Medical Oncologist
CION Cancer Clinics
Living donor liver transplant in India, explained | CION Cancer Clinics
In a living donor liver transplant, a healthy adult, usually a close relative, gives part of their liver to replace the patient's diseased liver. Both parts regrow. It is the most common kind of liver transplant in India. This page explains how it works for liver cancer, the real risks to the donor, the legal rules, and who it does not suit. At CION Cancer Clinics, a multidisciplinary tumour board weighs your liver function and your scans before recommending any treatment.
MM
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 living donor liver transplant?
- What must be true before a living donor transplant goes ahead?
- What happens in a living donor transplant, step by step?
- How is a living donor transplant different from a deceased donor one?
- What families often believe about donating part of a liver
- What this page cannot tell you
- Common questions about living donor liver transplant
The short answer
What is a living donor liver transplant?
In a living donor liver transplant, a healthy adult gives part of their liver, and that part replaces the patient's diseased liver. The liver can regrow, so both the donor's remaining liver and the transplanted piece grow back towards a normal working size over the following weeks and months.
Most liver transplants in India use a living donor, usually a close family member. Organs from deceased donors are fewer, and waiting lists, including Telangana's Jeevandan programme, can be long and unpredictable. That is why Western information, built around deceased donor systems, often does not match what Indian families face.
Who this page is for
This page is for families of someone with hepatocellular carcinoma (HCC), the cancer that starts in the liver's own cells, who have heard a living donor transplant mentioned. It explains how it works and what it asks of the donor. It does not ask anyone to donate. Donation is a free personal choice, and saying no is always acceptable.
Buying or selling an organ is illegal in India. Any offer of money for a liver, in either direction, is a crime.What has to line up
What must be true before a living donor transplant goes ahead?
Three separate things are checked. A willing donor does not change the first one.
The cancer must be suitable
The tumour must be within the size and number limits the transplant centre accepts, with no spread into major veins or outside the liver. A donated liver carries the same risk of the cancer coming back as any other. The Milan criteria page explains the best known limits.
The patient must be fit enough
Heart, lungs, kidneys and general strength are tested. The operation is long, and the medicines that stop rejection are taken for life.
The donor must be safe to donate
The donor is assessed by a separate team whose only job is the donor's safety. Blood group, liver size and shape, overall health and the donor's own free consent are all checked.
A donor can be turned down for
- A fatty or unhealthy liver
- A liver too small to share safely
- Heart, kidney or other health problems
- Any sign that consent is not truly free
The law must be satisfied
As of 2026, Indian law permits donation mainly from near relatives, and any other donor needs approval from an authorisation committee. Documents proving the relationship are required. The rules change, so check the current requirements with the transplant centre.
Not sure whether this applies to you?
Ask an oncologistFrom first talk to surgery
What happens in a living donor transplant, step by step?
The patient is assessed first
The transplant centre decides whether a transplant is right for the patient and the cancer. There is no point testing a donor until this is settled. The assessment page lists the tests.
A possible donor comes forward
The donor approaches the team on their own. They are seen alone, away from the patient and family, so they can decline privately if they wish.
The donor is tested in stages
Blood tests come first, then scans to measure the liver and map its blood vessels. Many people stop at an early stage because a test shows donating would not be safe for them.
Papers and committee approval
Identity, relationship and consent documents are checked. Where the law requires it, an authorisation committee interviews the donor and family before approval.
Two operations on the same day
One team removes part of the donor's liver. Another removes the patient's liver and places the donated part. Your team will tell you where the operations take place.
Recovery for both
Both stay in hospital. The donor recovers and returns to normal life over time. The patient begins lifelong medicines and regular follow-up.
Side by side
How is a living donor transplant different from a deceased donor one?
Living donor
Deceased donor
Timing can be planned once both are approved
Depends on when an organ becomes available
A healthy person undergoes major surgery
No healthy person is put at risk
Part of a liver is transplanted
Usually a whole liver is transplanted
Needs a willing, suitable, legally permitted donor
Needs registration on a waiting list such as Jeevandan
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Commonly believed
What families often believe about donating part of a liver
"Donating is completely safe because the liver grows back."
The liver does regrow, but donating is a major operation on a healthy person. Bleeding, infection, bile leaks and blood clots can happen, and in rare cases a donor has died. Every donor should hear these risks plainly before agreeing.
"The eldest son has to donate."
Nobody has to donate. Each person decides freely, and transplant teams will stop the process if they sense pressure. A family member who says no is not failing anyone.
"If a relative donates, the cancer will not come back."
The source of the liver does not change the cancer. Whether cancer returns depends on the tumour before the transplant. This is why centres apply the same cancer limits for living donors.
"An agent can find a donor if the family pays."
Paying for an organ is illegal in India, and anyone offering this is breaking the law. Report such an approach to the transplant centre. Committees check every donation for exactly this.
Being straight with you
What this page cannot tell you
It cannot tell you whether a transplant is right for your relative, or whether any family member could safely donate. Those answers come only from a licensed transplant centre after full testing of both people.
Who this does not apply to
A living donor transplant is not an option when the cancer has spread outside the liver or into a major vein, or when the patient is not fit for surgery. It is not used for cancer that has spread to the liver from the bowel or another organ. The eligibility page explains these reasons. Children with liver tumours follow a separate path.
Where CION fits
CION does not carry out transplants and does not arrange or find donors. CION cannot influence any waiting list or committee decision. CION's tumour board can review the scans, explain whether a transplant is worth discussing, and plan treatment such as TACE or medicines to keep the cancer controlled in the meantime. The cost of a transplant is quoted separately by the transplant centre; ask for a written, itemised estimate.
Questions we are asked
Common questions about living donor liver transplant
Who can be a living liver donor in India?
Usually a healthy adult who is a near relative, such as a parent, child, sibling or spouse, and whose blood group and liver are suitable. Other donors need committee approval. The donor page explains the checks in more detail.
What are the risks to the donor?
Bleeding, infection, bile leaks, blood clots and the general risks of a long operation. Most donors recover well, but serious complications happen, and rarely a donor dies. A separate team looks after the donor's interests and will stop the process if the risk is too high.
Does the donor's liver really grow back?
Yes. The remaining part grows back towards its normal working size over the following weeks and months. The donor still needs follow-up blood tests and checks to confirm recovery is on track.
Do the donor and patient need the same blood group?
Usually the blood groups must be compatible, in the same way as for a blood transfusion. Some centres do transplants across blood groups with extra treatment, but this is not routine. The blood group page explains this.
Can a donor change their mind?
Yes, at any point before surgery. Teams often let a donor withdraw privately and give the family a general medical reason, so the donor does not face blame. Changing your mind is a right, not a betrayal.
Is a living donor transplant covered by Aarogyasri or insurance?
Some schemes and insurance policies cover parts of a transplant, and the details change. Ask the transplant centre and your insurer for current written answers, including whether the donor's costs are covered. This is general information, not financial advice.
Should we register with Jeevandan as well?
Many families ask the transplant centre about this. Being on the deceased donor list and assessing a living donor are separate routes, and the rules change. The centre will advise which applies. CION cannot influence the list.
How can CION help while we decide?
CION's tumour board can review the scans, say whether transplant is worth exploring, and plan treatment to keep the cancer controlled while you decide. Call the helpline and someone will guide you to the right clinic.
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
- NIDDK — Liver Transplant - NIDDK
- MedlinePlus — Liver Transplantation
- NHS Blood and Transplant — Liver - Organ transplantation - NHS Blood and Transplant
- Cancer Research UK — Surgery for liver cancer
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
Who can be a living liver donor?The checks a possible donor goes throughWhat happens to the donor: risks and recoveryThe donor's side, stated plainlyDeceased donor transplant and the waiting listThe other route, and how the list worksWho is not eligible for a liver transplantWhen a transplant is ruled out, whoever the donor
Talk to us
Wondering whether a transplant is worth discussing for your relative?
Our tumour board can review the scans, explain whether a transplant fits, and plan treatment to keep the cancer controlled meanwhile. One helpline serves every CION centre.