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

This procedure involves transplanting a liver taken from a person who recently passed away. During the transplant, the liver transplant surgeon removes the damaged liver from the patient and replaces it with the healthy liver of the deceased donor.

Living Donor Transplant

In this transplant, a healthy person donates a part of their liver to a patient who requires a transplant. Donors must have compatible blood type and liver anatomy to be a suitable candidate for this procedure. The donor's liver will typically regenerate over time back to its full size, whereas the transplanted portion will also grow to its proper size in the recipient's body.

Split Donation

During this type of transplantation, the liver of a deceased person is split into two pieces, with each half implanted into a different patient, where they will grow to a normal size.

What Happens Before a Liver Transplant?

At the liver transplant centre, the doctor 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 doctor 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

After a liver transplant, patients should follow their aftercare instructions to ensure a smooth recovery. These include:


Patients must take immunosuppressant medications for the rest of their lives to prevent their new liver from being rejected, as well as to prevent complications such as blood clots and infections.

Follow-up appointments

Patients must schedule regular visits with a liver doctor to periodically assess liver function, adjust medications, and treat any potential issues that may arise.


Patients should follow a healthy and balanced diet. These include foods rich in fibre, fruits, vegetables, low-fat dairy products, and lean meat.


Patients should engage in regular and appropriate levels of exercise so as to improve their general health, including maintaining a healthy weight, strong bones and good heart health.
The Hepatobiliary & Pancreatic Surgery Centre is led by Dr Wong Jen San, a dedicated surgeon experienced in performing liver transplants. To find out more, call 6235 4088 today.
Dr Wong Jen San
Consultant Hepatobiliary & Pancreatic Surgeon
MBChB (UK), MMed (S’pore), Msc (S’pore), FRCS (Edin), FAMS

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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