18 Apr 2010
With its growing expertise and extensive clinical facilities, the SGH Campus has gained a strong reputation as Singapore’s transplant hub for vital organs
THE Singapore General Hospital (SGH) achieved medical breakthroughs last year, with the successful completion of complex transplant surgeries.
Last July, surgeons removed a kidney from a 75-year-old woman, Singapore’s oldest living donor and gave it to her daughter, aged 46.
In April last year, heart and liver surgeons from SGH and the National Heart Centre Singapore collaborated to complete Asia’s first combined heart and liver transplant, with the recipient getting replacement organs from a deceased donor.
In 2001, SGH hit the headlines when it performed the world’s first case of cord blood transplant for a patient with thalassaemia major, a blood disorder.
These are among the reasons why the SGH Campus, comprising SGH and the national centres for heart, cancer, neuroscience, eye and dental care in the SingHealth group with more than 40 clinical specialties, has gained a solid reputation as Singapore’s transplant hub.
The well-known medical hub at Outram Road made history in 1970 when Singapore’s first kidney transplant was carried out, and this was followed by transplant of the heart in 1990 and the lung in 2000.
Cornea transplant was first performed in 1962 while liver transplants have been available since 2006.
Professor Ang Chong Lye, assistant chief executive officer of SingHealth, says: “Historically, this is the place to do all these transplants, so we are able to congregate a huge mass.
“We do enough where the learning curve of the surgeons is comfortable and when the opportunity comes, they can do more complicated cases.”
An organ transplant is a multidisciplinary effort and all the needs of the recipients and increasingly, living donors, are cared for holistically.
Besides the surgeons and physicians, the patients are also attended to by transplant coordinators, allied health professionals for post-transplant rehabilitation and specialists from other clinical disciplines, says Prof Ang.
“Quite often, the patients will catch infections, so infectious diseases experts will come in. If it involves tissues, then even the pathologists.”
Medical social workers are also roped in to provide psychosocial and financial support.
“For living donors, we will do a psychosocial assessment of the family background, finances, motivation and expectation of both recipients and donors. We will then submit a detailed report to the transplant ethics committee to deliberate whether the transplant can proceed,” says senior principal medical social worker Crystal Lim
Augmenting these are specific post-transplant care and facilities to ensure the best outcome.
“The patients need to be cared for in a very special manner, so we dedicate even an intensive care unit or other very important clinical support facilities for them. Like special rooms for liver patients, so they’re protected in the immediate aftermath of surgery,” explains Prof Ang, who is also the CEO of SGH.
The Human Organ Transplant Act allows the removal of the heart, liver, kidneys and corneas for transplant, and the law is applicable to all Singaporeans and permanent residents above age 21.
Singapore has medical teams on standby round-the-clock that can be activated quickly to remove usable organs from dead donors, says Prof Ang.
“If we don’t do the harvesting within a certain time, then the tissue is not suitable. So there is always a rush to make sure that after declaring a person brain dead, you need to react within a certain amount of time.”
A heart has to be transplanted within four hours while a recovered liver must be used within 12 hours. Kidneys have up to 24 hours while corneas can be stored for up to two years.
Besides cadaveric donors, more people are coming forward to be living donors for their loved ones who suffer from organ failure. Prof Ang attributes the trend to increasing public awareness.
“Because of education, there is less fear. Because of technology and skills, and the support that we give to the patient is much more robust, people are more willing,” he says.
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