Social media appeals lead to more liver transplants from strangers

Online appeals have resulted in more people coming forward to donate their livers to strangers in recent years, a study by the National University Hospital (NUH) has found.

Between June 2014 and December 2019, the social media effect resulted in seven liver transplants between living donors and people they did not know at NUH's National University Centre for Organ Transplantation.

In comparison, the centre performed just two such procedures between living liver donors and strangers in the preceding 18 years.

Each such appeal can lead to upwards of 10 people offering to donate a part of their livers, said Associate Professor Shridhar Iyer, surgical director and senior consultant in the Adult Liver Transplantation Programme at the centre.

"We find that people come forward asking to donate livers, even though it is a major surgery, to somebody they don't know," he told reporters. These donors then have to be assessed on their suitability for the procedure, he said.

Donors should be above 21, in good health and meet other conditions such as having a blood type compatible with that of the patient.

Prof Shridhar noted that smokers and those with fatty livers can also qualify as donors, should they be assessed to be suitable after stopping smoking and making diet and lifestyle changes.

In liver donations between two adults, the right side of the liver - comprising about 70 per cent of the organ - is donated. Prof Shridhar says that the remaining 30 per cent is sufficient to regenerate the organ.

Donors will be able to recover and perform most normal activities within a month, and be able to do more strenuous activities within six weeks to three months after the procedure.

Most cases of living liver donor transplants here, however, were from parent to child. These made up 97 of the 204 such operations conducted by the centre from 1996 - when the procedure was first performed here - to 2019.

Liver transplants from living donors are becoming more important as donations of the organs from the dead have not kept pace with growing demand, said Prof Shridhar.

Since 1990, there have been more than 500 liver transplants from both living and dead donors in Singapore, with most of these procedures performed by the centre.

While Prof Shridhar noted that living donor liver transplant is a complex procedure with associated risks, the study - of which he was lead author - found no cases of donor deaths in the 204 procedures performed by the centre, with less than 10 per cent of donors experiencing complications, which were largely minor.

Patients also performed well after such transplants. At five years after the procedure, the survival rate for adult patients who received livers from living donors was 83 per cent, while for children it was 89.2 per cent.

Prof Shridhar hopes the study will assure the public it is safe to be a living liver donor in Singapore.

Mr Sakthibalan Balathandautham, 29, was recognised as The Straits Times Singaporean of the Year 2021 for donating 23 per cent of his liver to a one-year-old baby, Rheya, following a social media appeal in 2020.

She was diagnosed with biliary atresia - a rare disease in infants where the bile ducts in the liver are inflamed, blocking bile flow to the gall bladder. It eventually leads to liver failure.

Despite surgery to improve the bile flow, her condition did not improve and her parents were told she would need a liver transplant.

Mr Sakthibalan, a senior sales executive, said while he has had to cut down on oily and carbohydrate-heavy food since the procedure, he has not suffered any complications.

Now 2½ years old, Rheya is doing well, said Mr Sakthibalan, adding that he regularly checks in with her parents to see how she is doing.

People who wish to donate their livers or other organs, such as kidneys or pancreas, should consult their doctors to check on their suitability, and should do so only when they feel confident about it and are able to spare the time for the procedure and recovery, said Mr Sakthibalan, who is single.

"These kinds of things require a lot of commitment from the donor, and you have to be really healthy," he said.