Meeting the Rising Demands of Liver Transplant Procedures in India by Overcoming Challenges: Public Health Perspective

Abstract

End-stage liver disease (ESLD) usually presents in the form of cirrhosis and associated complications and has been acknowledged as one of the major public health concerns in India. The objectives of the current article are to ascertain the status of liver transplants in India, identify health system-related challenges which are preventing liver transplants, and propose targeted public health interventions to overcome the identified barriers, thereby improving liver transplantation rates. An extensive search of all materials related to the topic was carried out in the PubMed search engine. Initially, 52 research articles were identified based on the keywords, namely liver disease, liver transplant, and health system, in the title alone. These 52 articles were screened for eligibility, and finally, 25 articles were selected based on their suitability with the current review objectives and analyzed. The available literature suggests that most of the facilities and services for liver transplant are available in metropolitan cities in India, while multiple states, including northeastern states, have limited opportunities. A wide range of health system-related challenges have been identified that have cumulatively impacted the rates of liver transplantation in India. Acknowledging the rise in the number of ESLD cases in India, the rise in the demand for liver transplants, and the presence of multiple health system-related challenges, including accessibility and affordability concerns, there is an urgent need to take specific interventions to minimize the possibility of further widening of the demand–supply gap. To conclude, we have not been able to meet the demands of liver transplant in India due to a combination of factors. The need of the hour is to implement public health measures to not only reduce the demand for liver transplants but also effectively address health system-related challenges to bridge the gap between demand and supply.