Legal and safe Liver Transplant in Asia

Liver transplantation is the best treatment modality for patients with end-stage liver diseases. It has been landmarked as one of the most important advances in the medical field. Its applicability is expanding tremendously worldwide, particularly in many Asian countries.

The body’s largest internal organ responsible for controlling immune responses, removing bacteria and toxins from the blood and processing nutrients, medications, and hormones among other critical functions can pose a major threat to survival of a person if damaged or injured.

Laws and Legality:

The implementation of legislation on brain death in Asian countries (Taiwan, Japan, China , Malaysia ,Hong Kong ,India and Korea) from 1987 to 1999 helped propagate the practice of cadaveric liver transplantation (CLT) in Asia.

Various amendments to this act have been passed, under which rules regarding organ donation after brain death were eased.

Current Asian statistics for transplant centers:

Japan has – 352 transplant centers

Thailand – 27 kidney, 6 liver, & 6 Cardiac transplantation centers

Iran – 22 centers most of which are kidney transplantation centers

India – 110 centers for Kidney transplantation, 5 centers for Liver transplantation, 6 Cardiac transplantation centers.  Over 35 centers in India have undertaken cadaver transplants

Conditions that may strike a patient off the eligibility list for a transplant:

A person who needs a liver transplant may not qualify for one because of the following reasons:

  • Active alcohol or substance abuse- Persons with active alcohol or substance abuse problems may continue living the unhealthy lifestyle that contributed to their liver damage. Transplantation would only result in failure of the newly transplanted liver.
  • Cancers in locations other than just the liver weigh against a transplant.
  • Advanced heart and lung disease prevent a patient with a transplanted liver from surviving.
  • Severe infections pose a threat to a successful procedure.
  • Massive liver failure accompanied by associated brain injury from increased fluid in brain tissue rules against a liver transplant.
  • HIV infection.
  • The inability to follow a treatment regimen.
  • A lack of psychosocial support.

Liver transplantation is surgery to remove a diseased or injured liver and replace it with a healthy whole liver or a segment of a liver from another person, called a donor. People with either acute or chronic liver failure may need a liver transplant to survive.

In adults, chronic liver failure due to cirrhosis caused by hepatitis C is the most common reason for liver transplantation in the United States. The second most common reason is cirrhosis caused by long-term alcohol abuse.

In children, biliary atresia is the most common cause of liver failure and the need for a liver transplant.


The process for getting a liver transplant:

  • The process for getting a liver transplant begins with referral to a transplant center, where a transplant team carefully evaluates candidates to determine whether they are suitable candidates for transplantation. The transplant center’s liver transplant selection committee decides whether to register a candidate on the national waiting list for a transplant.
  • The national waiting list is maintained by the United Network for Organ Sharing (UNOS) Organ Procurement Organizations (OPO), facilitate the identification and procurement of livers for distribution through UNOS.
  • People on the waiting list are assigned a score that indicates how urgently they need a transplant. The two scoring systems are the Model for End-stage Liver Disease (MELD) scoring system, used for people age 12 and older, and the Pediatric End-stage Liver Disease (PELD) scoring system, used for children younger than 12. A higher score indicates a more urgent need for a liver transplant.
  • Critically ill patients with acute liver failure who are likely to die within a week are categorized as status 1 patients and are given highest priority for liver transplantation.
  • Most livers for transplantation come from deceased donors. A small number of transplants involve living donors, who donate part of their liver, usually to a family member.
  • Liver transplant surgery is complex and can take up to 12 hours. Patients usually stay in the hospital from 1 to 2 weeks after a liver transplant.

Further information about the surgical and non-surgical options, post-operative care for Liver transplant patients click Here( hyperlink to a new blog post with the details )

Medical Tourism: The new choice of Americans

Max,who works for an auto parts manufacturing company in the North Carolina, needs a knee replacement. This costs more than $50,000 in the US. The company gave Max a choice – he can either opt fora co-pay in the U.S. or outsource the procedure abroad for free. Max has decided to go to Costa Rica, one of the emerging medical tourism destinations. He feels it’s safe and it comes for free, as his company picks up the bill. Even with their insurance, Max would have paid $3,000 out of pocket in the U.S., which he feels he wouldn’t have been able to afford.

Max is among a growing wave of Americans who now prefer to head abroad for medical procedures. According to the U.S. Center for Disease Control and Prevention nearly one million Americans go overseas for medical procedures every year. Once considered unconventional, medical tourism is gaining mainstream acceptance today. It has transformed into a billion-dollar industry attracting both patients and healthcare providers alike.

And now, some American companies are considering medical tourism as a health care option.

In the United States, a gastric sleeve surgery would have cost about $30,000, but in Costa Rice, it comes to $17,386. In some countries like Thailand or India, it could be much cheaper, almost with similar type of amenities and quality care one can expect in the US.

Cost of Care

The low costs of medical care abroad has more and more patients shopping for medical procedures. Take a look at the following figures:


While it may sounds too good to be true, planning to travel overseas for treatment can be challenging. This is where medical travel facilitators come into play. These are professional agencies that help you with every aspect of your trip, right from searching the right medical consultant before you travel to providing accommodation and food assistance during your stay. Thus, these companies can greatly reduce the challenges that come from medical travel and make your trip a favorable one.

Thailand: The Medical Tourism Hub

It all started on February 2, 2002, when Bumrungrad International became the first hospital in Asia to achieve a JCI accreditation. Though the list of such hospitals has swelled now (see the list below), a decade ago it gave enormous credibility to not just the hospital but to the whole kingdom nation of Thailand. So, it’s no surprise that since then the medical tourism to Thailand has been steadily increasing, almost at an incredible rate with as many as 2.53 million medical tourists visiting Thailand in the year 2012 ( as per The Ministry of Health which works with Kasicom Research Centre). This has made Thailand the world’s most visited medical tourism destination.

In comparison to a competing nation like India, where the prices are about 20% lower than Thailand, tourist numbers are higher here for the fact that Thailand is considered to be a better tourist experience overall. While India has more specialized medical centres, Thailand offers mega-centres (Bumrungrad Hospital or Bangkok Hospital for instance) with full in-house services. Popular treatments range from organ transplants, orthopaedic treatments, cardiac surgeries, to cosmetic surgeries and dental treatments.

Being the capital and the largest city in Thailand, Bangkok is the country’s premier destination for medical tourism by default. Boosted with a newly developed international hospital, and an immensely popular tourism region; the southern town ofPhuket comes in second place. Other places with a high concentration of foreign tourists are now rising as options, such as Pattaya, HuaHin, Chiang Mai, and the island KohSamui.

The following is a non-exhaustive list of JCI accredited hospitals in Thailand –

  • Bumrungrad International
  • Bangkok Hospital
  • Samitivej Srinakarin Hospital
  • Samitivej Sukhumvit Hospital
  • BNH Hospital
  • Chiangmai Ram Hospital
  • Vejthani Hospital
  • Praram 9 Hospital
  • Ramkhamhaeng Hospital
  • Synphaet Hospital
  • Yanhee Hospital
  • Central General Hospital
  • Chaophya Hospital
  • Phuket International Hospital
  • Pitsanuvej Hospital
  • Sikarin Hospital
  • Bangkok Hospital,HuaHin
  • Bangkok Hospital,Samui

For medical tourists, Thai hospitals are extremely customer friendly. Many Thai physicians hold professional certifications from the US or UK, and the hospitals offer interpreters in many of the most common languages spoken by their patients.

Thailand also offers a wide range of accommodation options in all service levels, a wide variety of good and affordable restaurants and the soothing presence of pristine beaches. For medical tourists searching for a number of smaller procedures, Thailand is a safe alternative. However, those who are searching for specific major surgeries may carefully weigh the benefits between Thailand and other competitors like India and Singapore.