The Problem With Liver Transplants In India

With the growth of lifestyle diseases among Indians, the country has also seen a growth in liver-related diseases. The most common causes of liver disease include alcohol and other obesity-related disorders. Every year, about 10 lakh new patients are diagnosed with liver cirrhosis in India.

India accounted for over a one-fifth (18.3%) of global liver cirrhosis deaths in 2010, and the World Health Organisation (WHO) stated that liver is the 10th most common cause of deaths in India. One in five Indians is a potential risk for liver diseases.

Here are some startling facts on liver diseases:

- Hepatocellular carcinoma (HCC), or cancer in the liver, is the second most common cause of death due to malignancy in the world.

- In India, the age for alcoholic liver disease is coming down, and it mostly occurs between the ages of 30 and 40. Whereas, in the West, the average age of the disease has gone up to 45 to 55 years

- Non-alcoholic fatty liver disease (NAFLD) has emerged as the leading problem — the number of patients doubled in the 25 to 40 age group.

• Liver disease is the tenth most common cause of death in India as per the World Health Organization.

Often, those suffering from severe liver diseases are required to undergo a liver transplant. However, a liver transplant is also currently a major challenge in India, owing to several factors. About one lakh people die of liver diseases in India annually, and only 3,000 get a liver transplant. India has an annual requirement for 50,000 liver transplants, but there are approximately only 3,000 organs available. Also, 95 per cent of liver transplants take place via a donation from relatives. A cadaver or deceased donor can save up to nine lives, yet organ donations from the deceased stand at a dismal 0.34/million. Surprisingly, India topped a survey carried out in 28 countries, with 74% of the respondents willing to donate their organs in case of death. Unfortunately, willingness hasn’t translated into action, with the country facing a huge shortage of organs.

Lack of knowledge, awareness, superstitions, infrastructure are some of the reasons behind the shortage of organ donation in India. Another major problem of liver transplant in India is the high costs of the procedure. Less than 2% of liver transplants taking place in India happen in public hospitals. This means that liver transplants, which cost Rs 20–30 lakh in most cases, are available only to people with financial means.

However, crowdfunding has helped address this issue, as those from lower income groups have been able to successfully raise funds to afford a liver transplant. Ketto, one of the leading crowdfunding platforms, has raised over Rs. 10.2 crores for cases involving liver transplants.

One such recent case involved Mumbai couple, Sandesh and Supriya, who was shattered when their three-month-old daughter Arnavi was diagnosed with Biliary Atresia, a rare childhood liver condition in which one or more bile ducts are abnormally narrow, blocked, or absent. Though she underwent surgery at such a tender age, as she grew up, complications started developing. By the age of five, a liver transplant became necessary for her to survive. Her parents had run out of avenues to arrange the money for her treatment. They turned to crowdfunding on Ketto and were able to raise the required Rs. 21 lakhs within a few weeks, thanks to which their daughter Arnavi is leading a healthy life.

As the healthcare industry trend suggests, liver diseases are on the rise in India, which further indicate that the demand for a liver transplant will only grow in the country. There’s definitely a lot of work required to be done to increase the base of organ donors in the country. And while the cost of treatment is unlikely to go down, we also need an increase in the number of donors for crowdfunding campaigns hosted on platforms like Ketto, to try and reduce the number of deaths owing to lack of financial avenues of raising funds for treatment.