Children are a rewarding group to treat. Diseases causing end organ failure in childhood are often genetic or environmental, and transplant can be curative. Most parents voluntarily come forward as organ donors should children require transplant. The skills and facilities for performing complex surgery exist in the private and the public sector. Economic factors are often the only reason why transplants are not performed for children.

Hospitals are often reluctant to undertake these surgeries because of lack of insurance coverage for unexpected cost escalations (due to surgical or medical complications), and a lack of guaranteed long term support for medicines and laboratory tests which these children need.

Utilizing funding combining crowd funding supported by Corporate Social responsibility for healthcare has the potential to be a game changer in health care delivery as well as outreach. Selected private/ corporate partners can provide knowledge and skills transfer as well as a potential source of funding for such unforeseen catastrophic expense.

We have created a funding mechanism for affordable liver transplant for children over the past three years using a combination of CSR funding and crowd funding. This involved key stakeholders to ensure pricing control and equitable distribution of funding burden to avoid burdening the family with unsustainable expenses (Figure-1). The internet has lowered search and communication costs allowing funders to easily gather information, monitor their investment, and engage with the social platform coordinating funding, regardless of their geographic location.

The Aster Integrated Liver Care program is the largest supported pediatric liver transplant program in India, having performed 120 transplants for children at a cost of less than 5 lakhs per patient.