'I have been given my life back': Double transplant patient

SINGAPORE - Mr Shawn Huang, 29, is the first person in Singapore to receive a new kidney and pancreas in a simultaneous 51/2 hour transplant here on Sept 13.

Mr Huang suffered from Type 1 diabetes since he was 14. His kidneys failed in April and he had to go on dialysis.

"I was thirsty all the time and was drinking a lot of water then," he said. It was finally diagnosed when he went for a medical check-up.

"Every night I had to rush home to do dialysis. This was on top of injecting myself with insulin every morning and evening," he said.

Mr Huang was using peritoneal dialysis, where a special sterile fluid is introduced into the abdomen through a permanent tube in his peritoneal cavity.

This fluid circulates to draw impurities from surrounding blood vessels in the peritoneum, and drains them from the body.

Feeling tired all the time because of his condition, and the fact that he had to reach home at a certain time at night to do the dialysis, Mr Huang quit his job in sales and became a student at a private school.

It was his youth, the type of diabetes and his kidneys failing that made him the perfect candidate for the first kidney-pancreas transplant.

He said: "I was sleeping when I got the call that they had found a donor and I was to be the first to receive both kidney and pancreas. I thought I was dreaming."

It has been 35 days since his landmark surgery and Mr Huang said apart from taking his three types of medication, he no longer needs insulin shots or dialysis.

"It's like a rebirth. I have been given my life back and I have the donor, his family and the doctors to thank," he said.

S'pore's 1st pancreas + kidney transplant

S'pore's 1st pancreas + kidney transplant

The operation last month on Mr Huang gave him a second lease of life.

Teams from both the National University Hospital (NUH) and Singapore General Hospital (SGH) carried out the 51/2 hour transplant.

They were led by Associate Professor Krishnakumar Madhavan, who heads NUH's Adult Liver and Pancreas Transplantation Programme.

Others in the multidisciplinary team of doctors, nurses and transplant coordinators include Dr Victor Lee, who heads Pancreas Transplant at SGH; and Dr Tiong Ho Yee, director of Kidney Surgery and Transplantation at NUH.

The pancreas, a gland organ located behind the stomach, produces enzymes to break down food, and hormones like insulin to regulate the body's sugar level.

Last month's transplant surgery is a pilot programme funded by the Health Ministry's Health Services Development Programme (HSDP) to the tune of $2.7 million. It is currently set up in NUH with the collaborative surgical and medical pancreas transplant team from SGH and NUH.

HSDP, set up by the government as a funding platform for new clinical services piloted here, sets aside $15 million every year as financial support.

The grant given to the new National Pancreas Transplant Programme is targeted for five years, from this year till 2017.

The latest data available on Type 1 diabetes - from 1999 to 2006 - showed there were 98 patients suffering from end-stage kidney failure.

Dr Lee said of these patients, 64 have since died, three underwent kidney transplants and the rest, as of 2008, were on dialysis.

Professor A Vathsala, head of the Division of Nephrology and of the Adult Renal Transplantation Programme at NUH, said there are 465 patients on the kidney transplant waiting list.

She said: "Out of these, 45 are diabetic and we are conducting tests to see how many could be sustained with simultaneous pancreas and kidney transplant."

A pancreas transplant provides a potential cure for Type 1 diabetes, improving the quality of life.

Selection criteria

Selection criteria

But there is a selection criteria for both donor and recipient.

Dr Tiong said the donor, currently only cadaveric, must be between 12 and 55 years old, must not be suffering from diabetes or any diseases and must be slim.

Potential recipients are those with Type 1 diabetes and end-stage kidney failure.

The simultaneous pancreas and kidney transplant is the most common of three types of pancreas transplant, targeted at Type 1 diabetics who have end-stage renal failure requiring dialysis. The other two transplants are implanting a pancreas after the kidney had been transplanted earlier and a pancreas transplant alone.

Prof Madhavan said simultaneous pancreas and kidney transplant is picked as it significantly increases their chances of survival.

There is a 86 per cent chance that the patient can survive for the next five years. Dr Lee added: "The transplant patient will also live 10 years longer than a patient given a new kidney alone."

The cost for the first simultaneous pancreas and kidney transplant is between $80,000 and $100,000 and The New Paper understands this was largely funded by the Ministry of Health.

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