Guidelines for liver transplant at ANG Centre for Liver and Biliary Sciences, New Delhi. Evaluation of the recipient:
1. A letter from a gastroenterologist/hepatologist is essential prior to accepting a patient for transplantation. This is important, as we would like you to remain in the follow up of your gastroenterologist post transplant. 2. The need for transplant will be re-assessed once the patient reaches Delhi. 3. The recipient must have the following tests:
a) CBC, LFT, BUN, Cr, Na/K, PT, AFP, TSH, Blood group
b) Urine routine/microscopy, urine protein creatinine ratio. b) CT angiography of the liver if there is no renal failure. d) A recent Upper GI endoscopy.
e) ABG and Chest X-ray.
f) Stress echocardiogram and measurement of pulmonary artery systolic pressure. Tests for the donor before coming to us
1. The donor must have the same or a matching 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. The risk of liver donation is perhaps less than 1 in 500.
2. He or she must be in the age range 18 to 55 years.
3. Please get the following blood tests: CBC, LFT, Renal chemistry, Thyroid profile, lipid profile, HBaic, coagulation profile, anti HCV, HBsAg and HIV II and I, Hep B core lab.
4. Once the above tests are okay, please get a plain CT scan of the liver to measure the liver attenuation index and compare this with that of the spleen and then a complete contrast enhanced triple phase CT angiogram of the liver, this is called Liver attenuation index (LAI). In particular, the radiologist must report the diameter of the main portal vein and that of the right and left portal vein. You must bring a soft copy (CD) of the CT scan along with your CT scan films along with you.
5. A MRCP of the donor, once the CT scan is satisfactory.
5. If the CT scan and the MRCP is satisfactory and you can confirm this by sending me the report, you...
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