Liver transplant in India: donors, process and how to prepare

A liver transplant in India is possible for international patients, and for most families it means a living donor transplant: a healthy relative gives part of their liver to the patient. Before anything happens, the hospital’s transplant team must accept the case, and a government-approved Authorisation Committee must approve the donor. With good preparation, families can start this paperwork before they even fly.

This guide explains each step in plain language, for patients and for the son, daughter or spouse who is organising everything. It is general information, not medical advice. Only the transplant team who reads your reports can say whether a transplant is right for you.

What a liver transplant is, and who it is for

The UK’s NHS Blood and Transplant describes a liver transplant as a major operation in which a diseased liver is removed and replaced by a liver from a donor. It calls it a life-saving treatment for some patients with cirrhosis and end-stage liver disease.

Whether a transplant is the right step is a medical decision. Hepatologists (liver physicians) and transplant surgeons look at how well the liver is working, the cause of the disease, the rest of the body (heart, lungs, kidneys) and the patient’s general strength. Some patients are advised to have other treatment first, and some are told a transplant is not suitable. That is why the first step is always to send reports, not to book a ticket.

Living donor and deceased donor transplants

There are two main types:

• Living donor liver transplant. A healthy person donates part of their liver. Medanta explains that the donor’s liver regenerates to near-normal size and function within a few months. NHS Blood and Transplant says that for an adult recipient the larger right lobe is usually removed, and for a child the smaller left lateral lobe.
• Deceased donor liver transplant. The liver comes from a person who has died and whose family agreed to donation. Medanta also lists split liver transplants, where one deceased donor liver is shared.

For international patients, the living donor route is the one families usually plan around, because of the rules explained below.

India’s transplant law: what international families must know

Organ transplants in India are governed by the Transplantation of Human Organs and Tissues Act and the Transplantation of Human Organs and Tissues Rules, 2014. The Ministry of Health’s national organ transplant body, NOTTO, publishes the Act and Rules. Here is what they mean for a foreign patient, in simple words.

Who can donate

The Rules list “near relatives” as grandmother, grandfather, mother, father, brother, sister, son, daughter, grandson and granddaughter, above eighteen years of age. A spouse can also donate; the Rules handle spousal donors separately, with their own forms.

The Rules say a transplant will not be permitted if the recipient is a foreign national and the donor is an Indian national, unless they are near relatives. An Indian living donor who wishes to donate to a foreigner who is not a near relative “shall not be considered”. In practice, this means the donor usually travels with the patient from home.

The Authorisation Committee

When the donor or the recipient is a foreign national, the case must be approved by the hospital’s Authorisation Committee (or a district or state committee if the hospital does not have one). According to the Rules:

1. A senior official of your country’s embassy must certify the relationship between donor and recipient, on a set form known as Form 21.
2. The donor and recipient are personally interviewed, and the interview is video recorded.
3. The committee must take its final decision within twenty-four hours of holding the meeting, and urgent cases should be expedited.

The committee’s job is to protect donors: to make sure the donation is voluntary, that the relationship is real and that no money is involved. Families should bring original documents that prove the relationship (for example passports and birth or marriage certificates). The hospital’s transplant coordinator gives the exact list for your case, so ask for it early and start with your embassy as soon as you can.

Step 1: Send the patient’s reports

A transplant team needs a clear picture of the liver disease before giving an opinion. Useful reports usually include:

• A short summary from the current doctor: diagnosis, history, current medicines.
• Recent blood tests, especially liver function tests, kidney function, blood count and clotting tests.
• Hepatitis B and C tests, where done.
• Scans: ultrasound, CT or MRI of the abdomen, with the written report.
• Any endoscopy, biopsy or hospital discharge summaries.
• The patient’s blood group, and the blood group of any family member who may donate.

Clear photos or PDFs are enough at this stage. Healway Global sends the reports to the transplant teams you choose, so you can compare opinions. See how it works for the full process.

Step 2: The opinion, the donor plan and the written estimate

The transplant team replies with its opinion: whether a transplant seems suitable, what tests are still needed and whether a living donor will be required. Where the hospital offers it, a video consultation lets you ask questions directly before you decide.

At the same stage, Healway Global asks the hospital for a written estimate. It usually covers both the recipient and the donor, the expected time in hospital and the room category. It is an estimate, not a fixed price, because the final bill depends on how the patient and donor recover. You pay the hospital directly; our own role and fees are explained on our fees page.

Donor evaluation

The donor goes through careful tests before anyone is approved. Medanta says the evaluation includes medical history, physical examination, blood tests, imaging and specialist assessments. Some of these can sometimes be started at home, and the rest are done in India. Not every willing relative is found suitable, so families sometimes need to think about more than one possible donor.

Step 3: The medical visa and travel

India’s official e-Visa portal offers an e-Medical visa for the patient and an e-Medical Attendant visa for family members. The portal says:

• Only two e-Medical Attendant visas are granted against one e-Medical visa.
• The e-Medical visa allows multiple entries.
• You can apply online at least 4 days before arrival, within a window of 120 days.
• The patient needs a letter from the Indian hospital on its letterhead, giving the date or tentative date of admission.

The donor usually travels as one of the two attendants. Check the visa validity shown on the official portal when you apply. Healway Global helps you get the hospital letter and plans your arrival; read about our airport-to-airport support.

Step 4: The transplant and the hospital stay

After the donor evaluation and the committee approval, the hospital schedules surgery. NHS Blood and Transplant gives a general picture of what follows:

Stage	What NHS Blood and Transplant says
The operation	Done under general anaesthetic and usually takes 5 to 8 hours, depending on complexity
Intensive care	The first days are spent in intensive care with close monitoring
On the ward	Drains and lines are usually removed after 2 to 3 days; patients are encouraged to walk within a day or two
Time in hospital	Patients can expect to be in hospital for 7 to 14 days after the transplant
After discharge	Most patients are seen once a week in the transplant clinic at first

These are UK figures, given as a guide only. Your transplant team in India will tell you how long the patient and the donor are likely to stay in hospital, and how long the family should stay near the hospital after discharge for check-ups. Plan for this time when you book accommodation.

About the donor’s risks

Living donation is major surgery for a healthy person. NHS Blood and Transplant states that it carries a risk of the donor dying, of about 1 in 200 for adult (right lobe) donation and 1 in 1,000 for donation to a child. Donors should hear about the risks in their own case from the transplant team, privately, and should never feel pushed to donate.

Step 5: Going home and lifelong follow-up

A transplant is the start of lifelong care. NHS Blood and Transplant explains that patients take anti-rejection medicines, usually two or three different ones, and that some are needed for the lifetime of the transplant. Blood levels of these medicines are checked regularly: if they are too low there is a risk of rejection, and if they are too high side effects become more likely.

Before you fly home, make sure you have:

• A full discharge summary and a written medicine plan.
• Enough medicine for the journey, and a clear plan for buying it at home.
• A schedule of blood tests and who will read the results.
• A local doctor or hepatologist who agrees to follow the patient, in contact with the team in India.
• A way to reach the transplant team quickly if there are signs of infection or rejection.

Healway Global stays in touch after you go home and helps you share new reports with the hospital team.

Questions to ask the transplant team

Write these down for your video call or first meeting:

1. Is a transplant the right option now, or are there other treatments to try first?
2. Will we need a living donor, and which family members could be evaluated?
3. Which tests can the donor and patient do at home before travelling?
4. Which documents do you need for the Authorisation Committee, and how long does it usually take at your hospital?
5. How long will the patient and the donor be in hospital, and how long should we stay near the hospital afterwards?
6. What does the written estimate include, and what could make the final bill higher?
7. Which medicines will be needed after going home, and can we get them in our country?
8. How will follow-up work once we are home?

Hospitals and doctors for liver transplant

Healway Global works with JCI and NABH accredited hospitals in Delhi and Gurugram. Here is how three of them describe their liver programmes, in their own words:

• Medanta – The Medicity, Gurugram, describes its programme as “the nation’s largest living donor and ABO-incompatible liver transplant programme”. Dr. Arvinder Singh Soin is Chairman of liver transplantation there.
• Max Healthcare says its team established liver transplantation in India in 2001. Its Centre for Liver & Biliary Sciences is led by Prof (Dr.) Subhash Gupta.
• Artemis Hospital, Gurugram, says its liver unit performs both living donor and deceased donor transplants and uses minimally invasive techniques for living donor surgery. Its liver transplant chair is Dr. Giriraj Bora.

You can see more specialists on our liver and digestive care page.

How Healway Global can help

Healway Global is a medical travel company based in Gurugram, close to the hospitals where our patients are treated. We help families from Nigeria, DR Congo, Chad, Rwanda and many other countries plan treatment in India, calmly and clearly.

• WhatsApp first, no forms. Send one message and a real person replies, in English, French or Arabic.
• Only JCI and NABH accredited hospitals. Our partner hospitals are Medanta – The Medicity, Max Super Speciality Hospital Saket and Artemis Hospital, with others on request. See them all on our hospitals page.
• A written estimate before you travel. You see the hospital’s own estimate in writing, for the patient and the donor, and you pay the hospital directly.
• Video consultation first, where the hospital offers it, so you can speak to the transplant team before deciding.
• Help with the paperwork. We explain the documents the Authorisation Committee asks for, so you can start with your embassy early.
• Airport to airport. We help with the visa letter, your stay, and every day in the hospital, until you fly home.

We never promise outcomes, and we will tell you honestly if we think India is not the best option for you. To start, read how it works, see our guide to heart surgery in India, or simply send us a message on WhatsApp with the reports you have.