Insights on Liver Transplant: Interview with Dr. Sanjay Goja

Medically Reviewed by Dr. Aman Priya Khanna
Written by Charu Shrivastava, last updated on 3 May 2024
Insights on Liver Transplant: Interview with Dr. Sanjay Goja

The Liver Foundation estimates that each year, approximately 2,00,000 Indians are diagnosed with end-stage liver disease. You might also be surprised to know that around 0.05% of the population (25,000 people) requires liver transplants. The complex surgical technique allows replacing a diseased liver with a healthy liver.

In an exclusive interview with Dr Sanjay Goja, Director of Hepatobiliary Surgery at Narayana Health, we unveiled the advancements and hurdles in transplant procedures. Let’s look at a summarised comprehensive blog to explore all the information about liver transplantation.

About Liver Transplant

When liver failure strikes suddenly (acute liver failure) or progresses slowly over time (chronic liver failure), a transplant becomes a vital lifeline.

Acute Liver Failure (ALF) can occur unexpectedly, often caused by acute viral infections like Hepatitis A and E, particularly prevalent in India.

Chronic liver failure, known as end-stage liver disease, develops gradually, with cirrhosis being the most common cause. In cirrhosis, liver cells progressively die and are replaced by scar tissue.

Liver transplantation offers renewed hope and a chance at life by replacing a diseased liver with a healthy one.

What is Liver Transplant

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Is liver transplantation safe?

Thousands of liver transplants are done in India every year with a 95% success rate.

Dr Sanjay Goja highlights the safety of living liver donation, comparing it to donating blood or activities like air travel. 

Advanced techniques like Virtual Hepatectomy (Safe and Precise 3D Surgical Planning) enhance safety by simulating surgeries. With technological advancements, living donation offers a risk-free pathway towards healthier lives.

If you are worried that your life will be different after the transplant, there is nothing to worry about. In living donor transplants, despite donating up to 60% of the liver, the transplanted liver promptly becomes fully functional in the recipient while the donor's liver regenerates to restore the donated portion.

Dr Goja highlights how quickly the liver regenerates after surgery, showing notable progress in just 6 hours and nearly 90% regeneration within three weeks. Although the rate may slow down between 3 weeks and 3 months, the process stabilises, providing a steady path to recovery.

Is alcohol the sole reason for liver failure?

Are you concerned about the impact of alcohol on your liver? According to a study by Devarbhavi et al., 2023, it is one of the most prevalent risk factors for hepatic disease. It contributes to almost two million fatalities globally and accounts for 4% of all deaths (1 out of every 25 deaths).

Alcohol is a leading cause of liver disease due to its widespread consumption, but it's not the only factor. Conditions like obesity or hepatitis also contribute to liver damage.

Dr Goja points out that alcohol speeds up the progression from fatty liver to cirrhosis, with the impact varying based on how much and how long someone drinks. When alcohol is combined with conditions like Hepatitis B, the damage to the liver worsens.

To protect your liver, it's important to lead a healthy lifestyle, limit alcohol intake, and regularly see a doctor for check-ups. These steps can help prevent or manage liver damage from different causes.

Types of Liver Transplant

In India, 80% of liver transplants use living donors, while in Western countries, over 90% rely on deceased donors. Despite being more complex, living donor transplants are safely performed at experienced centres. Let’s read on to learn more about these transplants.

  1. Living Donor Liver Transplantation (LDLT): A healthy person donates a portion of their liver, which is then transplanted into the recipient. This is the most common form of liver donation in India.

  2. Deceased Donor Liver Transplantation (DDLT): The organs are obtained from recently passed away individuals. This helps save lives by utilising organs from donors who chose to donate upon death. There are two types of deceased donations:

    1. Donation after Brain Death

      1. Certified by a neurologist when brain function is permanently deranged

      2. Practised in India and abroad

    2. Donation after Cardiac Death

      1. Donation occurs after heart failure

      2. Legal in Europe but not in India

The Success Rate of LDLT vs DDLT

Success rates in liver transplantation, whether through LDLT or DDLT, depend on factors such as recipient health, organ quality, and medical expertise.

Studies such as Wong et al. (2019) have shown comparable survival rates (72.2% vs 81.5%) between matched LDLT and DDLT groups, highlighting the effectiveness of both approaches.

Some data indicates minimal differences in long-term outcomes between living and deceased liver donation, each method has distinct advantages.

Living donation allows for controlled quality and timely transplantation, which is particularly beneficial for recipients in good health. Conversely, a deceased donation may lack immediate availability but carry a rare risk of liver dysfunction.

Liver Transplant Eligibility Criteria

Nutritional Goals for Liver Transplant Patients

People with liver disease often struggle synthesising proteins crucial for muscle strength and overall health. Thus, a high-protein diet tailored to their condition is essential for surgery preparation. 

Dr Goja advises consuming 1-1.5 grams of protein per kg of body weight and 1800-2000 calories regularly. For example, a person weighing 70 kg should aim for 70-105 grams of protein and maintain 1.8-2 Kcal/day.

Even after transplantation, maintaining a healthy diet is crucial for caring for the new liver and preventing complications. Additionally, avoiding foods that contribute to liver fat formation or drinking alcohol is essential for long-term liver health.


Explore the intricate world of liver dysfunction with Dr Goja as he uncovers the nuances of hepatic crisis, offering invaluable insights into its causes, symptoms, and effective management strategies.

At HexaHealth, we're committed to delivering accessible, high-quality liver transplant surgeries in India. Whether you're seeking details on the procedure, costs, potential side effects, hospital accommodations, financing solutions, or post-surgery recovery, don't hesitate to contact us for comprehensive assistance.

Suggested Reads

Liver Transplant
Paediatric Liver Transplant
Liver Transplant Guide
Liver Transplant in Adults

Frequently Asked Questions

Can Only a Blood Relative Donate Liver?

No, a blood relative is not the only potential liver donor. While family members are often preferred due to a higher likelihood of tissue compatibility, it's not a strict requirement. 
It has to be a first-degree or second-degree relative. It is not legally permissible in India to have unrelated donors.
The primary consideration is compatibility between the donor and recipient, which involves factors like blood type and tissue matching.

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What quantity of alcohol can lead to liver failure?

The impact of alcohol consumption on liver health varies significantly, making it difficult to provide a definitive answer. While it's commonly understood that consistent intake of approximately 4-5 standard drinks over a prolonged period can lead to fatty liver disease, occasional binge drinking can also contribute to this condition.

A standard drink typically contains 14 grams of alcohol, though this measurement can vary. Individuals may consume alcohol over many years without developing liver issues, while others may develop complications.

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Can there be liver failure in non-alcoholic patients as well?

There are numerous causes of liver failure. Alcohol consumption is a significant factor, alongside the rising prevalence of

  1. Lifestyle-related liver diseases such as Non-Alcoholic Steatohepatitis (NASH) which is associated with obesity. 

  2. Viral causes like hepatitis B, C, A, and E infections also contribute, with acute liver failure occurring in hepatitis A and E infections. 

  3. Additionally, drug-induced liver damage, notably from antitubercular drugs, is common.

The spectrum of liver diseases in adults varies widely, encompassing a range of etiologies.

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Has Covid-19 also impacted liver failure?

People with chronic liver disease are at high risk when they get COVID-19. Even though liver enzymes and functions can be affected by COVID-19, there isn't enough evidence to say that it alone leads to liver failure.

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Can individuals with varying genders and ages be affected differently by liver failure?

Yes, individuals with varying genders and ages can be affected differently by liver failure. While factors like gender and age play a role, other variables such as underlying health conditions, lifestyle choices, and genetic predispositions also influence how liver failure manifests and progresses in different individuals.

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Is organ transplant or liver transplant legal in India?

Whether a deceased donor or a living donor, organ transplants are governed by strict legalities and some ethics. The Organ Transplant Act has guidelines that must be strictly followed.

  1. Donation after brain death is practised in India as well as abroad.

  2. Donation after cardiac death is not legal in India.

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Does donating the liver affect fertility?

Liver donation doesn't have long-term effects on sexuality or fertility. Liver function usually returns to normal afterwards, and there's no evidence of a lasting impact on fertility or marital life. The only concern is the risk of hernia formation around the time of surgery due to the incisional scar, but this is temporary. Beyond a few months, there are no lasting effects on family or sexual life from donation.

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How early can a baby undergo a liver transplant?

There's no definitive cutoff. It depends on the severity of the liver disease and the individual's likelihood of recovery.

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What is the survival rate of children in living donor liver transplantation?

Globally, children undergoing liver transplantation have a 95% post-survival rate, leading to excellent outcomes. Many children who receive liver transplants go on to live everyday lives and transition into adulthood successfully. 
For kids with end-stage liver disease, paediatric living donor liver transplantation (LDLT) has emerged as the gold standard. Patients' survival rates and long-term results following LDLT have greatly improved because of advancements in organ preservation immunosuppressive, surgical, and anaesthetic procedures. 
Close monitoring and meticulous follow-up are essential for maintaining these excellent results in children.

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What should be the nutritional goals for a liver transplant surgery patient?

Eat small, frequent meals throughout the day and include protein with every meal. The nutritional build-up and control diet form an essential part of the journey towards liver transplant; even after the transplantation, the person can have anything on any diet. Fatty food and drinking alcohol should be avoided.

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Life after liver transplantation – For both patient & donor

Both recipient and donor can lead a normal life after transplant. Preventive precautions should be followed, like not coming in contact with someone who already has an infection and not drinking.

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What is the recovery period post-liver transplant surgery?

Post liver transplant, the patient usually stays in the hospital for around 10-15 days; after that, for three months, he has to take absolute precautions against infection because this is a very highly susceptible time when he starts getting an infection.
It can take up to a year to fully recover, although you'll usually be able to start gradually building up your activities after a few weeks.

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How long does a transplanted liver last?

The liver transplant offers a lifelong organ solution. Thus, it's uncommon for individuals, including the elderly, who have undergone liver transplants to later die from liver failure. Globally, the majority, if not all, of liver transplant recipients pass away from ailments unrelated to liver complications.

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Are lifelong medications needed after a liver transplant?

To lower your chance of liver rejection, you will need to take immunosuppressive medications. Usually, two or three different medications are included. The doses of these medicines generally reduce over time, but some immunosuppressant medication will be needed for the lifetime of the liver transplant.

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How soon can you resume normal life after a liver transplant?

Following discharge from the hospital, it typically takes about three months for the patient to resume their normal lifestyle safely, minimising the risk of infection, especially in a workplace environment. Around the 3-month mark, the patient can consider working from home. 
However, returning to a physical workplace is usually recommended after six months, provided it's a clean, dust-free environment to reduce the risk of infection. 

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Is exercising allowed after a liver transplant surgery?

After the transplant, individuals can resume normal activities, including exercise and gym. However, heavy weight lifting should be avoided for the first 3 to 6 months due to the risk of hernia development at the incision site. After this period, they can gradually return to regular exercise routines without concerns.

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Does liver transplant surgery affect your sex life?

No, cirrhotic patients often experience decreased sexual desire due to hormonal changes, including elevated oestrogen levels in males. However, after surgery, this hormonal imbalance is typically reversed, leading to a return of sexual function for transplant recipients. For donors, there's no impact on sexual life.

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Can alcohol be taken after a liver transplant surgery?

You should never drink alcohol again if you have undergone liver transplant since it could damage your newly transplanted liver. This holds true even if alcohol was not the primary cause of your liver disease but was deemed to have had a role.

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Can the organ be rejected after a liver transplant surgery?

Yes, it's possible for the body to reject a transplanted liver after surgery. The liver is highly immunocompatible compared to other organs like the kidneys or lungs. While liver transplantation is less prone to rejection, it's not entirely risk-free. This happens when the immune system sees the new liver as foreign and attacks it. However doctors can usually treat rejection with medications.

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How often are follow-up consultations needed after liver transplant surgery?

For the first three months, rigorous follow-ups are necessary. It can be conducted virtually unless physical intervention is required. However, lifelong follow-up is essential, with the frequency of investigations increasing over time, typically ranging from monthly to once every three months. Regular, consistent follow-up is crucial for post-liver transplantation care.

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Does donating a piece of your liver impact your health?

Individuals who donate a portion of their liver can live healthy lives with the remaining liver. The liver is the body's only organ that can replace damaged or lost tissue (regenerate). After surgery, the donor's liver will rapidly grow to its natural size.

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In how much time can a liver regrow itself?

After a liver transplant, the liver starts regrowing. It gets nearly 90% of its normal size in about three weeks. Then, the regrowth slows down for the next three months. But within 90 days, the liver returns to its normal size.

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The success rate of living donor Transplant v/s Deceased Transplant

A study by Wong et al. (2019) found comparable survival rates (72.2% vs 81.5%) between matched LDLT and DDLT groups. LDLT often offers advantages over DDLT, like shorter waits and potentially better long-term outcomes.

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All the articles on HexaHealth are supported by verified medically-recognized sources such as; peer-reviewed academic research papers, research institutions, and medical journals. Our medical reviewers also check references of the articles to prioritize accuracy and relevance. Refer to our detailed editorial policy for more information.

  1. Moon DB, Lee SG. Liver Transplantation. Gut and Liver [Internet]. 2009 Sep 1 [cited 2020 Apr 22];3(3):145–
  2. Soin AS, Kakodkar R. Living donor liver transplantation in India. Tropical Gastroenterology: Official Journal of the Digestive Diseases Foundation [Internet]. 2007;28(3):96–
  3. Devarbhavi H, Asrani SK, Arab JP, Nartey YA, Pose E, Kamath PS. Global burden of Liver Disease: 2023 Update. Journal of Hepatology [Internet]. 2023 Mar 27;0(0).link

Updated on : 3 May 2024


Dr. Aman Priya Khanna

Dr. Aman Priya Khanna

MBBS, DNB General Surgery, Fellowship in Minimal Access Surgery, FIAGES

12 Years Experience

Dr Aman Priya Khanna is a well-known General Surgeon, Proctologist and Bariatric Surgeon currently associated with HealthFort Clinic, Health First Multispecialty Clinic in Delhi. He has 12 years of experience in General Surgery and worke...View More


Charu Shrivastava

Charu Shrivastava

BSc. Biotechnology I MDU and MSc in Medical Biochemistry (HIMSR, Jamia Hamdard)

2 Years Experience

Skilled in SEO and passionate about creating informative and engaging medical content. Her proofreading and content writing for medical websites is impressive. She creates informative and engaging content that educ...View More

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