What is a Liver Transplant?
A liver transplant is a surgical procedure that replaces a damaged liver with a healthy one from a donor. It is a treatment option for individuals with advanced liver disease or liver failure that is not manageable through other medical procedures or therapies. The donor's liver can come from a deceased or living donor. A whole liver may be transplanted, or just a portion of one. Generally speaking, a liver transplant can greatly improve one’s quality of life and lifespan.
When is a Liver Transplant Needed?
Liver transplant surgery is usually performed for patients with liver cancer (hepatocellular carcinoma), acute liver failure, or other end-stage liver disease. These diseases are often caused by viral hepatitis, cirrhosis, excessive alcohol and drug consumption, and genetic conditions.
What are the Types of Liver Transplant?
There are several types of liver transplant in Singapore, which include:
Deceased Donor Transplant
Living Donor Transplant
Split Donation
What Happens Before a Liver Transplant?
At the liver transplant centre, the surgeon will examine the patient's liver and general health; as well as ask about their symptoms, medical history, lifestyle and history of substance abuse (if any). A transplant assessment will also include further tests to confirm if the patient is suitable for a transplant, such as:
- Blood Tests - This helps determine the right donor match and to also identify infections.
- Diagnostic Tests - X-rays, ultrasounds, liver biopsies, and other imaging tests are used to examine the patient's liver and general health.
- Heart Tests - This test includes an electrocardiogram (ECG) to determine a person's cardiovascular health.
- Breathing Tests - Breathing tests, such as spirometry, help identify potential respiratory problems that could affect the success of the transplant procedure.
- Endoscopy - This procedure uses a thin tube with a light and camera inserted down the throat to detect any abnormality of the bile ducts.
How Do You Prepare for a Liver Transplant?
Proper preparation while waiting for a liver transplant in Singapore generally revolves around keeping one as healthy as possible:
- Attend all scheduled medical appointments with a liver transplant surgeon
- Maintain a healthy weight by following a balanced diet and getting regular exercise
- Ensuring other existing health problems are well managed
- Avoid smoking and alcohol consumption
- Fasting before the liver transplant surgery, as advised by one’s medical team
What Happens During & After a Liver Transplant?
Liver transplant surgery usually takes 6 to 12 hours, depending on the severity of the disease and the complexity of the patient's condition. During the procedure, the surgeon creates an incision across the stomach and toward the chest to gain access to the liver. The surgeon will then remove the diseased liver, attach the donor liver, and connect it to the blood vessels and bile ducts before closing the incision.
The patient will be transferred to the intensive care unit (ICU) following the procedure for monitoring and testing of the new liver’s function. The liver transplant surgeon will also arrange for a post-operative check-ups and prescribe medications to minimise the risk of complications. It may take a few months for patients to resume their normal activities after liver surgery.
What are the Risks of a Liver Transplant?
As with all surgical procedures, a liver transplant is associated with certain risks, such as:
- Bile duct leakage
- Severe bleeding
- Blood clot
- Infection
- Rejection of the donated liver
However, with proper management by an experienced medical team, the risks of complications occurring are kept to a minimal.
Life After A Liver Transplant
Medications
Follow-up appointments
Diet
Exercise
Upon graduating from the University of Leicester and completing his basic surgical training in the United Kingdom, Dr Wong went on to complete advanced training in Singapore before embarking on his HMDP clinical fellowship in Japan—specializing in living donor liver transplantation.
Prior to establishing his own practice, Dr Wong was previously a consultant with the Department of Hepatopancreatobiliary & Transplant Surgery at SGH, an adjunct assistant professor at the Duke-NUS Graduate Medical School and a visiting consultant at the National Cancer Centre Singapore.
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