In Conversation with Dr Kieron Lim: Liver Transplant

My name is Kieron Lim. I am a Gastroenterology and Hepatology Specialist at Mount Elizabeth Hospital in Singapore. Prior to starting my practice at Mount Elizabeth, I was at the National University Hospital where I was the head of Gastroenterology as well as the Medical Director of Organ Transplantation at the National University Centre for Organ Transplantation.

What liver transplant options are available here in Singapore?

There are 2 main groups of patients who should be considered and evaluated for a liver transplant. The large majority of patients that fall into the first category are patients with liver cirrhosis, and in particular patients who have more advanced cirrhosis or complications of cirrhosis. This is also known as decompensated liver disease.

Such complications include jaundice, fluid accumulation called ascites, confusion or encephalopathy, as well as the development of varices or bleeding from blood vessels, and last but not least the development of primary liver cancer or hepatocellular carcinoma. Patients who have such complications should certainly be referred to and evaluated at a liver transplant centre.

What liver transplant options are there in Singapore?

In Singapore, we have cadaveric liver transplants which are not able to meet the demands of the number of patients on the waiting list. Most transplant centers in Singapore get around that by being able to offer living donor liver transplants. Predominantly, the donors are relatives of the patients; however, in Singapore on a case-by-case basis. Patients who have emotional relationships to the potential donor can be considered and has been approved by our National Transplant Ethics Committee.

How are liver transplants managed in Mount Elizabeth?

In Mount Elizabeth Hospital, we are privileged to have a large team of experts in various fields of liver transplantation. Such specialties include liver transplant surgeons, transplant hepatologists, critical care specialists, infectious disease specialists, as well as very specialised nursing support. Nurses in ICU, operating theatre, in anaesthesia, and all these (nurses) are specifically trained to look after such complicated and complex cases of liver transplants.