Guidelines for Live Donor Liver Transplantation (LDLT) in Iran Details
Recipient’s evaluation
- Patients must carry a prescription or a letter from his physician/gastroenterologist/hepatologist that suggests a Liver Transplant as the treatment of his liver disease.
As we wish that you should stay under the care of your physician once you go back, this is important for us. - Once you reach your preferred hospital in Iran, the requirement of the liver transplant will be re-diagnosed and confirmed.
- In case you wish to seek an opinion through e-mail about regarding the possibility of a Liver Transplant, you can please send a mail attaching the following reports:
- Urine protein creatinine ratio and Urine routine/microscopy
- Anti HCV, HIV I & II, Liver Function Tests (LFT), P time / INR, Urea, Creatinine, CBC / Hemogram, Sodium, Potassium, AFP, HbsAg
- Triple phase CT angiography of the liver (Patients with normal creatinine levels, urea, and no contrast allergy can get this test done safely)
- Your Medical Summary prepared by your doctor carrying information about your past medical history/symptoms.
- Recent Upper GI endoscopy report
All these reports are required to confirm the requirement and cost of a Liver Transplant.
Nevertheless, once the patient reaches the preferred hospital in Iran, the liver transplant candidate would be examined again and would have to undergo certain other essential tests such as ABG, PA pressure measurements, PFT, Stress Echo, for checking his fitness before undergoing the transplant surgery.
Evaluation of Donor:
- He/She should be a relative of the patient and should be happy to donate his liver on a selfless basis.
- It is preferable that the donor must be between the age group of 18 and 45 years. He/she should be fit, strong, and have a matching or compatible blood group:
Patient blood group | Matching donor groups |
A+ or A- | A+/ A- /O+ / O- |
B+ or B- | B+ / B- / O+ / O- |
AB+ or AB – | Any blood group acceptable |
O+ or O- | O+ / O |
- Though the liver looks like a single organ it consists of 8 different lobes and thus can be separated into these lobes.
Generally, the donor’s right half of the liver is donated during an adult – to – an adult liver transplant.
Liver’s bloodless division into right and left has now become possible because of the latest techniques and gadgets.
A living donor can now easy donate his liver safely as the remaining left side grows back to around 80 percent of liver’s original size in few weeks and quite close to the original size within few months.
The ratio of risk in the liver donation is even lower than 1:200.
- The donor must be a psychologically-sound adult who is aware of taking any sort of decision.
- If an unrelated liver donor is doing the transplant for financial reasons, it is illegal and punishable under Iran laws.
No queries in this regard would be entertained. - In case, you want to start the evaluation of the donor on an immediate basis; you can get done the Level I and Level II tests in your own country and send the reports to us by mail:
Level I: Blood group HBsAg, HbA1c, Anti HCV, HIV I & II CBC / Hemogram, Creatinine, P time / INR, LFT, Urea
After 14 hour Fasting, Serum T3, T4, Lipid profile, and TSH
If the reports are fine, go on to Level II
Level II: Triple phase CT Liver Angio (donor protocol) along with a plain scan for looking at Liver Attenuation
You can courier or mail us the reports or bring along a CD in DICOM format
This scan is a crucial part of the donor workup:
Level III: MRCP
Level IV: Stress Echo, Chest X-ray, ECG, Lung Function Tests USG breast & pelvis, Mammography (less than 40 yrs), CA 125, HLA tissue typing, PAP smear (married ladies), Blood group antibody screen
- Tests at Level III and IV for the donor and all tests for the patient can be done within 48 hrs of arrival at a hospital in Iran.
If the test reports are fine, a liver transplant can be done quickly once permission from Government of Iran Transplant Authorization Committee is taken.
All this might take a week.
Assistance in Visa Formalities
- As we receive an email with the patient’s and donor’s passport details, the details of up to 2 more attendants, we can get you an Invitation letter issued from the preferred hospital.
Another copy of the letter would be sent to the Iran High Commission.
You must apply only for a Medical Visa soon as this letter is of great help to get a Medical Visa quickly. - The patient would be required to stay for two months and the donor for one month.
Out of these, the patient would spend 21 days, and the donor would spend ten days in the hospital.
It is advisable that post-transplant, the patient should stay close to the hospital after discharge for around four weeks.
Guidelines for Live Donor Liver Transplantation (LDLT)
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