Living Donor Liver Transplant in Chennai: Cost & Donor Safety

End-stage liver disease and acute liver failure need timely, highly specialised surgical care. A living donor liver transplant offers an alternative to an unpredictable wait for a deceased-donor organ, because the operation can be planned electively rather than in an emergency. Dr. Babu Elangovan has been part of 230+ liver transplants and is experienced in both the donor hepatectomy and the recipient implantation — the two halves of this operation.

This page covers the living-donor operation specifically: donor safety, the surgical steps, cost in Chennai, the legal framework, and recovery. For the wider transplant service — conditions treated, evaluation and the transplant programme — see the liver transplant speciality page.

Table of Contents

• What a living donor liver transplant involves
• Who is a candidate
• Donor safety and liver regeneration
• The operation, step by step
• Legal framework: THOTA and the Authorisation Committee
• Cost in Chennai and CMCHIS cover
• Recovery: donor and recipient

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What a living donor liver transplant involves

In a living donor liver transplant, a healthy volunteer donates a portion of their liver, which replaces the recipient's failing liver. The operation is possible because the liver is the only internal organ that regenerates: the donor's remnant and the transplanted graft both grow toward normal volume and function within weeks.

The practical difference from deceased-donor transplantation is timing. A deceased-donor transplant depends on a centralised waiting list, and the wait can run to months or years. A living donation can be scheduled — which means the recipient can be operated on before decompensation, variceal bleeding or encephalopathy make surgery far riskier. Our guide comparing living donor and deceased donor liver transplant sets out the trade-offs of each route in more detail.

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Who is a candidate

Candidacy is established for irreversible liver failure — decompensated cirrhosis, acute liver failure, or hepatocellular carcinoma (HCC) falling within accepted size and number criteria. Underlying causes include chronic hepatitis B and C, alcohol-related liver disease, NASH and biliary or metabolic liver disease.

Assessment is deliberately rigorous, covering cardiac and kidney function, nutrition, infection screening and psychological readiness, because the recipient must tolerate major surgery and then lifelong immunosuppression. Warning signs that should prompt early referral — persistent jaundice, ascites, encephalopathy or recurrent variceal bleeding — are covered in our guide to the warning signs of cirrhosis. What the assessment itself involves is set out in what happens during liver transplant evaluation.

Referral early in the disease course widens the options. Suitability is decided only after individual clinical assessment.

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Donor safety and liver regeneration

Donor safety governs the entire process. The donor gains no medical benefit from the operation, so their safety cannot be traded against the recipient's need — and donation is declined whenever the margin is not clearly adequate.

How regeneration works

When a segment is removed, the remaining liver begins to grow immediately through cellular division. Both the donor remnant and the recipient's graft reach close to normal volume and full function in about 6 to 8 weeks.

Donor selection

• Age and health: typically 18–55, in good physical and mental health.
• Compatibility: compatible blood group with the recipient.
• Anatomy: favourable vascular and biliary anatomy on high-resolution CT and MRI.
• Remnant volume: CT volumetry to confirm the donor retains a safe remnant, usually at least 30–40%.
• Voluntariness: independent counselling to confirm the decision is free of pressure.

Donors do not require long-term medication once regeneration is confirmed and liver function is normal.

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The operation, step by step

The transplant runs as two coordinated operations in adjacent theatres.

1. Final clearance. Donor and recipient complete medical clearance; legal approvals are verified.
2. Donor hepatectomy. The planned segment is mobilised and divided — usually the right lobe for an adult recipient, the left lobe for a child.
3. Recipient hepatectomy. The diseased liver is removed.
4. Implantation. The graft is flushed with cold preservation solution and implanted, reconstructing the hepatic veins, portal vein, hepatic artery and bile ducts. Running the two operations in parallel keeps cold ischaemia time short.
5. ICU care. Both patients go to a transplant ICU for haemodynamic monitoring, pain control, and Doppler and blood-test assessment of early graft function. The recipient starts immunosuppression, which is then managed lifelong.

Liver transplantation is performed within a dedicated multidisciplinary transplant programme at the affiliated transplant centre.

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Legal framework: THOTA and the Authorisation Committee

Living donation in India is tightly regulated to prevent commercial exploitation.

THOTA and near-relative rules. Under the Transplantation of Human Organs and Tissues Act, donors should normally be a near relative — parent, sibling, child, spouse, grandparent or grandchild — with the relationship established through verifiable legal documentation and, where required, DNA profiling.

State Authorisation Committee. Donations outside the near-relative category, and cases requiring verification, are referred to the State Authorisation Committee in Chennai. The committee interviews donor and recipient independently to confirm the donation is altruistic and non-commercial. The clinical team guides families through assembling this documentation, which is best started early — approvals take time.

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Cost in Chennai and CMCHIS cover

Cost varies with the clinical course, and no two transplants are identical. Published ranges for a living donor liver transplant in Chennai are broadly of the order of INR 18,00,000 to INR 25,00,000. Treat that as an indication only: a written estimate for your own case comes after assessment.

What moves the figure:

• Donor and recipient evaluation before surgery.
• Duration and complexity of both operations.
• Length of stay in the transplant ICU and ward.
• Management of any post-operative infection or complication.
• First-year immunosuppression and follow-up imaging and laboratory tests.

CMCHIS. For eligible Tamil Nadu residents, the Chief Minister's Comprehensive Health Insurance Scheme provides cashless cover for liver transplantation up to Rs 22,00,000 at empanelled hospitals. This makes transplantation reachable for families who could not otherwise fund private tertiary care. Eligibility and the treating hospital's empanelment should be confirmed before admission.

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Recovery: donor and recipient

Recovery differs sharply between a healthy donor and a recipient who has been chronically ill.

The donor. Around 5 to 7 days in hospital. Light, sedentary activity usually resumes in 2 to 3 weeks; heavy lifting and strenuous exercise are avoided for 6 to 8 weeks while the abdominal wall heals. By 2 to 3 months regeneration is complete, with no long-term dietary or physical restrictions.

The recipient. Usually 2 to 3 weeks in hospital while graft function is monitored and immunosuppression is titrated. Strict infection precautions apply at home for the first 3 months, when immunosuppression is heaviest. Most recipients return to normal daily activity over 3 to 6 months, with lifelong immunosuppression and regular blood tests to monitor drug levels and liver function.

A transplant replaces the whole organ. That is a different operation from liver resection, which removes only the diseased part of the liver and leaves the native organ in place — and which is part of the wider HPB surgery service.

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Consult Dr. Babu Elangovan

Dr. Babu Elangovan is a surgical gastroenterologist and liver transplant surgeon in Chennai with over 20 years of experience, and has been part of more than 230 liver transplants — experienced in both donor hepatectomy and recipient implantation.

Care runs as a continuous pathway: evaluation and donor assessment, the THOTA approval process, surgery, then long-term follow-up for recipient and donor.

To discuss transplant suitability or donor compatibility, book an appointment or call +91 99626 60009. Sharing your reports before the visit helps the team prepare.

This page is general information, not medical advice. Whether a transplant is appropriate — and which operation suits your case — is decided only after individual clinical assessment by a qualified surgeon. Outcomes vary between patients and cannot be guaranteed.