It is the country's financial capital and also a medical tourism centre, but low liver transplants in the city has always been a cause for concern. Private hospitals, such as Kokilaben Dhirubhai Ambani Hospital (KDAH) and Fortis hospital, had to bring on board liver experts from outside the city to start live liver transplant programmes.
Dr Rakesh Rai, liver transplant expert at Fortis hospital, said, "There was no successful live liver transplant programme. Patients had to go to Delhi or down south for the transplants as the cadaver waiting lists are long."
Experts blame it on the reluctance to perform live transplant because it is a technically difficult procedure. KDAH, therefore, had appointed the entire team from Delhi's Sir Ganga Ram hospital, which is famous for the liver transplant surgery.
Dr Vinay Kumaran, who heads the liver transplant surgery team in KDAH, said, "In the past one year, we have done 42 liver transplants — 38 live ones and four paediatric cases. The problem with Mumbai hospitals, when it comes to liver transplant, is that they don't have full-time surgeons. For liver transplant, you need dedicated full-time surgeons to make the programme a success. Things are changing now though, with many city hospitals keen to change this."
Kumaran also said that cadaver donation too is picking up in the city, but it is not enough to match the actual need. While private hospitals are slowly picking up in terms of liver transplant, public hospitals are still struggling, for example, KEM hospital.
The hospital in Parel is the only public hospital to have a liver transplant programme. Currently, it has 20 people waiting on its list for the organ. A senior doctor from the team of KEM hospital's liver transplant programme said, "After the initial failure of live transplants, we decided to do only cadaver transplants. Once this picks up, we will restart live transplants."
In the last one year, the hospital has conducted eight cadaver liver transplants. The hospital's liver transplant facility, which was inaugurated in June 2010, has so far conducted only five live transplants.
"Live transplants were stopped after both recipient and donor died in November 2010 in one case. We are only concentrating on cadaver transplants. In the last six months, we did one cadaver transplant as it depends on the availability of the organ as per the ZTCC waiting list," said the senior doctor.
A liver transplant in any private institute costs up to Rs18-20 lakh. KEM hospital has subsidised the cost to about Rs5 lakh
While the city sees close to 300 patients suffering from end-stage liver disease, less than 10% of them manage to get an organ in Mumbai, according to liver transplant experts. Another 10% go to Delhi or Chennai, Hyderabad or Vellore in the hope of getting a transplant.
Almost 80% die waiting for a transplant as they can't afford the surgery
In Mumbai alone, nearly 2,000 patients die annually from liver failure or liver cancer and 300 are waiting for a transplant at any given point of time