For individuals with terminal liver disease, where the liver can no longer carry out its essential functions, a transplant is frequently a conclusive treatment. This intricate medical treatment provides a restored opportunity for life and health. The process of obtaining a new liver involves a carefully organised clinical pathway, overseen with great precision by expert teams. Comprehending this process offers crucial insights for patients and families as they make their way through the healthcare system in Singapore.
Stage 1: The Referral to a Liver Specialist
The first step in the journey towards a liver transplant is a referral from a gastroenterologist to a hepatologist, or liver specialist, at a dedicated transplant centre. This typically occurs when a patient’s liver disease has progressed to a point where other medical treatments are failing. During the initial consultation at a specialised public hospital, the specialist will conduct a thorough review of the patient’s medical history, assess the severity of their condition, and determine if they are a potential candidate for a transplant. This is the stage where the groundwork for the entire process is laid.
Stage 2: The Comprehensive Pre-Transplant Evaluation
Once a patient is viewed as a possible candidate, they must go through a thorough assessment. This consists of a thorough series of medical and psychosocial evaluations aimed at confirming that the patient is physically and mentally fit for the surgery and the following recovery. The assessment consists of thorough blood analyses, imaging examinations of the abdomen, and evaluations to assess the performance of other essential organs such as the heart and lungs. The patient will also engage with different members of the transplant team, including dietitians and social workers, to guarantee that a strong support network is established for the upcoming journey.
Stage 3: Organ Source and Waitlist Protocol
There are two sources for a new liver. The first is a living donor, usually a close family member or friend, who donates a portion of their healthy liver. The liver has a unique and powerful ability to regenerate, allowing both the donor’s remaining liver and the transplanted portion to grow back to full size. This pathway reduces waiting time. If a suitable living donor is not available, the patient is placed on the national waiting list for an organ from a deceased donor. The allocation of these organs is managed centrally and ethically under Singapore’s Human Organ Transplant Act (HOTA).
Stage 4: The Surgical Procedure and Immediate Care
A liver transplant is a significant and intricate procedure that necessitates a surgical team. Throughout the operation, the affected liver is taken out and substituted with the healthy donor liver or a segment of it. After the surgery, the patient is moved to an intensive care unit for careful observation. This crucial phase right after surgery is vital. The healthcare team closely monitors to verify the proper functioning of the new liver and oversees the administration of strong medications to stop the body from rejecting the transplanted organ.
Stage 5: Long-Term Management and Lifelong Follow-Up
Recovery from a transplant continues long after leaving the public hospital. Patients must commit to a lifelong regimen of immunosuppressant medications to prevent their immune system from attacking the new liver. Adherence to this medication schedule is crucial for the long-term success of the transplant. Patients will also have a regular schedule of follow-up appointments and blood tests with their liver specialist. This ongoing monitoring helps the team manage any potential complications and ensure the patient and their new liver remain healthy for years to come.
Conclusion
The liver transplant process in Singapore is a well-defined medical journey, from the initial specialist referral and in-depth evaluation to the complex surgery and lifelong aftercare. Each stage is coordinated by a multidisciplinary team within our public hospital system, ensuring patients receive the highest standard of care. While the path is demanding, it provides a clear and structured route to recovery for individuals with severe liver disease.
If you are beginning the liver transplant journey, the first step is an expert consultation. Contact the National University Hospital (NUH) to arrange a comprehensive assessment with our team.