Curing the incurable

Breaking new frontiers to save lives with living liver donor transplants:

by Rosanne Koelmeyer Anderson in Singapore

With the increasing incidence of liver diseases in Asia today, there is a pressing need for liver donors and a critical shortage of cadaveric donor divers for transplant in the world, but now there is hope. The Living Donor Liver Transplant (LDLT) at Gleneagles Hospital Singapore, a member of the Parkway Group Healthcare (Pvt) Ltd., spearheaded by Dr. K.C. Tan, a renowned world specialist has paved the way for curing the incurable, by making liver transplants feasible for all patients.

The 2007 Liver symposium on Liver Transplantation in the 21st century at Gleneagles Hospital Singapore was held in Singapore recently in conjunction with the official launch of the Parkway Liver Centre which performs this highly complex procedure the (LDLT). There were many issues discussed related to liver transplantation, liver dialysis, management of acute liver failure and hepatitis B and C.

The Parkway Group Healthcare (Pvt) Ltd. in Asia is the largest private healthcare organisation with an extensive network of hospitals and integrated healthcare facilities in the region and has a International Patients Assistance Centre (IPAC), office in Sri Lanka and forty two other countries. Parkway Liver Centre at Gleneagles Hospital has a fully integrated treatment centre with seven ICU's.

(LDLT) offers new hope to both adults and children with end stage liver disease, providing them with an alternative to waiting sometimes indefinitely for a suitable cadaveric donor liver.

Some common diseases where transplantation may be considered include, chronic hepatitis B/C, Cirrhosis, Liver abscess, bile duct and gall bladder, cancer, pancreatic cancer, acute liver failure. Primary, Scierosing Cholangitis, Carolis Syndrome, Hepatocellular. Carcinoma, Wilson's disease and Fulminant Liver failure.

Presently yearly, thirty such (LDLT) procedures ae being performed at Gleneagles Hospital, and they expect to increase it to 50 such procedures yearly.

Dr. K.C. Tan, the world renowned Hepatobiliary Transplant of Gleneagles Hospital has performed about approximately 600 liver transplant operations and has many firsts to his credit.

In an interview with Dr. Tan as well as a donor and recipient (son and mother), it was evident that the living liver donor transplant had proved to be a success story of people who are bent on sacrificing their lives for the sake of another without looking back.

What is (LDLT) one may ask (LDLT) is a procedure in which a diseased liver is replaced with a segment of liver from a healthy human donor usually a sibling or close family member.

During LDLT two team of doctors will perform the donor and recipient operations almost simultaneously, and about half the liver will be retrieved from the living donor.

Once the diseased liver is removed from the recipient, the liver graft that was retrieved earlier is implanted. Both halves of the liver will regenerate and grow to full size in four to six weeks.

This simultaneously performed operation takes eight to ten hours respectively. After the operation the donor is nursed in the intensive care unit for 24 hours and should be out of bed with assistance after two to three days and should be able to resume most light chores and activities within a month.

The donor is not given dietary restrictions but will be prescribed vitamins for a few months, as explained by Dr. Tan.

The recipient is however expected to stay in hospital for a longer period, usually three to four weeks, initially in the intensive care unit and later in the surgical ward during which time he will be monitored for infection, rejection and regeneration of the transplanted liver.

To facilitate this intricate procedure the hospital is well-equipped with the latest state-of-the-art medical equipment as well as a highly experienced medical team.

Dr. Paul Joseph Thuluvath, Chief of Hepatology and Medical Director for Liver Transplantation, and Director of Liver Research John Hopkins University School of Medicine, USA, Associate Prof. Lee Kang Hoe, Consultant Physician, Pulmonologist and Intensivist, Gleneagles Hospital, Dr. Desmond Wai Chun Tao, Consultant Transplant Hepatologist and Gastroenterologist and many distinguished specialists addressed the sessions.

Two leading Sri Lankan doctors Dr. Kemal Kamardeen, member of the American Society of Colon and Rectal Surgeries colorectal surgeon and Dr. Shiraz Hassan gastroenterologist, medical and consultant physician also participated at the symposium.

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