Sunday, May 30, 2010

Singapore becoming a liver transplant center

Many desperate patients faced with long wait lists at home with little hope of receiving their life-saving transplant before dying, decide to seek help elsewhere and Singapore is becoming a magnet for transplant tourism. This report notes that 28 foreigners traveled to Singapore for liver transplants last year.

By Salma Khalik AsiaoneHealth

SINGAPORE is gaining a name as a liver transplant center, with increasing numbers of foreigners coming here for the complex surgery.

A decade ago, such transplants were rare. Last year, 28 donor-recipient pairs came for such transplants - or more than one case every fortnight. The numbers were 27 in 2008 and 21 in 2007.

These patients came primarily from the region, but some were from as far away as the Middle East.

The bulk of these transplants were performed at two private hospitals under the Parkway Group: Gleneagles and Mount Elizabeth.

The cost was roughly $300,000.

A spokesman for Parkway said it expects more patients to come for complicated procedures like liver transplants, as Singapore establishes itself 'as a global and premier medical hub'.

The liver is the most difficult organ to transplant because of the intricate blood vessels involved. When the donor is alive, the case is even more difficult, since there is risk to both parties.

The risk to a liver donor is far higher than it is to someone donating a kidney, which is considered relatively safe.

Recipients also face risks. The first month is the most dangerous, when rejection or infection can occur. The Parkway Group claims a 96 per cent survival rate in the 30 days after the transplant.

Countries such as Australia and New Zealand are unable to perform live-donor liver transplants. They perform liver transplants using only dead donors. This was why the Western Australian government gave a young mother of two a A$250,000 (S$294,000) loan to come here for a transplant in March.

Ms Claire Murray had already had one cadaveric transplant done in Australia. But that failed within months. The authorities decided she was not eligible for a second cadaveric organ because of her predilection for drugs.

Her family then turned to Singapore. Although the transplant of part of her aunt's liver was successful, she died a fortnight later from a proliferation of blood clots.

Her doctor, Dr Jeyaraj Prema Raj, who operates at Mount Elizabeth Hospital, said the demand for such transplants is high, though some who want to come do not meet Singapore's stringent rules against organ trading.

He said he performed two transplants last year, but turned down four others for this reason.

'I turned them down as I felt the donors were unrelated and were 'bought',' he said.

This year, he has carried out four, turned down two, and has two lined up in the next two months.

Besides the 28 foreigners who came for new livers last year, eight Singaporeans had a new lease of life with part of a liver taken from a relative.

Another 17 people here received livers from dead donors last year, said the Ministry of Health.

At National University Hospital (NUH), the cost to a recipient - regardless of whether the liver is cadaveric or comes from a live donor - ranges from $60,000 to $100,000.

Any Singaporean can enjoy a subsidy of 50 per cent. Those less well off get a 65 per cent subsidy.

A hospital spokesman said: 'Over the past few years, we have seen an increase in the number of liver transplants, from nine cases in 2007 to 20 cases last year.'

NUH has carried out five adult liver transplants so far this year.

The hospital also performs a number of paediatric liver transplants, where the donated sliver of liver usually comes from a parent.

Last year, it carried out 11 transplants on children, up from seven in 2008.

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