Medical Oncologist
CION Cancer Clinics
Deceased donor liver transplant and the waiting list in India | CION Cancer Clinics
A deceased donor transplant uses a whole liver from someone who has died and whose family agreed to donate. In Telangana, livers are shared through the Jeevandan programme by set rules: blood group, how sick the liver is and whether the cancer fits agreed limits. Money and contacts play no part. This page explains how the list works, what happens while you wait, and who is not usually listed. At CION Cancer Clinics, a multidisciplinary tumour board weighs your liver function and your scans before recommending any treatment.
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Medically reviewed by Dr. Muralidhar MuddusettyConsultant Surgical Oncologist · MBBS (AIIMS), MS (Surgery, AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh) · last reviewed October 2026, next review due October 2027
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On this page
- What is a deceased donor liver transplant?
- What decides who gets the next liver on the waiting list?
- How does a liver cancer patient get on the waiting list?
- What happens to the cancer while you wait for a liver?
- Who is usually not listed for a deceased donor liver?
- What this page cannot tell you
- Common questions about the deceased donor waiting list
The short answer
What is a deceased donor liver transplant?
It is a transplant using a whole liver from a person who has died, usually after brain death in an intensive care unit, whose family agreed to donate. In India, patients wait on a state waiting list, and livers are shared by set rules, not by who asks first or who pays more.
Why it matters in India
Most liver transplants in India use part of a liver from a living relative. Deceased donation is growing but still provides fewer livers than are needed. In Telangana, deceased donor organs are shared through the state programme, Jeevandan. The Jeevandan page explains how the programme itself works.
Who this page is for
This is for families of someone with primary liver cancer, usually hepatocellular carcinoma (HCC, cancer that starts in the liver cells), often with cirrhosis (scarring of the liver), who has been told a transplant might be possible. It does not apply to cancer that spread to the liver from another organ. Transplant is generally not used for that.
Being on the list is not a promise of a liver. It is a place in a fair queue that nobody can jump.How livers are shared
What decides who gets the next liver on the waiting list?
The exact rules are set by the state programme and change from time to time. These are the factors that usually count.
How sick the liver is
The MELD score (a number worked out from blood tests for bilirubin, INR and kidney function) estimates how urgently a person needs a liver. Sicker patients are usually placed higher. The MELD score page explains it.
The cancer itself
Liver cancer patients often have a fairly low MELD score because their liver still works. Some programmes add extra priority for cancer that stays within agreed limits. Whether and how this applies is set by the programme.
Blood group and size
The donor liver must suit the patient's blood group and body size. Some blood groups wait longer because fewer compatible livers come up.
What does not count
Never part of allocation
- Money, influence or contacts
- Which doctor or clinic referred you
- Requests from family or friends
Not sure whether this applies to you?
Ask an oncologistIn order
How does a liver cancer patient get on the waiting list?
The cancer team asks the question
Your oncologist or tumour board decides whether the cancer looks suitable for transplant and suggests a referral to a licensed transplant centre.
The transplant assessment
The transplant centre runs scans, blood tests, heart and lung checks, and a social and psychological assessment. Many patients are found unsuitable at this stage.
Registration
If accepted, the transplant centre registers you with the state programme. Families cannot register directly. Documents and fees are handled through the centre.
Waiting, with regular checks
Scans and blood tests are repeated while you wait, to make sure the cancer still fits the rules and you are still fit for surgery.
The call
When a matching liver becomes available, the centre calls. You must be reachable at all hours and able to reach the hospital quickly.
During the wait
What happens to the cancer while you wait for a liver?
The cancer does not pause. Nobody can say in advance how long any one person will wait, and that is why teams usually treat the cancer during the wait. This is called bridging therapy. It aims to stop the tumour growing past the transplant limits.
What bridging can look like
Options include TACE (a procedure that delivers treatment straight into the tumour's blood supply), ablation (destroying the tumour with heat) or radiation. CION coordinates these through accredited partner hospitals, and the tumour board reviews each new scan. The bridging therapy page covers the choices.
Why some people come off the list
If the cancer grows beyond the agreed limits, spreads, or the person becomes too unwell for surgery, the transplant centre may remove them from the list. This is painful news. It is decided to protect the patient from an operation unlikely to help, and to give the liver to someone it can help. Other treatments for the cancer usually remain.
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Did you know
Buying or selling an organ is illegal in India. No person, agent or hospital can sell you a faster place on the deceased donor list, and anyone offering to is breaking the law. Report such an offer to the transplant centre.
Who this does not suit
Who is usually not listed for a deceased donor liver?
A transplant is a large operation followed by lifelong medicines that weaken the immune system. It is generally not offered when the cancer has spread outside the liver, has grown into the main blood vessels, or is well beyond the usual size and number limits. The Milan criteria describe those limits in plain words.
Other reasons
Serious heart or lung disease, an active infection, recent alcohol use that the centre's rules exclude, or a lack of family support for the months of recovery can all stand in the way. These are medical and practical judgments, never a judgement of the person.
The other routes
Some families explore a living donor transplant, where a willing relative gives part of their liver. That carries real risk for the donor and is a free choice for that person alone. Others choose surgery to remove the tumour, ablation, TACE, or medicines such as immunotherapy. CION's tumour board can set out which of these fits.
Being straight with you
What this page cannot tell you
It cannot tell you how long you will wait or whether a liver will come. That depends on your blood group, your scores, how many livers are donated and the rules in force at the time. Only the transplant centre can tell you where you stand.
The rules change
Jeevandan and the national organ sharing rules are revised from time to time, including who can register and how cancer is prioritised. What is written here reflects the position as of 2026. Check the current rules with your transplant centre before making plans.
What CION can and cannot do
CION's surgical oncologists and tumour board can review the scans, advise whether a transplant referral makes sense, and keep treating the cancer during the wait. CION does not perform transplants and cannot influence anyone's place on the waiting list.
If you are unsure whether to ask for a transplant referral, call the helpline. Someone will explain the next step.Questions we are asked
Common questions about the deceased donor waiting list
How long is the waiting list for a liver in Telangana?
Nobody can give a fixed answer. The wait depends on blood group, how unwell you are, how many donations happen, and the rules at the time. Some people are called quickly, some wait a long time, and some never receive a liver. Your transplant centre can tell you where you stand.
Can we pay to move up the list?
No. Places are decided by set rules, not money or influence. Buying or selling organs is illegal in India. Anyone who offers a faster liver for payment is breaking the law, and you should tell the transplant centre.
Can we register directly with Jeevandan?
Usually not. Registration is done by a licensed transplant centre after it has assessed the patient and accepted them. The centre handles the forms and tells you what documents are needed. The rules can change, so check with the centre at the time.
Can we be on the list in more than one state?
The rules on this differ between states and change over time, including rules about residence. Ask the transplant centre what is allowed for you now. This page cannot give legal advice on registration.
Does a liver cancer patient get extra priority?
Some programmes add priority for liver cancer that stays within agreed limits, because the MELD score alone can underrate the risk. Whether this applies in Telangana, and how, is set by the programme. The page on exception points explains the idea.
Is a deceased donor liver worse than a living donor liver?
Not as a rule. A deceased donor liver is usually a whole liver, and each donated liver is checked before it is used. The main difference is timing. A living donor operation can be planned, while a deceased donor liver comes when it comes.
What happens if the cancer grows while we wait?
The team usually treats the cancer during the wait to keep it within limits. If it still grows past them, the centre may take the patient off the list. Other treatments for the cancer normally remain, and the tumour board can set them out.
How can CION help while we wait?
CION's tumour board can review new scans, plan bridging treatment through partner hospitals, manage symptoms and help with scheme paperwork. CION cannot change anyone's place on the list. Call the helpline to arrange a consultation.
Your Specialists
Meet CION's liver cancer specialists. Bring your scan reports and liver blood tests.
Our medical and surgical oncologists plan liver cancer care together, weighing the tumour and how well your liver works before choosing surgery, a liver-directed procedure or medicines.
Medical Oncologist
Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
Medical Oncologist
Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
Medical Oncologist
Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
Medical Oncologist
Medical Oncologist
Surgical Oncologist
Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Surgical Oncologist
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Sources
- MedlinePlus — Liver Transplantation
- American Cancer Society — Surgery for Liver Cancer
- Cancer Research UK — Surgery for liver cancer
- American Cancer Society — Treatment of Liver Cancer, by Stage
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Jeevandan: Telangana's organ donation programmeHow the state programme itself worksHow to register on the transplant waiting listThe paperwork and steps, in orderBridging therapy while waiting for a transplantKeeping the cancer in check during the waitLiving donor liver transplant in IndiaThe other route, and what it asks of a donor
Talk to us
Should we be asking for a transplant referral?
CION's tumour board can review the scans and explain whether a transplant referral makes sense, and keep treating the cancer while you wait. One helpline serves every CION centre.