What is a liver transplant? What causes liver failure and who is a suitable candidate for liver transplantation? Dr Reina Lim Tee Gan, Consultant, at the Department of Gastroenterology and Hepatology, Singapore General Hospital, and SingHealth Duke-NUS Liver Transplant Centre answers these questions in this article.

What is a liver transplant?

A liver transplant is an operation to remove a damaged liver and replace it with a healthy one. It is usually recommended when the liver has been damaged to the point that it cannot perform its normal functions, that is, when someone has developed liver failure or end-stage liver disease.

What causes liver failure?

Liver failure can be caused by viral hepatitis infection, non-alcoholic fatty liver, alcoholism, autoimmune liver disease and drug-induced liver injury. When a liver fails, the only option for survival is a liver transplant because unlike other organs such as kidney, there is no device (dialysis machine) which can perform the function of the liver.

Who is a suitable candidate for liver transplantation?

A person is considered a suitable candidate for liver transplantation if, without a liver transplant, he or she is highly likely to have a shorter expected lifespan, or if the quality of life is so poor as to be intolerable. There is a thorough assessment process to determine one’s suitability for liver transplantation. This is because it involves a major operation, and donated livers are scarce.

Liver transplant can also be considered in someone with a functional liver if the individual develops liver cancer which cannot be treated by conventional methods, or metabolic diseases associated with enzyme deficiencies. A multidisciplinary team of doctors (liver transplant physicians, surgeons, infectious disease specialists, radiologists etc) will review each case before deciding a patient’s suitability for a liver transplant.

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