A Second Life
When 26-year-old Ayush Karki stepped into the operating theatre at Nepal Mediciti Hospital, he wasn’t just going under the knife, he was stepping into one of the most defining moments of his life.
A Son's Gift of Hope through Liver Transplant
This is the story of courage, family, and a growing hope that more lives in Nepal can be saved through organ donation, without having to cross borders in search of treatment.
Seven Years of Silent Struggle
Originally from Pokhara, the Karki family has spent the past several years living in Kathmandu for easier access to treatment. It’s been seven years since Ishwor, a 56-year-old businessman, was diagnosed with liver cirrhosis at Nepal Mediciti Hospital.
At first, the symptoms were subtle: restlessness, fatigue, digestive troubles, but they were brushed aside as minor issues. Even as the illness advanced, Ishwor kept the truth to himself, managing his work with the help of a business partner. By the time his family discovered the full extent of his condition, it had become severe.
A turning point came during a family trip to Chitwan. After eating heavy, protein-rich food, Ishwor fell seriously ill, vomiting on the journey home, becoming disoriented, and unable to recognize everyday things. The toxins his damaged liver could no longer process were affecting his brain. That was when the family rushed him to the hospital, where the diagnosis was confirmed: advanced liver cirrhosis.
For seven years, Ishwor survived on expensive monthly medication and countless check-ups. But as his health worsened, the only solution became clear: a liver transplant.
The Decision to Donate
The idea of a family member donating part of their liver was not the first solution the family considered. Buying an organ seemed like the more common route. But Dr. Ram Babu Sah, one of Nepal’s most experienced transplant surgeons, encouraged them to consider living donation.
Ayush, who had been caring for his father through checkups and even the India trip, stepped forward. His mother couldn’t donate due to a fatty liver, and his twin brother had health issues that ruled him out.
“I researched everything,” says Ayush. “I spoke to international donors, learned the risks, and prepared my body through healthy habits. The fear was there, but it was my father. How could I not?”
The Operation Day
On Jestha 8, both father and son entered surgery. The procedure, expected to take 16–17 hours, was completed in just 12. Ayush donated 700 grams of his liver, which will regenerate over time. The first 48 hours were critical. Within four days, Ishwor’s creatinine levels dropped from 2.7 to 1.3, signaling strong recovery.
“I felt blessed with a second life,” says Ishwor. “If I had found a donor like my son years ago, I would have done this sooner. I couldn’t ask him directly, but his courage gave me hope.”
Life After Surgery
For Ayush, recovery meant two months of bed rest, nutritious food, and avoiding strenuous activities. He has returned to normal life but still avoids extreme physical strain. “The scars are nothing,” he says. “What matters is that I gave my father more time.”
For Ishwor, the journey continues. Medication doses are gradually decreasing, muscle strength is returning, and diet restrictions remain strict. But he can walk, talk, and smile again, things that once seemed impossible.
Along their life, their bond has silently strengthened too! Before the transplant, Ayush was planning for his master’s degree, living a life typical of a young man in his 20s. He was close to his father but not as involved in day-to-day care. Now, the roles have shifted.
“I’m updated on every detail of his health,” Ayush says. “It’s not just communication anymore, it’s constant care.”
Organ Donation from Dr.’s Lens
Liver transplant surgeries in Nepal are still rare, not because the country lacks skill, but because awareness and donor availability are low. According to Dr. Sah, “We have the capability, facilities, and international standard safety protocols right here. People don’t need to go abroad.”
The real challenge is convincing families that living donation is safe. With proper screening, legal documentation, and medical supervision, donors can return to full health. Yet, many patients deteriorate while waiting for a donor, as was nearly the case for Ishwor.
This case of Ishwor Karki and Mediciti’s transplant program is a sign of progress, proving that with the right expertise, Nepal can save more lives at home country.
Ayush’s Message to Nepal
“Donating under proper authority is safe. My liver will grow back, but my father’s life wouldn’t. If you’re clear about the risks and have the right guidance, donation is not as scary as it sounds. One organ can save another person’s life and restore a family’s happiness.”
Conclusion
Today, two months after the operation, father and son still visit Mediciti for follow-ups. The hospital and the staffs there have been one of their own. The Karki family’s journey shows that organ donation is not an act of loss, but of love. It’s proof that sometimes, the greatest gift you can give isn’t bought, but given from one beating heart to another.
Liver Donation: What You Should Know
• A healthy person can donate up to 60–70% of their liver, which naturally regenerates within months.
• Living donor liver transplants follow strict medical screening and legal documentation to ensure the donor’s health is never compromised.
• Most donors return to a normal life within a few months—working, traveling, and enjoying daily activities.
• Nepal now has the capacity to perform liver transplants that meet international standards, making treatment, follow-ups, and recovery easier for patients and families.
Tips for a Healthy Liver
• Limit alcohol intake
• Maintain a balanced diet
• Stay hydrated
• Include atleast moderate exercises
• Avoid unnecessary medications
• Regular check-ups
Doctor’s profile
Dr. Ram Babu Sah, Consultant Hepato-Pancreato-Biliary (HPB) and Liver Transplant Surgeon at Nepal Mediciti, is a leading expert in liver transplantation and complex hepatobiliary and pancreatic surgeries. Trained in Nepal, India, South Korea, and China (PhD in HPB Surgery, Master’s in General Surgery), he has advanced liver surgery in Nepal through both adult and pediatric transplants, as well as open and laparoscopic procedures for a wide range of liver, gallbladder, and pancreatic conditions. His expertise spans from liver cirrhosis to pediatric disorders like Wilson’s disease and biliary atresia. A member of the Nepal Medical Association and the Surgical Society of Nepal, Dr. Sah is dedicated to delivering the highest standards of surgical care.
