Understanding the Difference: Liver Transplantation & Liver Resection By Dr. Vivek Mangla – Senior Director, GI & HPB Surgical Oncology

03 Sep, 2025

“Doctor, what is the difference between Liver Transplant and Liver Resection? Which one should I choose for the best outcome in liver cancer treatment?”

As a liver cancer surgeon, I often meet patients with this confusion. Both Liver Resection and Liver Transplantation are important surgical options in liver cancer, but the choice depends on the patient’s condition, liver health, and stage of the disease.

What is Liver Resection?

Liver resection, also known as Hepatectomy, is a surgical procedure in which the cancer-affected part of the liver is removed.

Suitable candidates for Liver Resection:

• Tumour confined to one side of the liver.
• Healthy remaining liver, enough to regenerate.
• Patients with primary liver cancer or cancer spread from colorectal cancer or certain other types of cancer.
• Patients with good liver function (no advanced cirrhosis, no severe portal hypertension).

Benefits of Liver Resection:

• Quick recovery with fewer complications
• In many cases, it can completely cure liver cancer
• Since patients keep their own liver, there is no need for lifelong immunosuppressive medicines

Figures & Outcomes:

• Risk of death: <1% in carefully selected patients.
• >90% of patients recover and are discharged within 7–10 days
• Only ~10% require longer hospital stay due to minor issues like fluid accumulation or jaundice
• Liver regenerates back to near normal size within weeks after surgery.

What is Liver Transplantation?

A liver transplantation involves replacing the entire diseased liver with a healthy donor liver. Unlike resection, transplant not only removes cancer but also cures cirrhosis and advanced liver disease at the same time.

Suitable candidates for Liver Transplant:

• Patients with advanced stage liver cancer (but still cancer confined to liver)
• Patients with cirrhosis, portal hypertension, poor liver function, or multiple tumours
• Patients not suitable for resection due to poor liver reserve

Benefits of Liver Transplant:

• Removes both cancer and the diseased liver background, lowering recurrence risk.
• Offers a chance of long-term survival even in advanced cases

Figures & Outcomes:

• Cure rates are excellent in selected patients, especially with advanced cirrhosis
• Requires lifelong immunosuppressive medicines to prevent organ rejection.
• Suitable for patients with end-stage liver disease or those not fit for resection.

How to Know Which Option is Right for You?

The decision between liver resection and liver transplant is made by an experienced liver cancer surgeon based on:

• Stage and spread of cancer
• Liver function and presence of cirrhosis
• Patient’s overall health and comorbidities
• Donor availability (for transplant)
• Chances of achieving the best long-term outcome

“In well-selected patients, liver resection can be truly curative – the cancer is removed, and the liver regenerates. But when the liver itself is too damaged, a liver transplant becomes the only lifeline. Both are life-saving, but they serve entirely different patient groups. The art lies in selecting the right treatment for the right patient.”

Liver surgery was once considered extremely difficult, but today it is routinely performed in advanced liver centers with excellent results. What matters most is:

• Accurate patient selection
• Skilled liver surgeons with extensive experience
• Advanced ICU and operation theaters with specialized instruments

If you or your loved one is facing liver cancer (HCC), do not delay. Early consultation can make a life-saving difference.

For consultation with Dr. Vivek Mangla, Senior Director – GI & HPB Surgical Oncology, visit Max Superspeciality Hospitals, Patparganj & Vaishali, Delhi NCR.

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