Day-wise Liver Transplant Package for Cadaveric Donor

Preoperative Period (Day 1 – Day 7)

Day 1-2: Preoperative Evaluation

1. Recipient Evaluation:
   • Blood tests: Complete Blood Count (CBC), Liver Function Tests (LFTs), Coagulation Profile, Viral Markers (Hepatitis B, C, HIV), Kidney Function Tests (KFTs).
   • Radiological Imaging: CT scan or MRI to assess liver size, blood flow, and portal vein.
   • Cardiac & Pulmonary Assessment: Echocardiogram and Pulmonary Function Tests.
   • Endoscopy: To rule out esophageal varices or gastric ulcers.
   • Liver Biopsy (if needed): To assess the severity of liver disease.
   • Psychological Evaluation: Assessment of mental readiness and family support.

Day 3-6: Medical Optimization

1. Recipient Medical Preparation:
   • Nutritional Optimization: Correct malnutrition with dietary planning.
   • Coagulation Correction: Administration of fresh frozen plasma and vitamin K to correct clotting issues.
   • Infection Control: Treat pre-existing infections before transplant surgery.

Day 7: Waitlist Management

1. Organ Matching:
   • Recipient remains on the transplant waitlist until a suitable donor liver becomes available.
   • Upon availability, the recipient is notified and admitted to the hospital.

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Surgery Day (Upon Notification)

1. Donor Organ Procurement:
   • The liver is harvested from the deceased donor, transported to the hospital, and prepped for surgery.
2. Recipient Surgery:
   • Explantation: Removal of the diseased liver.
   • Implantation: The new liver is connected to the major vessels and bile ducts.

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Postoperative Period (Day 1 – Day 21+)

Day 1-4: ICU Stay

1. Hemodynamic Monitoring:
   • Continuous monitoring of heart rate, blood pressure, and oxygen levels.
2. Liver Function Tests:
   • Daily monitoring of liver enzymes (AST, ALT), bilirubin, and INR.
3. Immunosuppression Therapy:
   • Administration of immunosuppressive medications like tacrolimus or cyclosporine to prevent organ rejection.

Day 5-12: Step-Down Unit

1. Recipient Care:
   • Close monitoring for liver complications and adjustment of immunosuppressants.
   • Early ambulation and physiotherapy to aid recovery.

Day 13-21: Discharge Preparation

1. Recipient Care:
   • After stabilization, the patient will be discharged with detailed instructions on medications, diet, and lifestyle changes.

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Post-Discharge Follow-Up (First 3-6 Months)

1. Regular Monitoring:
   • Weekly liver function tests for the first month, followed by bi-weekly and monthly checks for 3 months.
2. Medication Management:
   • Strict adherence to immunosuppressive therapy to prevent rejection.

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Complications Specific to Cadaver Liver Transplant:

• Delayed Graft Function (DGF): Delayed liver function due to cold ischemia time.
• Primary Non-function (PNF): Rare cases where the liver fails to function post-transplant.
• Immunological Issues: Higher immunogenicity with cadaveric livers requiring more intensive immunosuppression.

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Cadaver Liver Transplant Package (Normal)

👉 Total Cost: ₹25,00,000 to ₹30,00,000

Package Inclusions:

1. Pre-Workup: Comprehensive medical evaluation prior to the transplant.
2. Liver Transplant Surgery: Performed by a highly skilled team of surgeons and specialists.
3. Hospital Expenses: Covers hospital stay, surgery, medications, and post-operative care for up to 21 days.

Additional Details:

• Registration Fee: ₹50,000 (non-refundable).
• Waiting Period: 45 to 60 days (depending on donor availability and medical factors).

Important Note:

• ICU Charges: This package excludes ICU charges for any complications before or after the transplant.
  • If ICU care is required, the total bill may increase.