Singaporean feels 'reborn' after double transplant

Photo above: Mr Shawn Huang with Ms Manjit Kaur, assistant director of clinical transplantation at NUH, who advised and counselled him during the process.

SINGAPORE - A Singaporean man who has been diabetic half his life became the first in the country to get not only a pancreas transplant, but also a new kidney at the same time.

Doctors from National University Hospital (NUH) and Singapore General Hospital (SGH) operated last month on Mr Shawn Huang, 29, who described himself as "reborn".

The student, who was diagnosed with Type-1 diabetes when he was 14, used to need insulin injections every day.

And last April, with both kidneys failing, he had to be put on peritoneal dialysis - where a dialysis solution is placed in his abdominal cavity through a catheter.

This he did for 10 hours every night, at home.

The soft-spoken man said he thought he was dreaming when he learnt that the surgery had been successful. "I can live like a normal person from now on."

Such double transplant surgery is not new in other countries, where it has been around since the late 1970s.

But it was only in the last five years that the concept gathered steam here as the Government provided funding and more doctors became convinced of its benefits.

More than 90per cent of those who have a pancreas-kidney transplant live for another five years at least, compared to 38per cent for those who do not, said Dr Victor Lee, who heads SGH's pancreas transplant programme.

Both of Mr Huang's new organs were harvested from the same dead man - who was in his 40s - before the operation, which took less than six hours.

But because the pancreas is not included under the Human Organ Transplant Act - which covers the heart, lungs, liver and corneas - special permission had to be sought from the dead man's kin.

"I have to thank the donor and his family for giving me a new life," said Mr Huang, who is also the first person in Singapore to have a pancreas transplant.

Among the factors that delayed the use of such transplants here was the medical community not being entirely sold on the idea, said Associate Professor Krishnakumar Madhavan, who heads NUH's hepatobiliary and pancreatic surgery division.

"Many people needed to be convinced this was a good thing to have, even the professionals," he said.

"They had to be made to think out of the box."

Figures show that from 1999 to 2006, there were only 95 diabetics here also suffering from kidney failure, added Dr Lee.

Professor A. Vathsala, who heads the division of nephrology at NUH, said another barrier is the low number of organ donors.

"We couldn't anticipate starting this programme earlier because the organ donation rate in the country has not been among the highest in the world," she said.

Countries such as the United States boast some 40 donors per million population, while the rate here is only about 6.5 per million.

The availability of Ministry of Health funding also helped to make Mr Huang's operation possible.

Some $2.7 million has been set aside for a national pilot programme for pancreas transplants, set up last year at NUH. This amount is slated to last until 2017.

Mr Huang's operation was partly covered by this programme.

Before this, double-transplant operations of this kind - which are estimated to cost between $80,000 and $100,000 - were unavailable here.

Both hospitals are now working to identify who else would benefit from a similar procedure.

Doctors expect up to four such patients to qualify every year.

With the transplant, Mr Huang is potentially cured of his Type-1 diabetes, a condition by which the body cannot produce any insulin at all as the pancreas no longer works properly.

Most diabetics here have the Type-2 form, whereby the body becomes less sensitive to insulin.

He no longer needs insulin injections or dialysis, which he found "very inconvenient".

He is now on lifetime medication to prevent his body from rejecting the organs.

"I have to take pills but this is nothing compared to injections and dialysis every day."

chpoon@sph.com.sg


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