support, you can overcome any challenges and receive the medical treatment you need to live a healthy and happy life.