S'pore girl with rare liver disease gets organ donation from unknown 'uncle'

PHOTO: S'pore girl with rare liver disease gets organ donation from unknown 'uncle'

SINGAPORE - He has never met her, yet he went under the knife on Wednesday so that a 10-year-old child will have a chance to live a normal life.

The 'mystery' man is the second person in Singapore to donate part of his liver to a total stranger. The first, cabby Tong Ming Ming, volunteered part of his organ to civil servant Toh Lai Keng in March last year.

Phyllis Poh, a Primary 5 pupil at Bedok Green Primary School, found a donor after her older brother, Skye, expressed a wish to The Straits Times in November that someone would give an organ to her. Two men came forward, and one of them, who is in his 40s, was a match.

Skye, 12, himself had a liver transplant from his mother in February last year. He went on to complete his Primary School Leaving Examination (PSLE) the same year, though he missed months of school.

The siblings required new livers because they cannot produce a critical enzyme due to a genetic condition called glycogen storage disease.

The enzyme is needed to break down glycogen - the body's store of sugar. Without it, the glycogen simply accumulates in the liver, where it is stored. This often results in the liver swelling.

The body also cannot use the glycogen to regulate the blood-sugar level, and this affects physical and neurological growth.

That is why the siblings had always been the shortest in their classes.

Tumours in the liver

Need for transplant

Because of the condition, they cannot take white sugar and need a regular feed of uncooked starch, such as cornstarch - which they take mixed with water at night before sleeping.

The accumulation of unused glucose in the liver can also cause patients to develop tumours there in their teens, which could become cancerous.

After doctors found two small tumours in Skye last year, it made the need for a transplant - which would provide him with the missing enzyme and normalise his development - more acute.

His mother, Madam Joanne Ng, a 36-year-old housewife, gave him part of her liver.

She could not also donate part of her liver to Phyllis, much as she wanted to. Their father, who operates a food stall, is not a match.

Skye found himself in the news when the PSLE results were released, and he took the chance to voice his wish for his sister to find a donor.

Liver transplants from living donors are not as common as kidney transplants, as they carry a higher risk. Last year, there were 12 living liver donors here, compared with 34 for kidney.

A very excited Phyllis said: "I want to meet the uncle and say thank you and wish him a speedy recovery."

Under organ transplant rules here, the donor and recipient cannot meet before the transplant, but both parties have said they would like to meet, and will likely do so after they have recovered from surgery.

Before being admitted to hospital ahead of her operation, Phyllis made him a card covered with stickers that she treasures specially because "you have given me part of your precious liver".

She entered National University Hospital (NUH) on Monday to prepare for surgery. Her fear was soothed by a thorough briefing from Skye, so she said she is only "a little scared".

But more than that, the little girl, who because of her disease is shorter than her healthy seven- year-old sister, is looking forward to a more active life - like that which Skye now enjoys.

Skye has grown by more than 10cm since his transplant last year.

She said: "I'm so very grateful that Singaporeans have such big hearts, to come forward like this."

Unlike kidney donation which is considered very safe, liver donation carries a higher risk of complications to the donor of 10 to 15 per cent, according to international figures, and the risk of death or a serious problem of 1 per cent.

A spokesman for NUH said the hospital has done close to 50 living donor liver transplants and "we have not had any deaths or serious complications".

Dr Alfred Kow from the National University Centre for Organ Transplantation led the team to get the liver, and Professor K. Prabhakaran, head of paediatric surgery at NUH, transplanted the liver into Phyllis.

Mystery liver donor 'recovering well'

The mystery man is understood to be recovering well after the operation.

Dr Alfred Kow, who was in charge of operating on the donor, said the six-hour operation went off smoothly, but the man will need to be closely monitored over the next few days.

But for Phyllis Poh, who received the liver in an eight-hour operation, the next 72 hours will be especially critical, said Professor K. Prabhakaran, who operated on her.

"The surgery went well, with no major issues," he said on Thursday night.

Both operations took place at National University Hospital - the national paediatric transplant centre here.

A spokesman said NUH has done close to 100 living donor liver transplants with no serious complications since 1990.

Professor Quak Seng Hock, head of paediatric gastroenterology at NUH, has been looking after Phyllis and her 12-year-old brother Skye, who had his own liver transplant last year. He said the road to recovery could last as long as a year.

Following her transplant, Phyllis would need to stay on immunosuppressant drugs to prevent rejection of the liver.

After the first six to 12 months, the dosage of the drugs will be reduced.

But until then, she would be susceptible to infections and would have to avoid crowds and wear a mask for the first few months, he explained.

If all goes well, Prof Quak added, "she is expected to be able to attend normal school and take part in normal school activities".

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