MEDIWIN Articles · Serious illness · Updated 30 September 2026 · 7 min read
A liver transplant in Korea is usually a living donor operation, not a wait for a deceased donor organ. One Seoul hospital has now published the results of 6,000 consecutive living donor liver transplants, and a nationwide study of 7,073 cases shows how much the hospital’s annual volume changes the risk.[1][2] For a patient abroad with cirrhosis or liver cancer, those two numbers matter more than any brochure.
Key points
- Korea performs mostly living donor liver transplantation (LDLT), because deceased organ donation rates in Asia are low.[1]
- At Asan Medical Center, adult patients aged 50 or under had patient survival of 92.7% at 1 year and 85.9% at 5 years across 6,000 procedures.[1]
- In-hospital mortality was 2.8% at Korean centres doing more than 50 transplants a year, against 6.7% at centres doing fewer than 10.[2]
- Among 832 Korean living liver donors there were no donor deaths; major complications occurred in 1.9%.[3]
Why a liver transplant in Korea is usually from a living donor
In most Western countries a liver comes from a deceased donor and the patient waits on a list. In Korea, deceased organ donation is rare, so surgeons developed the living donor operation instead: a healthy relative gives part of their liver, and both livers regrow. Asan Medical Center reports this is why it became an extremely high-volume living donor centre, and that the approach substantially reduces waiting-list mortality.[1]
That matters for an international patient: a liver transplant in Korea does not depend on a national waiting list you cannot join, but on whether a family member is a suitable donor and whether you are well enough for surgery.
| Graft type | When it is used |
|---|---|
| Right liver graft | The usual adult graft. 82.1% of adult overseas recipients at Asan received one.[4] |
| Left liver graft | Smaller graft, when it is big enough for the recipient and safer for the donor |
| Dual graft (two donors) | When no single donor can safely give enough liver. 510 of the 6,000 Asan cases were dual-graft.[1] |
| Paediatric graft (segments 2–3) | Children; 312 of the 6,000 cases were in patients under 18.[1] |
What the published survival figures show
The Asan series covers 6,000 consecutive procedures between December 1994 and January 2021. In adults transplanted at age 50 or under, patient survival was 92.7% at 1 year, 85.9% at 5 years, 82.1% at 10 years and 70.9% at 20 years; in children, 92.9%, 89.0%, 88.1% and 81.9%. In-hospital mortality among adult recipients was 3.8%, and viral hepatitis-related cirrhosis was the reason for transplant in 69.8% of adults.[1] These are one very experienced team’s results, not a promise for any individual.
Hospital volume changes the risk
A national cohort study using Korean health insurance data covered all 7,073 adult living donor liver transplants at 50 Korean centres between 2007 and 2016. In-hospital mortality was 2.8% at high-volume centres (more than 50 liver transplants a year), 4.1% at medium-volume and 6.7% at centres doing fewer than 10. After adjustment, the odds of in-hospital death were more than twice as high at low-volume centres, and long-term survival up to nine years was also better at high-volume centres.[2]
That is the single most useful piece of evidence when choosing where to have a liver transplant in Korea: ask how many liver transplants the hospital performs each year, in writing.
Is it safe for the donor?
Donor safety is the main ethical question in living donation. The Korean Organ Transplantation Registry prospectively followed all 832 people who donated part of their liver between April 2014 and December 2015. There were no donor deaths. Overall complications occurred in 9.3%, biliary complications in 1.7% and major complications (Clavien grade III or above) in 1.9%, most often bile leak or duct narrowing. Six months after donation, average liver blood tests were back in the normal range.[3]
Complication rates differed by graft type and by how much liver was left behind, which is why donor assessment includes liver volume measurement on CT and is decided by the transplant team, not the family.[3]
Liver transplant for liver cancer
For hepatocellular carcinoma, transplant is considered only within defined selection criteria, because the cancer can return in the new liver. The 2022 KLCA-NCC Korean practice guidelines set out where transplantation sits among the options, alongside resection, ablation, radiation and systemic therapy.[5]
Korean centres have tested wider criteria. At the National Cancer Center Korea, 280 patients transplanted for hepatocellular carcinoma were assessed with FDG PET/CT and total tumour size; those meeting the criteria had 5-year overall survival of 85.2% and disease-free survival of 84.0%, against 60.2% and 44.4% beyond them.[6] Whether a specific tumour qualifies is a judgement the transplant team makes after imaging.
If liver cancer is the reason you are enquiring, our overview of serious illness treatment in Korea explains how these cases are staged, and our article on proton therapy in Korea covers one of the non-surgical options.
How international patients are assessed
Korean centres treat foreign patients under a published framework, not case by case. Between 2010 and 2019 Asan Medical Center transplanted 105 non-Korean patients — 3.1% of its living donor cases, most from the United Arab Emirates and Mongolia — using the same selection criteria as for Korean citizens. Overall patient survival was 96.2% at 1 year and 92.4% at 5 years.[4]
- Send records. Recent liver function tests, hepatitis serology, CT or MRI imaging and current medications.
- Identify a potential donor. Usually a healthy adult blood relative with a compatible blood group — most often sons and daughters for adult recipients, parents for children.[4]
- Specialist review. The transplant team decides whether transplantation is appropriate, or another treatment better.
- Work-up in Seoul. Donor and recipient assessment is completed in Korea before any decision to operate.
MEDIWIN is a foreign-patient facilitator registered in Korea and works with three Seoul university hospitals. We arrange the specialist review; the transplant decision is made only by the hospital team. A second opinion is the sensible first step if you want an existing recommendation checked.
Frequently asked questions
Do I need a family donor for a liver transplant in Korea?
In practice, yes. Korean transplant activity is overwhelmingly living donor, and a deceased donor organ is not a realistic route for a non-resident. Donors were most often the recipient’s own adult children, or parents for a child.[1][4]
What are the risks to my donor?
In the Korean national registry of 832 donors there were no deaths; major complications occurred in 1.9%, most often bile leakage or duct narrowing.[3] The donor is assessed independently and may be declined on safety grounds.
Can a liver transplant cure liver cancer?
In selected patients it treats both the tumour and the underlying cirrhosis, but recurrence is possible and eligibility depends on tumour size, number and biology under published criteria.[5][6] No team can guarantee a cure.
Considering a liver transplant in Korea?
Send your liver function tests, imaging and a short history. A MEDIWIN coordinator arranges review by a Seoul transplant team before you travel.
References
- Yoon YI, Kim KH, Hwang S, Ahn CS, Moon DB, Ha TY, Song GW, Lee SG. Outcomes of 6000 living donor liver transplantation procedures: a pioneering experience at ASAN Medical Center. Updates Surg. 2025;77:1777–1785. Updates in Surgery
- Yoo S, Jang EJ, Yi NJ, Kim GH, Kim DH, Lee H, Jung CW, Ryu HG. Effect of institutional case volume on in-hospital mortality after living donor liver transplantation: analysis of 7073 cases between 2007 and 2016 in Korea. Transplantation. 2019;103:952–958. Transplantation
- Lee JG, Lee KW, Kwon CHD, et al. Donor safety in living donor liver transplantation: the Korean Organ Transplantation Registry study. Liver Transpl. 2017;23:999–1006. Liver Transplantation
- Kim SH, Hwang S, Song GW, et al. Institutional standard framework and experience of living donor liver transplantation for overseas non-Korean patients at Asan Medical Center. Korean J Transplant. 2021;35:93–99. Korean Journal of Transplantation
- Korean Liver Cancer Association (KLCA) and National Cancer Center (NCC) Korea. 2022 KLCA-NCC Korea practice guidelines for the management of hepatocellular carcinoma. Clin Mol Hepatol. 2022;28(4):583–705. Clinical and Molecular Hepatology
- Lee SD, Lee B, Kim SH, Joo J, Kim SK, Kim YK, Park SJ. Proposal of new expanded selection criteria using total tumor size and 18F-FDG PET/CT for living donor liver transplantation in patients with hepatocellular carcinoma: the National Cancer Center Korea criteria. World J Transplant. 2016;6(2):411–422. World Journal of Transplantation
Written by MEDIWIN Medical Editorial Team, based on the published medical references listed above.
Medical review: Park Jin Heung, MD — review scheduled after publication.
This article is general information and not medical advice. Treatment decisions are made by the treating hospital’s transplant team. It does not describe results for any individual patient. MEDIWIN Co., Ltd. is a foreign-patient facilitator registered in Korea (No. A-2022-01-01-4465).