BANDAR SERI BEGAWAN – Brunei has completed 10 living donor liver transplants since launching its local programme in February 2025, marking a milestone in the country’s ability to deliver specialised treatment.

Led by the Ministry of Health (MOH) in collaboration with Jerudong Park Medical Centre (JPMC), the programme allows patients to undergo liver transplantation in-country, with local doctors working alongside visiting specialists throughout the treatment process.

Dr Taufique Ahmed, lead of the Liver Transplant Programme, said an estimated 60% to 70% of patients who underwent transplants in Brunei would previously have been unable to receive the treatment because they were too unwell to travel overseas or faced other clinical challenges.

Before the programme was established, MOH typically sent only one or two patients abroad for liver transplants per year.

What the milestone means for patients

A living donor liver transplant is possible because of the liver’s unique ability to regenerate.

During the procedure, a healthy person has a portion of their liver surgically removed and transplanted into a recipient to replace their diseased liver. Within a couple of months, the liver pieces in both the donor and the recipient regrow to normal size and take over typical function. 

Having a liver transplant programme in Brunei means patients can receive treatment closer to their families and support networks.

This can reduce the practical difficulties associated with treatment overseas, including travel and accommodation expenses, and extended periods away from home.

However, transplantation requires extensive assessments to determine whether recipients are fit for surgery and whether living donors can safely donate part of their liver.

The transplant team also warned that obesity-related liver disease could place high demands on the transplant programme.

While vaccination and advances in treatment have helped reduce liver disease linked to hepatitis B and C, fatty liver remains a major concern in Brunei, where 32.4% of adults were obese, according to the 2022–2023 National STEPS Survey.

Fatty liver disease can progress to cirrhosis and liver cancer, potentially leaving patients in need of a transplant.

Building local expertise

Pg Dr Hj Md Khalifah Pg Hj Ismail, director-general of Medical and Health Services, said the Liver Transplant Programme reflects the value of the partnership between MOH, JPMC and the specialist teams involved.

The collaboration gives local medical professionals the opportunity to develop their expertise through shared clinical practice, helping build the skills needed to sustain the transplant programme.

Visiting Consultant Hepatobiliary and Liver Transplant Surgeon, Dr P Balachandran Menon, is one of the specialists who works alongside local doctors, including MOH Consultant General Surgeon, Dr Amy Thien.

“Dr Amy is a valued member of the surgical team, and her contribution highlights the expertise Bruneian doctors bring to this programme… Working together strengthens the collective experience needed to develop and sustain transplant care here in Brunei,” he said.

Liver transplantation depends on close collaboration across many disciplines, including surgery, hepatology, anaesthesia, intensive care, radiology, pathology, infectious diseases, pharmacy, nursing and allied health services.

JPMC Acting Chief Medical Officer, Dr Pg Siti Nur’ashikin Pg Dato Paduka Hj Tengah, said the programme requires close coordination between teams, as well as follow-up care for transplant recipients and donors. 

“Helping patients and families understand each stage of the process is an important part of building confidence in the care available here in Brunei,” she said.

She stressed that the programme must be developed responsibly, with the welfare of both patients and donors in mind.

A donor’s perspective

For Kimmy, 39, the decision to donate part of her liver to her 60-year-old father was a significant undertaking. 

Before the surgery, Kimmy and her siblings underwent medical assessments to determine who would be the most suitable donor. The process included comprehensive medical checks and discussions to ensure the decision was voluntary.

She said the process also addressed personal and family considerations, including whether donors had adequate support throughout their recovery.

“Recovery was not easy, especially during the first two days, but we got through it with the care and support of my family and the medical team.

“The experience made me realise how important support is, not just for the patient but also for the donor. I am truly grateful to everyone who supported both my father and me throughout this journey.”

Kimmy (R) donated part of her liver to her father (L) through the local Liver Transplant Programme. Photo: The Scoop

Her experience has shaped her advice to others considering becoming living liver donors.

“My advice to anyone considering becoming a living liver donor is to understand the risks, ask the doctors questions and make sure you have good family support. Most importantly, the decision must be your own and not made because someone is pressuring you,” Kimmy said.

“I would not want to encourage someone to donate without considering their own circumstances. It is a personal decision that each individual must make for themselves.”

A second chance at life 

Dato Seri Setia Hj Johar Hj Muhammad initially sought treatment in Singapore before the opportunity arose for him to undergo a liver transplant in Brunei.

The father of eight said only one of his children shared his blood type and could be considered a potential donor.

Dato Seri Setia Hj Johar Hj Muhammad shares his journey through liver transplantation with The Scoop. Photo: The Scoop

The night before the operation, he had an emotional conversation with his daughter, who was preparing to donate part of her liver to him.

“I wanted to make sure that she was truly sincere about her decision and that her willingness to donate came from the heart,” he said.

His daughter, who was studying overseas, put her studies on hold to prepare for and undergo the surgery.

Her willingness to make that sacrifice meant a great deal to Dato Hj Johar, who saw the transplant as a second chance at life.

“As a Muslim, I believe it is important to always pray, seek forgiveness from Allah SWT and recite istighfar. I also made promises to myself and prayed that, if I were given another chance at life, I would fulfil the things I had promised to do.”