Pair A
A willing donor is suitable medically but may not be an appropriate direct donor for the intended recipient.
What Is ABO-Incompatible & Swap Liver Transplant?
ABO-Incompatible Transplant
In selected living-donor cases, transplantation may be considered despite an ABO blood-group mismatch. This requires specialised assessment and an appropriate centre-specific protocol.
Swap / Paired Donation
A swap arrangement may be considered when a willing donor is not suitable for their intended recipient but may be suitable for another recipient, subject to applicable requirements.
Direct Living Donation
When a donor is medically suitable and appropriately matched, direct living-donor transplantation remains another possible pathway. Donor safety is fundamental.
Can an ABO-Incompatible liver transplant be performed?
In selected living-donor cases, it may be considered by centres using specialised protocols. Suitability depends on the recipient, donor, compatibility and the proposed transplant pathway.
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Clinical pathway
How Does The Evaluation Work?
1
Recipient Assessment
The team assesses liver disease, transplant indication and overall fitness for transplantation.
2
Donor Assessment
A potential living donor undergoes detailed medical, laboratory and imaging evaluation. Donor safety is paramount because donation provides no medical benefit to the donor.
3
Compatibility & Graft Assessment
The team considers blood group, anatomy, graft size, donor liver health and recipient requirements together.
4
Approved Transplant Pathway
If a specialised pathway is appropriate, the team explains risks, alternatives and applicable approvals before proceeding.
What is evaluated before an ABO-Incompatible or swap liver transplant?
The evaluation considers the recipient’s transplant indication and fitness, donor safety, blood-group compatibility, liver anatomy and graft size, along with the requirements of the proposed transplant pathway.
Book ConsultationABO-Incompatible Liver Transplant
Immunological Assessment
The team evaluates the blood-group mismatch and recipient factors before deciding whether an ABO-incompatible pathway is appropriate.
Specialised Preparation
Selected centres use protocols intended to reduce immunological risk. The exact protocol should be explained by the treating transplant team.
Close Follow-Up
Patients require close monitoring after transplantation for graft function, rejection, infection and other complications.
Selected-Case Pathway
Present ABO-Incompatible transplantation as a specialised option for selected cases after individual assessment.
Risk-Benefit Discussion
The transplant team should explain risks, alternatives and the rationale for the proposed pathway before proceeding.
Clinical Oversight
Medical and transplant-system requirements should be confirmed for each case; do not publish fixed thresholds or protocol details without separate approval.
Is ABO-Incompatible liver transplantation a routine alternative to compatible donation?
No. It should be presented as a specialised option for selected living-donor cases after individual medical, compatibility and transplant-system assessment.
Book ConsultationSwap Transplant: Understanding The Concept
Pair B
Another donor-recipient pair may have a complementary compatibility situation.
Exchange
If permitted and approved, donors may be paired with alternate recipients through an approved pathway.
Specialist Assessment
The exact exchange pathway depends on medical suitability, donor safety and applicable requirements.
What is a swap liver transplant?
A swap or paired-donation arrangement involves donor-recipient pairs whose donors may be matched with alternate recipients, subject to applicable medical, legal and transplant-system requirements.
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Multidisciplinary care
Donor & Recipient Assessment
Recipient Suitability
Assessment focuses on the liver disease, indication for transplant and overall fitness for transplantation.
Living-Donor Safety
The donor undergoes detailed medical, laboratory and imaging evaluation. Donor safety remains fundamental.
Compatibility & Anatomy
Blood group, liver anatomy, graft size, donor liver health and recipient requirements are considered together.
Donor Liver Health
The potential donor’s liver health is reviewed as part of donor suitability and safety.
Graft Size
Graft size and anatomy are assessed in relation to recipient needs and the proposed pathway.
Pathway Approval
Any specialised pathway proceeds only after the relevant clinical assessment, explanation of risks and alternatives, and applicable approvals.
Does blood-group incompatibility automatically prevent living donation?
No. It may affect the available pathway, but the specific donor-recipient combination must be assessed by the transplant team.
Book ConsultationPatient Journey
Initial Consultation
Discuss the recipient’s liver disease, transplant indication and potential donor situation.
Recipient Evaluation
Assess disease severity and overall fitness for transplantation.
Donor Evaluation
Assess the potential donor’s health, anatomy and suitability, with donor safety as a central requirement.
Compatibility Review
Review blood group, graft size, anatomy and the available transplant pathway.
Specialist Pathway Planning
If appropriate, the team explains the proposed ABO-incompatible or swap pathway, risks, alternatives and approvals.
Transplant & Follow-Up
After transplantation, patients require close monitoring for graft function, rejection, infection and other complications.
What happens after an ABO-incompatible liver transplant?
Patients require close follow-up for graft function, rejection, infection and other complications. The treating transplant team determines the individual monitoring plan.
Book ConsultationRisks, Monitoring & Follow-up
1
Graft Function
Close post-transplant monitoring includes assessment of graft function.
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2
Rejection
Patients require monitoring for rejection and other transplant-related complications.
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3
Infection
Post-transplant care includes monitoring for infection.
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4
Individualised Follow-Up
The exact monitoring and management plan is determined by the treating transplant team.
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What is important after an ABO-incompatible transplant?
Close specialist follow-up is required, with monitoring of graft function, rejection, infection and other transplant-related complications.
Book ConsultationWhen May This Pathway Be Considered?
ABO Mismatch
A potential living donor may not be directly compatible with the intended recipient by blood group.
Direct Donor-Recipient Mismatch
A willing donor may be medically suitable but not an appropriate direct donor for the intended recipient.
Complementary Pair
Another donor-recipient pair may have a compatible exchange opportunity.
Specialist Evaluation
The pathway is considered only after individual medical, compatibility and transplant-system assessment.
Who may need an ABO-incompatible or swap transplant evaluation?
It may be considered for selected donor-recipient pairs where direct living donation is affected by blood-group incompatibility or donor-recipient matching. Suitability requires specialist transplant evaluation.
Book ConsultationSpecialised Liver Transplant Care At Ruby Hall Clinic
Recipient Evaluation
Assessment of transplant indication and recipient fitness.
Living-Donor Evaluation
Detailed donor assessment with donor safety as a fundamental requirement.
Compatibility Assessment
Blood-group, anatomy and graft-size considerations are reviewed.
Our Doctors
Meet Our Liver Transplant Surgeons & Hepatology Team
Dr. Manoj Shrivastav
MBBS · DNB (General Surgery) · Fellowship in Liver Transplantation, Global Hospital, Chennai
Dr. Manoj Shrivastav is a liver transplant surgeon at Ruby Hall Clinic, Pune, and currently leads the multi-organ transplant programme. He has personally completed over 200 liver transplants in Pune, 100 of them in the past year alone, with a survival rate above 95% and a one-year survival rate of 92% across his transplant series.
800+
Liver transplants
in Pune
in Pune
95%+
Survival
rate
rate
92%
One-year
survival rate
survival rate
He is equipped to handle acute surgical emergencies and trauma across a variety of scenarios, has performed major liver resections for hepatocellular carcinoma and cholangiocarcinoma, and believes a successful transplant depends on excellent teamwork across the entire clinical team — not one surgeon alone.
Meet the Team
FAQs
Frequently Asked Questions
Can an ABO-Incompatible liver transplant be performed?
In selected living-donor cases, it may be considered by centres using specialised protocols. Suitability is individual.
What is a swap liver transplant?
A swap or paired-donation arrangement involves donor-recipient pairs whose donors may be matched with alternate recipients, subject to applicable requirements.
Does blood-group incompatibility automatically prevent living donation?
No. It may affect the available pathway, but the specific donor-recipient combination must be assessed.
When may ABO-incompatible transplantation be considered?
It may be considered in selected living-donor cases after specialist assessment of the recipient, donor, compatibility and proposed pathway.
What does donor evaluation involve?
The pathway includes detailed medical, laboratory and imaging evaluation, together with assessment of donor suitability and safety.
Why is donor safety emphasised?
Living donation provides no medical benefit to the donor, so donor safety is a fundamental requirement of the evaluation.
What is paired or swap donation?
It is a pathway in which donor-recipient pairs that are not suitable for direct transplantation may be considered as part of a compatible exchange, subject to applicable requirements.
Is ABO-incompatible transplantation suitable for everyone?
No. It is a specialised option for selected cases and requires individual assessment.
What is assessed before a swap transplant?
The transplant team considers recipient suitability, donor safety, blood group, anatomy, graft size and applicable transplant-system requirements.
What happens after transplantation?
Patients require close monitoring for graft function, rejection, infection and other complications.
Talk to the liver team
Discuss ABO-Incompatible & Swap Liver Transplant Care in Pune
Speak with the transplant team about donor compatibility, evaluation and the appropriate pathway.