Of the 491 patients who underwent liver transplant at Amrita Institute of Medical Sciences (AIMS) between 2007 and 2016, 30% had absolutely no history of alcohol consumption. They were either obese or had lifestyle dis eases like diabetes or hypertension.Another 30% were chronic alcoholics; 20% had acute liver failure due to hepatitisdrug side effects. In some cases, people had consumed rat poison to commit suicide and 20% were children who developed complications due to genetic factors.
“Over the past few years, we have seen a significant increase in non-alcoholic fatty liver disease (NAFLD). Developing countries in South Asia, like India, have one of the highest incidence of fatty liver disease and related cirrhosis. This is mainly due to the lack of exercise, eating more saturated fat and total fat over 30% of daily diet, con suming more refined sugars and having less fibre diet, coexisting metabolic syndrome as a result of type-II diabetes or raised cholesterol and lipids, abdominal obesity,” said Dr Solomon Kuruvilla P John, multi organ transplant surgeon, PVS Memorial hospital. Of the 250-odd liver transplants he has done, almost 30-40% were suffering from non-alcoholic cirrhosis.
Doctors said that NAFLD is turning out to be a problem here that needs to be addressed. The problem is that by the time the patients are referred for a transplant, they would have often developed multiple complications. It will be too late by then. “In the West, non-alcoholic liver diseases has overtaken alcoholic liver disease now. In Kerala, it is now almost at par,” said Dr S Sudhindran, chief transplant surgeon, AIMS. “The problem is that there is no effective medicine to treat non-alcoholic cirrhosis and so exercise and lifestyle changes are important to prevent disease progression,” said liver transplant expert at KIMS, Thiruvananthapuram, Dr B Venugopal.
Of the 491 patients who underwent liver transplant, 153 died, with a majority dying within the first three months due to infection or chronic rejection.Some died of heart attack, others de veloped cancer after transplant. “However, 60-70% of the patients, who would have otherwise died within a year, lead a normal life,” added Dr Sudhindran.
Gastroenterologist Dr Philip Augustine said the overweight population is increasing in Kerala. “Almost 80% people above the age of 30 will have fatty liver problem. But only those will fatty liver disease needs to be treated if there are changes in the liver function,” he said.
“This is the price people pay when they compromise on health, take diet shortcuts and avoid exercise,” said Dr Mathew Jacob, abdominal multi-organ transplant surgeon, Aster Medcity, Kochi.