Summary:
|
Choosing to donate part of your liver to a loved one or someone in need is a generous act that could make a meaningful difference in their life. At the same time, it’s a major decision, and it’s natural to have questions about what it could mean for your own health.
If you’re considering becoming a living donor for a liver transplant in Singapore, here’s what you should know before making your decision.
What Is Living Donor Liver Transplantation?
A living donor liver transplant involves taking part of a healthy person’s liver and transplanting it into someone with severe liver disease or liver failure.
For patients who need a liver transplant in Singapore, living donation offers another option without having to wait for a liver from a deceased donor.
How Is Part of the Liver Transplanted?
During liver transplant surgery, a portion of the donor’s liver is removed and transplanted into the recipient. The donated portion is connected to the recipient’s blood vessels and bile ducts.
The amount removed depends on the recipient’s needs, the donor’s anatomy and how much functioning liver must remain.
How Does the Liver Regrow in the Donor and Recipient?
The liver can regenerate after part of it is removed. The remaining liver in the donor and the transplanted portion in the recipient gradually increase in volume.
Liver regeneration begins soon after surgery, with substantial growth occurring over the following months. However, the liver may not return to its exact original size or shape.
Who Can Become a Living Liver Donor?
Living liver donors may include family members, spouses, friends or other suitable individuals. However, anyone considering donation must undergo medical assessments and meet the necessary consent requirements.
What Are the Age, Health and Relationship Requirements?
A potential liver donor generally needs to meet the following criteria:
- Age: Donors must meet the age requirements set by the hospital’s liver transplant team. Their overall health and suitability for surgery will also be assessed.
- Health: Good overall health without significant conditions that increase surgical risks.
- Liver suitability: Healthy liver tissue and sufficient remaining liver volume.
- Compatibility: Donors generally need a compatible blood group, although exceptions may be possible in certain cases.
- Consent: A voluntary decision made without pressure or financial inducement.
What Conditions May Rule Out a Donor?
Certain medical conditions may prevent donation, including:
- Significant liver disease or advanced fatty liver disease.
- Certain infections, including hepatitis B or C, which may affect donor eligibility.
- Serious heart or lung conditions.
- Active cancer or certain previous cancers.
- Conditions that increase bleeding or blood-clotting risks.
Insufficient liver volume or unsuitable liver anatomy may also rule out donation. Other conditions, including obesity or diabetes, require individual assessment.
What Happens During the Donor Assessment Process?
Before a living donor liver transplant in Singapore, your liver transplant surgeon and medical team will assess your health to determine whether you can safely donate part of your liver.
What Blood Tests, Scans and Liver Measurements Are Needed?
The assessment may include:
- Blood tests: To check liver function, blood group compatibility, clotting and infections.
- Computed tomography (CT) or magnetic resonance imaging (MRI) scans: To examine the liver’s anatomy, blood vessels and bile ducts.
- Liver volume measurement: To calculate the amount that can be donated while preserving sufficient liver tissue.
- General health checks: To assess fitness for surgery and anaesthesia.
Further investigations, including a liver biopsy, may be required in selected cases.
Why Are Psychological Assessment and Informed Consent Important?
A psychological or psychosocial assessment helps establish whether donors understand the potential consequences and have adequate support.
In Singapore, the Transplant Ethics Committee must authorise living organ donation. It assesses informed consent, medical risks and possible coercion.
Following approval, donors have a seven-day cooling-off period. They may withdraw consent before surgery, even after completing the assessment.
If you are considering liver donation, our surgeons at Digestive & Liver Surgery can discuss the assessment process and surgical considerations. Contact us to arrange a consultation.
What Happens During Donor Surgery?
During living donor liver transplant surgery, part of the donor’s liver is removed and transplanted into the recipient, where it is connected to the blood vessels and bile ducts.
The amount of liver removed depends on the recipient’s needs, the donor’s liver anatomy and how much healthy liver must remain for the donor.
What Are the Open and Minimally Invasive Approaches?
The transplant team will determine the most suitable surgical approach based on the donor’s liver anatomy and the portion being donated. The two main approaches are:
- Open surgery: Your surgeon makes an incision in the abdomen to access and remove the planned portion of the liver.
- Minimally invasive surgery: Your surgeon uses smaller incisions and specialised laparoscopic or robotic instruments. This approach may offer some short-term recovery benefits for suitable donors, but it is not appropriate for everyone.
What Can Donors Expect in Hospital?
After surgery, your medical team will monitor your liver function and check for bleeding or other complications. You may initially need closer monitoring in a high-dependency or intensive care unit.
During your hospital stay, your care team will manage your pain, perform blood tests, care for your wound and help you start walking.
Most donors stay in hospital for about a week, although this depends on how well they recover.
How Long Does Liver Donation Recovery Take?
Recovery after donating part of the liver varies between individuals. Tiredness, abdominal discomfort and reduced stamina are common during the initial weeks.
Recovery generally involves:
- First few weeks: Rest, gentle walking and avoiding strenuous activity.
- Around six to twelve weeks: Some donors may return to work, depending on their progress and job requirements.
- Following months: Physical stamina and activity levels may continue improving.
Some donors may continue to experience symptoms beyond the initial recovery period, which may affect their ability to return to physically demanding work.
Your surgical team will assess your recovery and advise when you can safely return to work, drive, exercise and lift heavy objects.
What Are the Risks to the Donor and Long-Term Health?
Even with careful medical assessments and surgical planning, donating part of your liver carries certain risks.
What Complications Can Occur After Surgery?
Potential complications include:
- Bleeding: May require a blood transfusion or further treatment.
- Infection: Can affect the wound or abdominal cavity.
- Bile leakage: May require drainage or another procedure.
- Blood clots: Including deep vein thrombosis or pulmonary embolism.
- Incisional hernia: Weakness around the surgical incision.
- Reduced liver function: Rarely, the remaining liver may not function adequately.
Although uncommon, serious complications, including life-threatening complications, can occur.
Does Liver Donation Reduce Life Expectancy?
Many liver donors remain in good health after surgery. However, long-term health outcomes vary, and the effect of donation on life expectancy cannot be predicted for every individual.
Some donors may experience persistent physical symptoms or psychological difficulties. Regular follow-up appointments with your liver transplant surgeon are important for monitoring liver function, assessing your overall health and addressing any concerns after donation.
What Are the Costs and Support for Donors in Singapore?
The cost of liver donation in Singapore depends on the hospital, investigations, surgery and follow-up care.
At private hospitals in Singapore, surgeon’s fees for living liver donation can cost up to approximately S$29,000, excluding hospital charges, anaesthesia and other expenses.
Expenses may include medical assessments, hospitalisation, medications and time away from work.
Under Singapore’s Human Organ Transplant Act (HOTA), living donors may receive reimbursement for reasonable donation-related expenses and loss of earnings. However, buying or selling organs is prohibited.
Before donating, confirm who will pay for your medical assessments, surgery, recovery expenses and treatment if complications arise.
Frequently Asked Questions
Can You Donate Part of Your Liver to a Non-Relative?
Yes. Friends and non-relatives can be liver donors if they meet medical requirements and receive ethical approval. Donation must be voluntary, without prohibited financial incentives.
How Long Until the Liver Grows Back?
The liver begins regenerating soon after surgery, with substantial regrowth usually occurring within several months. However, recovery varies, and the liver may not return to its original size or shape.
Speak to a Surgeon About Living Liver Donation in Singapore
If you are considering becoming a liver donor in Singapore, it is important to know what the process involves, including the possible risks and how donation may affect your health.
At Digestive & Liver Surgery in Singapore, our experienced surgeons Dr Victor Lee Tswen Wen and Dr Tan Ek Khoon are happy to talk you through the process, assess your suitability and address any concerns you may have.
Contact us to arrange a consultation.
