Although liver transplant is considered as the last option for patients with end-stage liver disease, it nevertheless offers patients hope for 2nd life. There are 3 types of liver transplantation that are practiced in the world. They are cadaveric, live donor and split-liver/ reduced size transplant.
 

Cadaveric Liver Transplantation 
Liver transplant from a deceased donor is known as cadaveric transplant. The majority of livers that are transplanted come from brain dead organ donors where consent is available. A liver transplant from a brain dead donor (cadaver) needs to occur within 12 to 24 hours after the liver is removed from the donor for the organ to remain viable. During this time, the surgeon will do a final assessment of the donor liver to ensure it's healthy and a good match.

Due to personal or religious reasons or lack of awareness, many people do not come forward to be an organ donor this way. This causes a shortage of liver for transplantation and many people die waiting for a compatible liver.

Split-Liver Transplantation
Due to the shortage of paediatric cadaveric donors, there was a higher death rate among children with end-stage liver disease. With the changes to HOTA (Human Organ Transplant Act) allowing a wider donation and a greater understanding of split liver/ reduced size transplant, the deaths among children with end-stage liver diseases have dramatically reduced. In the split liver/ reduced size transplant, the donor’s liver (an adult) is split into 2 and transplanted into a child and another adult recipients with end-stage liver disease.

Living Donor Liver Transplantation in Asia
With the prevalence of liver disease in Asia, there is an increasing demand for liver transplantation for patients with end-stage liver disease. There is also a worldwide shortage of donated livers and every country has a long waiting list.

As such, Living Donor Liver Transplantation (LDLT) has become an important and effective life saving procedure, in particular those with liver failure and hepatocellular carcinoma (HCC). The current waiting period for a cadaveric donor liver is often too long to benefit patients with these rapidly progressive diseases. Without LDLT, it is highly unlikely that patients will be transplanted before they develop fatal complications. Besides being an alternative source of donor livers, the other advantage of LDLT over cadaveric organ donation is that it allows scheduling of the procedure. As such, the patient with decompensated liver function can be optimized prior to the operation. In addition, the quality of the graft is better as it is retrieved from a healthy donor and the cold ischaemic time (time the donated liver has no blood supply) is much shorter. The most important disadvantage of LDLT is the potential for complications or even death of a healthy donor. There are limitations when faced with living donor liver transplantation. The foremost is finding a suitable compatible donor, who has the same blood group and is fit to undergo the surgery. The donor can be the next of kin, relatives and even close friends.

ACLDT AND LIVER TRANSPLANTATION
Asian Centre for Liver Diseases & Transplantation (ACLDT) with its experienced team of doctors, offers living donor liver transplantation for adults and children. For those patients who have a suitable donor, the investigations for the donor and recipient are extremely stringent to ensure both the safety of the donor and the optimal graft for the patient.

One of the investigations carried out uses State-of-the-art technology from a German company called MeVis Distant Services (MDS) which allows us to reconstruct the liver anatomy accurately from CT Scans. The data from the CT scan of the donor is uploaded to MDS where a team of highly specialised technicians and a radiologist interpret the data and send back detailed information and colour pictures depicting the vascular anatomy, the volume and the suitability of the proposed liver graft. It is a precise and highly individual diagnostic tool which enables the surgeon to perform the donor operation with utmost safety and confidence. The ACLDT is currently the only institution in Southeast Asia using this technology.

If you wish to know more about our liver transplant programme, please contact us by e-mail, fax or phone. Please click here for contact details.