A second chance at life from liver failure

If medical treatment/therapy has been proven unsuccessful and the liver is no longer able to function, liver transplantation remains the only option for patients suffering from liver failure.
Liver transplantation is a surgical procedure whereby a diseased or failing liver is removed and replaced by a whole new liver from a deceased donor (cadaveric) or part of a healthy liver from a living donor.
Living Donor Liver Transplantation (LDLT)
In LDLT, the diseased liver is removed and replaced with a part of the liver from a healthy donor.
ACLDT's Respiratory Physician Dr Lee Kang Hoe, who specialises in critical care management of all acute liver failure, says that the main advantage of LDLT is the timeliness because it decreases the risk of complications and death while waiting for match from deceased donors. It allows scheduling of the transplant surgery such that the patient with decompensated liver function can be optimised prior to surgery.
In addition, LDLT can be performed on living unrelated (or emotionally related) recipients and donors at ACLDT. This is unique as Singapore is one of the few countries within Asia that can do so. The other important advantage is that the quality of the graft is better as it is retrieved from a healthy donor.
The transplant journey
At ACLDT, they adopt a multi-disciplinary approach to the clinical treatment and management of patients' medical conditions.
The recipient and the donor are operated on simultaneously by two transplant teams including surgeons, anaesthetists, nurses and technicians in two separate operating theatres.
The surgeon working on the donor removes a portion of the liver — between 40 to 60 per cent of it — depending on whether the recipient is an adult or child.
The grafted liver is then transplanted into the recipient as soon as possible to ensure that it will function well after it has been transplanted.
The other surgeon operating on the recipient will first remove the diseased liver, leaving the major blood vessels clamped and in place. When the grafted liver is available, he will place it into the abdominal cavity and then proceed to connect it with the major blood vessels. Once this is done, the radiologist will do an ultrasound scan to ensure that there is blood flow in the new liver.
The liver has an amazing ability to regenerate. Hence, the donor's liver will regenerate back to its full size within a few weeks of the surgery without affecting its normal functioning. The transplanted liver will also grow until it is the appropriate size for the recipient's body.
The outcome for liver transplant surgery has improved dramatically over the past two decades. Most liver donors are able to return to a normal quality of life within three months and, the recipients within six months.
Special liver ward at Gleneagles Hospital
To provide the best possible care and treatment for liver transplant patients, Gleneagles Hospital has a dedicated ward, especially for the care of patients suffering from liver diseases including those undergoing liver transplantation.
Complementing ACLDT's highly successful LDLT Programme is the Parkway Asian Liver Ward, which comprises seven Liver Intensive Care Units (ICU) and ten patient rooms. It is an integrated facility that is co-managed by ACLDT and Gleneagles Hospital, with advanced medical equipment, including the various types of liver dialysis machines and monitoring devices, to ensure that every patient receives the best treatment for his/her liver condition.
Liver dialysis serves as a bridge for critically ill patients with liver failure until their transplant surgery can be performed.