Liver transplantation is a complex procedure and the transplant operation is just one event in the journey that a patient and his caregivers have to embark on. In any long process, well begun is half done and therefore this event ie the operation, if performed and tolerated well, increases the chances of patient survival and eventual well-being. However it must be remembered that this in itself does not ensure a smooth course.
Nearly 10-20% liver transplant patients will need to have an intervention ( either radiological, endoscopic or surgical) during the same admission as their transplant procedure. Often these interventions if not performed emergently and by experienced personnel, can lead to loss of graft and indeed loss of life. It therefore follows that the transplant team should be available round the clock to anticipate, detect early and intervene in time to salvage the graft and the life of the patient.
In the first three months following discharge, at least 10% transplant recipients may need hospital admission under the care of the transplant team for problems related to infection, rejection or surgical complications. If these are not managed well, they can lead to graft as well as patient loss.
There is a tendency among Indian patients to jump on the bandwagon and travel great distances to few transplant centers for their surgery (often at an exploitatively elevated cost) or have transplants performed by commercially-motivated visiting teams attracted by real or exaggerated claims of success, aggressive marketing or through inducement of their referring physicians. While there is no doubt that the right to choose lies with the patient, there is often no consideration given to the availability of continuous surveillance once the patient returns to his community. Patients are lulled into a (false) sense of complacency by the promise of periodic visits by members of the transplant team or placement of inadequately trained minions in the community to look after them for which a 'follow up fee' is charged upfront.
I have recently come across several cases of these 'transplant orphans' who having undergone 'successful' surgery at centers far away from their communities, have suffered due to the lack of direct surveillance and landed up in graft damage or even graft loss. Travelling the distance for managing the complication, imposes an even greater financial burden and moreover patient status may not even allow safe travel in time even if one were to disregard the economics. These patients are frustrated and left to fend for themselves or cared inadequately by inexperienced personnel through telephonic or email directions from the transplant centre. They then have no alternative to running from pillar to post to get proper care from nearby transplant physicians who may not necessarily be willing to takeover the case.
I think anybody traveling to a distant center for a complex procedure like liver transplantation should really consider the availability of longterm experienced followup in his community and ensure that adequate provisions are made for this before the surgery (whenever possible).
There is often a price to pay for going the distance and sometimes the price can be just too high!
Nearly 10-20% liver transplant patients will need to have an intervention ( either radiological, endoscopic or surgical) during the same admission as their transplant procedure. Often these interventions if not performed emergently and by experienced personnel, can lead to loss of graft and indeed loss of life. It therefore follows that the transplant team should be available round the clock to anticipate, detect early and intervene in time to salvage the graft and the life of the patient.
In the first three months following discharge, at least 10% transplant recipients may need hospital admission under the care of the transplant team for problems related to infection, rejection or surgical complications. If these are not managed well, they can lead to graft as well as patient loss.
There is a tendency among Indian patients to jump on the bandwagon and travel great distances to few transplant centers for their surgery (often at an exploitatively elevated cost) or have transplants performed by commercially-motivated visiting teams attracted by real or exaggerated claims of success, aggressive marketing or through inducement of their referring physicians. While there is no doubt that the right to choose lies with the patient, there is often no consideration given to the availability of continuous surveillance once the patient returns to his community. Patients are lulled into a (false) sense of complacency by the promise of periodic visits by members of the transplant team or placement of inadequately trained minions in the community to look after them for which a 'follow up fee' is charged upfront.
I have recently come across several cases of these 'transplant orphans' who having undergone 'successful' surgery at centers far away from their communities, have suffered due to the lack of direct surveillance and landed up in graft damage or even graft loss. Travelling the distance for managing the complication, imposes an even greater financial burden and moreover patient status may not even allow safe travel in time even if one were to disregard the economics. These patients are frustrated and left to fend for themselves or cared inadequately by inexperienced personnel through telephonic or email directions from the transplant centre. They then have no alternative to running from pillar to post to get proper care from nearby transplant physicians who may not necessarily be willing to takeover the case.
I think anybody traveling to a distant center for a complex procedure like liver transplantation should really consider the availability of longterm experienced followup in his community and ensure that adequate provisions are made for this before the surgery (whenever possible).
There is often a price to pay for going the distance and sometimes the price can be just too high!
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