Living Donor Liver Transplant

What is living donor liver transplant (LDLT)?

Living donor liver transplant (LDLT) is an important life-saving procedure for patients suffering from decompensated liver cirrhosis, acute liver failure and hepatocellular carcinoma (HCC) (liver cancer).

It can be performed on patients with end-stage liver disease regardless of the original cause of the disease. Potential recipients are carefully selected and must meet stringent criteria.

LDLT offers many advantages over cadaveric liver transplantation:

  • Surgery can be scheduled when the recipient's condition is optimised.
  • The quality of the liver graft is better because it is provided by a healthy donor, with a shorter cold ischaemic time (the time the donated liver has no blood supply).
  • Waiting time for LDLT is much shorter than cadaveric liver transplant, which is very important for patients with rapidly progressive liver diseases or deteriorating liver function, or both.

How it works

In LDLT, a healthy donor donates part of their healthy liver to replace the damaged liver of the recipient.

Both the transplanted liver and the portion left behind in the donor are able to regrow rapidly. Even with 70% of its mass removed, the liver will regenerate to 100% functionality within 4 – 6 weeks.

Living donor liver transplant requirements

A suitable living donor would meet the following requirements:

  • Aged between 18 – 60
  • Be of a healthy weight, in good health and psychologically sound
  • Have a compatible blood type with the patient
  • Have a healthy functioning liver and kidney
  • Willing and prepared to go through the entire living donor liver transplant process including pre-donation evaluation, surgery and recovery

Why do you need an LDLT?

LDLT is usually a treatment for:

  • Patients with end-stage liver disease.
  • Decompensated liver cirrhosis (liver scarring) in adults. Liver cirrhosis is mainly caused by hepatitis B and C, chronic alcohol consumption, autoimmune liver disease and build-up of fat in the liver.
  • Biliary atresia in children, caused by absent or blocked bile ducts, which are tubes that carry bile out of the liver to the gallbladder. The bile backs up and damages liver tissue, and eventually leads to cirrhosis.

Other reasons for LDLT include:

  • Liver cancer
  • Benign (non-cancerous) liver tumours
  • Hereditary liver diseases

Who should not undergo an LDLT?

Liver transplant is recommended only when the risk of demise from the liver disease outweighs the immediate and long-term risks of the transplant. You may not be suitable for liver transplant if you have:

  • An active infection
  • Cancer outside of the liver
  • Alcohol or drug abuse

Your doctor will advise you on your suitability for a living donor liver transplant.

What are the risks of an LDLT?

Liver transplant surgery carries a risk of complications including:

  • Bile duct complications, including bile duct leaks or strictures of the bile ducts
  • Bleeding
  • Blood clots
  • Failure of donated liver
  • Infection
  • Rejection of donated liver

Long-term complications may also include recurrence of liver disease in the transplanted liver.

While the procedure is often life-saving for the recipient, donating a portion of the liver also carries certain risks for the donor. Some mild but uncommon complications that may occur for the donor include:

  • Hernia at the incision site
  • Prolonged numbness
  • Wound infection

Severe complications are rare and the surgeon will discuss them in detail with you prior to the surgery.

Why choose Mount Elizabeth Hospitals?

Mount Elizabeth Hospitals is a trusted name for medical care in Singapore, with modern technology and facilities.

Our team of gastroenterology specialists is experienced in diagnosing and treating hepatopancreatobiliary (HPB) disorders including liver conditions that require a living donor liver transplant. Together with a multidisciplinary team including surgeons, allied healthcare professionals and transplant coordinators, we are committed to providing you with good clinical outcomes.

Our gastroenterologists and general surgeons

Our gastroenterology team comprises experienced gastro specialists and general surgeons skilled in treating hepatology (liver, gall bladder, bile ducts and pancreas) conditions, including liver diseases that require a living donor liver transplant.

Our fully integrated care model includes our nursing team and endoscopic equipment to optimise your care options. You will also benefit from ancillary support in ultrasound, X-ray, and magnetic resonance imaging (MRI).

Please check with your insurance provider for more information, and for their most up-to-date list of panel doctors.

^Specialists may qualify to be on the Extended Panel (EP). You may enjoy selected panel benefits depending on your policy and riders.
This page has been reviewed by our medical content reviewers.

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