China's Premier Center for Liver Transplantation
The Department of Liver Surgery and Transplantation at Renji Hospital — affiliated with Shanghai Jiao Tong University School of Medicine — is one of China's most distinguished and highest-volume liver transplantation centers, with a national reputation for excellence in deceased donor liver transplantation, living donor liver transplantation (LDLT), pediatric liver transplantation, re-transplantation, and the surgical management of complex hepatobiliary conditions. Renji Hospital's liver transplantation program is consistently ranked among the top programs in China by annual transplant volume and outcomes, offering international patients access to some of China's most eminent transplant hepatologists and liver surgeons.
For international patients with end-stage liver disease, hepatocellular carcinoma within transplant criteria, acute liver failure, or a metabolic liver disease requiring liver transplantation — Renji Hospital's liver transplantation program offers an unparalleled combination of surgical expertise, organ allocation experience, and post-transplant management. China Medical Concierge Shanghai (CMCS) provides seamless end-to-end coordination for international patients throughout their liver transplantation journey at Renji Hospital.
About the Department
Renji Hospital's liver surgery and transplantation department is a national key clinical specialty performing hundreds of liver transplants annually, making it one of the highest-volume liver transplant centers in China. The department operates dedicated liver transplant wards, a liver transplant intensive care unit (LTICU), a living donor evaluation program, a post-transplant outpatient clinic, a hepatology service for pre- and post-transplant medical management, and works in close collaboration with hepatology, interventional radiology, anesthesia, and critical care through a fully integrated multidisciplinary team.
Faculty members publish regularly in leading transplantation and hepatology journals including American Journal of Transplantation, Liver Transplantation, Journal of Hepatology, Hepatology, and Transplantation.
Liver Transplantation Programs
Deceased Donor Liver Transplantation (DDLT)
Renji Hospital performs deceased donor liver transplantation using organs from China's national organ donation and allocation system (COTRS). The program offers:
- Standard Whole Liver Transplantation — Full-size deceased donor liver transplantation for adult recipients; piggyback technique for caval preservation
- Split Liver Transplantation — Ex vivo and in situ splitting of a single deceased donor liver for two recipients (typically one adult and one pediatric recipient); maximizing organ utilization
- Marginal Donor Organs — Extended criteria donors (ECD); machine perfusion (normothermic and hypothermic) for organ assessment and reconditioning; DCD (donation after circulatory death) livers
- Normothermic Machine Perfusion (NMP) — Ex vivo liver perfusion for assessment and reconditioning of marginal donor livers; viability testing before transplantation
Living Donor Liver Transplantation (LDLT)
Renji Hospital's LDLT program is one of the most experienced in China, offering living donor transplantation for patients who cannot wait for a deceased donor organ or for whom LDLT offers superior outcomes:
- Right Lobe LDLT — Right hepatectomy (segments V-VIII) from living donor; most common adult-to-adult LDLT; graft-to-recipient weight ratio (GRWR) optimization
- Left Lobe LDLT — Left hepatectomy (segments II-IV) for smaller recipients or when donor safety requires smaller resection
- Left Lateral Segment LDLT — For pediatric recipients; segments II-III graft from parent or related donor
- Dual Graft LDLT — Two left lobe grafts from two donors for large adult recipients when a single left lobe is insufficient
- Donor Evaluation & Safety — Comprehensive living donor evaluation including CT volumetry, liver biopsy, cardiopulmonary assessment, and psychological evaluation; donor safety is the paramount priority
- Donor Follow-Up — Systematic long-term follow-up of living donors; liver regeneration monitoring
Pediatric Liver Transplantation
Renji Hospital's pediatric liver transplantation program is one of the most experienced in China for children with end-stage liver disease:
- Biliary Atresia — The most common indication for pediatric liver transplantation; living donor left lateral segment transplantation from parent
- Metabolic Liver Diseases — Wilson's disease; tyrosinemia type I; maple syrup urine disease; urea cycle disorders; organic acidemias; primary hyperoxaluria type 1
- Acute Liver Failure in Children — Emergency listing and expedited transplantation for pediatric ALF
- Alagille Syndrome — Living donor transplantation for end-stage cholestatic liver disease
- Progressive Familial Intrahepatic Cholestasis (PFIC) — Liver transplantation for PFIC not responding to biliary diversion or IBAT inhibitors
Re-Transplantation
- Primary Non-Function (PNF) — Emergency re-transplantation for immediate graft failure
- Hepatic Artery Thrombosis (HAT) — Re-transplantation for ischemic cholangiopathy after HAT
- Chronic Rejection — Re-transplantation for ductopenic rejection refractory to immunosuppression
- Recurrent Disease — Re-transplantation for recurrent HCV (pre-DAA era), recurrent HBV, and recurrent PSC
Indications for Liver Transplantation
Chronic Liver Disease & Cirrhosis
- Hepatitis B Cirrhosis — HBV-related end-stage liver disease; post-transplant HBV prophylaxis with HBIG + tenofovir/entecavir; excellent long-term outcomes
- Hepatitis C Cirrhosis — DAA therapy pre- and post-transplant; SVR rates >95%; recurrence prevention
- Alcoholic Liver Disease (ALD) — Alcohol-associated cirrhosis; 6-month sobriety requirement; early liver transplantation for severe alcoholic hepatitis in selected patients
- NASH/MASLD Cirrhosis — Metabolic dysfunction-associated steatotic liver disease; weight management post-transplant; cardiovascular risk management
- Autoimmune Hepatitis (AIH) — AIH cirrhosis refractory to immunosuppression; post-transplant recurrence monitoring
- Primary Biliary Cholangitis (PBC) — End-stage PBC; post-transplant UDCA and obeticholic acid; recurrence monitoring
- Primary Sclerosing Cholangitis (PSC) — End-stage PSC; cholangiocarcinoma surveillance; IBD management post-transplant
- Wilson's Disease — Acute liver failure and decompensated cirrhosis; curative transplantation
Hepatocellular Carcinoma (HCC)
- Milan Criteria HCC — Single tumor ≤5cm or up to 3 tumors each ≤3cm; excellent post-transplant outcomes; locoregional therapy as bridge to transplantation
- Extended Criteria HCC — UCSF criteria; Up-to-7 criteria; AFP-based selection; downstaging with TACE/HAIC/systemic therapy to within Milan criteria
- HCC Downstaging — TACE, HAIC, SBRT, and systemic therapy (atezolizumab + bevacizumab) for tumor downstaging to transplant criteria; response-guided listing
- Fibrolamellar HCC — Transplantation for unresectable fibrolamellar HCC
- Combined HCC-Cholangiocarcinoma — Case-by-case evaluation
Acute Liver Failure (ALF)
- Drug-Induced ALF — Paracetamol and non-paracetamol DILI; N-acetylcysteine; emergency listing; King's College criteria for transplant listing
- Viral ALF — Hepatitis B, hepatitis E, and HSV ALF; antiviral therapy; emergency transplantation
- Autoimmune ALF — Acute presentation of AIH; corticosteroids; emergency transplantation for non-responders
- Indeterminate ALF — Systematic evaluation; emergency listing for rapidly deteriorating patients
Metabolic & Other Indications
- Primary Hyperoxaluria Type 1 — Combined liver-kidney transplantation; lumasiran as bridge to transplantation
- Familial Amyloid Polyneuropathy (FAP) — Liver transplantation for TTR-FAP; patisiran and inotersen as alternatives
- Urea Cycle Disorders — Liver transplantation for OTC deficiency and other UCDs
- Polycystic Liver Disease — Liver transplantation for massive polycystic liver disease causing symptoms
- Budd-Chiari Syndrome — Liver transplantation for acute and chronic Budd-Chiari refractory to TIPS
Post-Transplant Management
Immunosuppression
- Calcineurin Inhibitors — Tacrolimus (preferred) and cyclosporine; trough level monitoring; minimization protocols to reduce nephrotoxicity
- mTOR Inhibitors — Everolimus and sirolimus; conversion from CNI for renal protection; anti-tumor properties for HCC recipients
- Mycophenolate Mofetil — Adjunct immunosuppression; CNI-sparing protocols
- Corticosteroid Minimization — Early steroid withdrawal protocols; steroid-free maintenance for selected patients
- Rejection Treatment — Pulse methylprednisolone for acute cellular rejection; plasmapheresis and rituximab for antibody-mediated rejection
Disease Recurrence Prevention
- HBV Recurrence Prevention — HBIG + tenofovir/entecavir prophylaxis; HBsAg monitoring; HBV DNA surveillance
- HCV Recurrence Treatment — DAA therapy (sofosbuvir/velpatasvir, glecaprevir/pibrentasvir) for post-transplant HCV recurrence; SVR rates >95%
- HCC Recurrence Surveillance — CT/MRI every 3-6 months; AFP monitoring; mTOR inhibitors for HCC recipients
Why International Patients Choose Renji Liver Transplantation
- High-Volume Program — One of China's highest-volume liver transplant centers with outcomes benchmarked against international standards
- Living Donor Expertise — Extensive LDLT experience including right lobe, dual graft, and pediatric living donor transplantation
- HCC Transplantation — Extended criteria and downstaging protocols for HCC patients beyond Milan criteria
- Machine Perfusion — Normothermic machine perfusion for marginal donor organ assessment and reconditioning
- Pediatric Transplantation — Expert pediatric liver transplantation for biliary atresia and metabolic liver diseases
- Cost-Effectiveness — World-class liver transplantation at significantly lower cost than equivalent treatment in Western countries
The CMCS Patient Journey
- Initial Inquiry — Share your liver disease history, liver function tests, imaging (CT/MRI), liver biopsy, MELD score, and prior treatment history with CMCS.
- Medical Record Preparation — We translate and organize your records for specialist pre-consultation review.
- Transplant Evaluation Coordination — We coordinate your pre-transplant evaluation including hepatology consultation, surgical assessment, cardiac evaluation, and psychosocial assessment.
- Living Donor Coordination — If you have a potential living donor, we coordinate their evaluation in parallel with your recipient workup.
- Priority Scheduling — We secure a transplant hepatology and surgical consultation with minimal waiting time.
- Travel & Logistics — Assistance with visa invitation letters, long-term accommodation near Renji Hospital, and Shanghai airport transfers.
- Transplant Admission Support — Full coordination of pre-operative assessment, transplant admission, LTICU care, and post-operative recovery.
- Post-Transplant Follow-Up — Immunosuppression management guidance, laboratory result translation, and remote follow-up coordination after you return home.
Book a Consultation
If you or a family member requires liver transplantation — whether for end-stage liver disease, hepatocellular carcinoma, acute liver failure, or a metabolic liver condition — CMCS can arrange a specialist consultation with Renji Hospital's liver transplantation team in Shanghai.
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