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Liver Transplantation

Liver transplantation is now the accepted standard of care for patients with end stage liver diseases, and selected cases of hepatocellular carcinoma (primary liver cancer).

 

In Singapore, a liver graft for transplant can be obtained through a living donation by an individual who is alive (Living Donor) or recovered in the event of death from any cause for the purpose of transplantation (Deceased Donor) under the Human Organ Transplant Act (HOTA) or the Medical (Therapy, Education and Research) Act (MTERA).

Our Experience


To date, our Centre has performed more than 340 successful adult living and deceased donor liver transplantations. We continue to provide post-transplant care and medical follow-ups at our Specialist Outpatient Clinic for over 1,500 liver patient visits annually.

In 2016, NUCOT performed 55% of the total number of liver transplants in Singapore (both living and deceased donors liver transplants)1 .

 

We are a National Referral Centre for Singapore’s deceased donor liver donations and transplants. In 2016, we performed 69% of the total number of deceased donor liver transplants in Singapore.1
 

 

Post-Transplant Outcomes 


Outcomes for liver transplantation in NUCOT are amongst the best internationally.

Based on our latest survival data over the past 10 years (2007 - 2016), our short-term post-transplant recipient survival rates are comparable to the international standards2 for both living donor liver transplants (LDLT) and deceased donor liver transplants (DDLT).

 

In terms of long-term post-transplant recipient survival rates, we are doing better than the international standards2 as illustrated in the table below:

 

NUH Post Liver Transplant Survival Data (Adult) in comparison with Organ Procurement and Transplantation Network (OPTN)


 

A Centre of Excellence


NUCOT brings together a comprehensive multidisciplinary suite of medical specialty services required throughout our patients’ transplantation journeys.

The services available include pre-transplant medical assessments, surgical and micro-surgical specialized services, post-transplant intensive care and recovery, outpatient check-ups and lifetime medicine reviews. Our team-approach ensures that transplant patients are provided one-stop comprehensive, dedicated and individualized care within an institution.

Key to the success of liver transplantation and in managing possible ensuing complications, we are well-equipped with interventional radiology and endoscopy services – thereby improving graft and patient survival.

Our transplant coordinators and other allied healthcare professionals (such as medical social workers, transplant pharmacists and dieticians) work together to provide the required support and knowledge to our patients and their care-givers.

Our Medical Achievements


NUCOT has performed many firsts in Singapore in liver transplantation:

  • 1990 - First deceased donor liver transplant performed in Singapore 
  • 1996 – First living donor liver transplant performed in Singapore 
  • 1997 – First split liver transplant performed in Singapore 
  • 2002 – First right lobe graft from a living donor
  • 2009 – First living donor liver transplant in patient with porto-mesenteric thrombosis
  • 2010 – First successful combined liver and kidney transplant performed on a young person 
  • 2016 – First successful altruistic non-directed donor liver transplant performed in Singapore

Footnotes:

1. National Organ Transplant Unit (NOTU) Annual Report 2016

2. OPTN - US Dept of Health and Human Services, Organ Procurement and Transplantation Network. https://optn.transplant.hrsa.gov/data/view-data-reports/national-data/#

 

Information accurate as at March 2018.