Day before the transplant surgery:

The day before the transplant surgery, both the recipient and the donor will be hospitalized and undergo a series of blood test, chest x-ray and ECG, and a final assessment by the surgeon and the anaesthesiologist. This is to ensure both patients are fit to undergo the surgery and any infection is caught.

In addition, a physiotherapist will be assigned to educate both patients on breathing on their own once the ventilator is removed post-surgery. A pain coordinator (dedicated nurse)

Both the recipient and the donor may receive an enema to clean their bowels and prevent constipation after surgery. The chest and abdomen area will be shaved clean to prevent infection. The donor and recipient will be nil by mouth from midnight immediately before the operation. This means no food, drink or water.

There have been instances when a transplant surgery had to be cancelled. This is especially so with liver cancer patients. The recipient’s surgical team will make an incision to open the abdominal cavity and look at the surrounding organs to ensure that the cancer has not spread outside the liver. A pathologist will be on hand to immediately examine any biopsy on any lumps/ nodules to check for malignancy. If it has been found that the cancer has spread to the surrounding tissue or organs, the transplant will need to be cancelled.

During Surgery

You and the donor will be operated on simultaneously and attended by 2 teams of surgeons, anaesthesiologists, nursing assistants and technicians. You and the donor will be taken to a pre-operative holding area, where your anaesthesiologists will start preparing IV to be inserted into your arms. This will allow for the administration of medications that are part of your general anaesthetic. Before any medications are administered, members of the surgical team will verify your names and explain the type of procedure and surgery that will be done. In the operating room, general anaesthesia is administered and you will be “intubated”. A breathing tube, connected to a ventilator, is inserted down your throat into your lungs to breath for you during the procedure. Other medications are given throughout the surgery. The transplant surgeon will explain more about these drugs prior to surgery when consent is obtained. You will also be connected to other machines that will monitor your blood pressure, your heart, and to drips and blood transfusion tubes.

The transplant surgeon will make an incision on top of the breast bone and extending down to the right and left of the bottom of the rib cage. It is called the "Mercedes" incision because of its similarity to the trademark logo of Mercedes Benz (see photo).

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