Becoming a Living Donor

Everyone has the opportunity to become an organ donor, either through deceased or living donations.

Under the Human Organ Transplant Act (HOTA), all Singapore Citizens and Permanent Residents aged 21 and above who are not mentally disordered are automatically included unless they have opted out. HOTA allows for the removal of kidneys, heart, liver, and corneas for transplantation in the event of death from any cause.

Additionally, anyone aged 18 and above, regardless of nationality, can pledge to donate their organs and/or tissues outside of HOTA under the Medical Therapy Education and Research Act (MTERA).

Organs that can be donated while the donor is alive include the kidney and part of the liver.

Research indicates that recipients of organs from living donors generally experience better outcomes compared to those who receive organs from deceased donors. A kidney or liver from a living donor usually begins functioning immediately in the recipient.

For donors, organ donation is an act of great kindness and can significantly reduce someone's waiting time for a transplant. Potential donors can be tested in advance to identify the most compatible match for the recipient, and the transplant can be scheduled at a convenient time for both the donor and recipient.

In Singapore, living organ donation is regulated by the Human Organ Transplant Act (HOTA). Under HOTA, the following organs can be donated by living donors:

• Kidneys: Living kidney donation is the most common type of living organ donation. A person can donate one of their kidneys to someone in need of a transplant.

• Liver: Living liver donation involves donating a portion of the liver to a recipient in need of a liver transplant. The liver can regenerate, allowing both the donor's and recipient's livers to grow back to normal size after the transplant.

These are the primary organs that can be donated by living donors in Singapore under HOTA. It's important to note that living organ donation involves thorough evaluation and consent processes to ensure the safety and well-being of both the donor and the recipient.

For deceased organ donations under HOTA, organs are allocated to the common pool of patients on the organ transplant waiting lists.

Living donors, however, have the option to choose their recipient, as long as they a biological or emotional connection to the recipient.

Additionally, living donors can also opt to donate to the common pool of patients on the organ transplant waiting lists.

To determine suitability for living organ donation, transplant physicians conduct comprehensive evaluations of potential donors. This involves thorough physical examinations and medical test, which includes assessments conducted by an independent physician, medical social worker, psychiatrist, and transplant surgeon.

The potential donor receives counselling about the donation process, procedures, medical risks, and the short- and long-term implications to ensure an informed decision. While there is no upper age limit for donors, those over 65 are considered on a case-by-case basis.

Potential donor will need to undergo tests and screenings to confirm their eligibility to donate a liver or kidney.

You may be eligible to donate a liver if you:

• Are aged between 18 and 60
• Maintain a healthy weight
• Are in good physical and emotional health
• Have a healthy, functioning liver and kidney
• Are committed to completing the entire process, from pre-donation evaluation through surgery and recovery

You may be eligible to donate a kidney if you:

• Are at least 21 years old
• Maintain a healthy weight
• Are in good physical and emotional health
• Have a healthy, functioning kidney
• Are committed to completing the entire process, from pre-donation evaluation through surgery and recovery
• Are willing to undergo long-term follow-up to monitor kidney function

In Singapore, a living organ donor can be either a relative or a stranger (altruistic donation).

The living donor must be either biologically or emotionally related to the recipient:

• Biologically related such as parents, siblings, cousins, aunts, uncles, nephews or nieces
• Emotionally related such as spouses, friends, or in-laws 

There have also been cases of non-related (altruistic) donation in which people voluntarily donate their organ or tissues to anyone who needs them. The donated organ will be allocated to the common pool of patients on the transplant waiting list, in accordance to national allocation criteria.

Altruistic donation:

There are also cases where non-related (altruistic) donations occur. In these instances, individuals voluntarily donate their organs or tissues to anyone in need. The donated organ is then allocated to the common pool of patients on the transplant waiting list, according to national allocation criteria.

Generally, the steps include:

1. Kidney or liver failure patients should consult their doctors on their suitability for living donor organ transplants
2. The potential donor and recipient pair seeks initial consultant at a transplant centre
3. The potential donor and recipient pair undergoes further medical accessions and consult by a multidisciplinary transplant team
4. Authorisation from the Transplant Ethics Committee (TEC) is required before any living donor organ transplant can proceed in Singapore

Learn more about living donor liver transplants and living donor kidney transplants and how you can start your recovery journey at Mount Elizabeth Hospitals.

Organ donation surgery is generally considered safe, but like any surgery, it carries certain risks. Potential complications for living donors include:

• Pain
• Infection
• Bleeding
• Blood clots
• Pneumonia
• Allergic reactions to anaesthesia
• Wound complications
• Injury to surrounding tissue or other organs
• In rare cases, death

As transplant surgeries become more common and surgical techniques improve, the risks associated with living donation continue to decrease.

Kidney donation

When you donate a kidney, you give one of your two kidneys. The remaining kidney will enlarge slightly to take over the function of both kidneys.

Liver donation

For liver donation, you can donate up to 70% of your liver to be transplanted into another person. The remaining liver will regenerate and grow back to nearly its original size within weeks, regaining full function.

Life after donation

Generally, after recovering from the donation procedure, you can expect to lead a normal life. Donating an organ will not affect a female donor's ability to conceive.

The length of your hospital stay depends on your individual recovery rate and the type of procedure performed. On average:

• Kidney donation: The hospital stay is typically 3 – 5 days.
• Liver donation: The hospital stay is approximately 7 days.

Living donation does not alter life expectancy. After recovering from the surgery, most donors go on to live happy, healthy, and active lives. They often experience the positive impact of their donation, knowing they have significantly helped someone in need.