- This year’s theme is “Angdaan – Jeevan Sanjeevani Abhiyaan”
- Today, with the right patient selection, it is widely recognised as the gold standard in eligible cases, offering survival outcomes far superior to conventional options.
- Awareness, early cancer detection, and a stronger organ donation healthcare system are essential if we are to bridge this gap
DR SANKET MEHTA
As we observe Indian Organ Donation Day 2025 under the theme ‘Angdaan – Jeevan Sanjeevani Abhiyaan,’ it is important to understand the sobering reality of India’s liver transplant crisis. For those with Hepatocellular Carcinoma (HCC) in the setting of cirrhosis, liver transplantation is no longer an experimental treatment—it’s now a mainstream treatment option.
From my perspective as a GI and Hepatobiliary cancer surgeon, I’ve witnessed a dramatic shift in how transplantation is integrated into cancer care. A decade or so ago, the option was considered for only a handful of patients, often in advanced centres abroad. Today, with the right patient selection, it is widely recognised as the gold standard in eligible cases, offering survival outcomes far superior to conventional options.
Yet, despite this progress, access remains limited—largely due to late diagnosis, referral delays, and the shortage of donor organs. That’s why awareness, early cancer detection, and a stronger organ donation healthcare system are essential if we are to bridge this gap.
Eligibility and early detection
Eligibility for liver transplantation is determined by a combination of factors—tumour stage, underlying liver function, the patient’s overall health, and whether the cancer meets internationally accepted criteria such as the Milan criteria. The tragedy we face is that many patients in India arrive far too late in the disease course. By the time they reach a specialist, the cancer may have spread beyond the liver or exceeded transplantable limits.
This is why public education and early detection are so vital. High-risk groups—such as those with chronic hepatitis B or C, or long-standing alcohol-related liver disease—should undergo regular liver surveillance so that cancers are caught early, when transplant or curative surgery is still possible.
Survival and quality of life
Liver transplantation has moved from being an experimental option to becoming the gold standard for select patients with HCC in the setting of cirrhosis. In India, the five-year survival rate for HCC patients treated with conventional therapies remains below 15% in advanced disease. By comparison, a timely liver transplant in an eligible patient can achieve around 60% five-year disease-free survival.
What stands out is not just the improved survival but the quality of life after transplant. Patients who have undergone successful transplantation are able to return to normal life. In contrast, those on long-term palliative or targeted treatments often deal with ongoing side effects and the uncertainty of indefinite therapy.
Access and infrastructure gaps
Access is one of our biggest challenges. Currently, over 95% of liver transplants in India are performed in private sector hospitals, with only a small fraction in public sector facilities. This disparity unfortunately limits access for economically disadvantaged patients who most need these services.
We urgently need more transplant centres in tier-2 and tier-3 cities, public-private partnerships to bridge infrastructure and expertise gaps, and strengthening of healthcare facilities in the public sector so that cost is no longer a barrier.
Systemic reforms
India faces one of the world’s most severe organ shortages. For cancer patients, this shortage often means losing the narrow window when a transplant is still possible. Public awareness is extremely vital, but it’s only one piece of a difficult puzzle. We also need streamlined organ allocation systems, interstate sharing protocols, mandatory brain-death certification in all hospitals, and expanded financial support for underprivileged patients.
A call to action
One donor can save up to eight lives through organ donation, and transform the quality of life for many more through tissue donation. For cancer patients—especially those with liver cancer—the impact can be even more profound as their eligibility for transplantation is often restricted to a small window; once the cancer spreads, the chance for a curative transplant is lost forever.
That is why timely organ availability can be the difference between life and death, between a cure and palliative care. Signing that pledge could mean you are the reason a family’s darkest moment turns into one of hope, healing, and gratitude. As I often tell people: “There is no greater legacy than giving life itself.”
The author of this article, Dr Sanket Mehta, is an expert Surgical Oncologist who specializes in Gastrointestinal (GI), Gynecologic oncology, Cytoreductive surgery, and advanced cancer treatments like HIPEC (Hyperthermic Intraperitoneal Chemotherapy) and PIPAC (Pressurized Intraperitoneal Aerosol Chemotherapy) and complex hepatobiliary cancer surgery.
Dr Mehta is president of the Society of Peritoneal Surface Oncology
He is the visionary founder of SSO Cancer Hospitals and Clinics, a state-of-the-art facility that provides specialized, organ-specific cancer care at an affordable cost
Dr. Mehta also serves as the Chief of the Division of Peritoneal Surface Oncology at Saifee Hospital
He is also the founder of Cancer Charity Trust
