Number of patients waiting for liver transplant triples

By Melissa Pang, The Straits Times, 25 Jun 2012

THE number of patients waiting for a liver transplant has nearly tripled over the last five years.

There were 24 such patients on the waiting list last year, up from just nine in 2007, said the Health Ministry.

While the figure may seem relatively low, an average of about seven patients die each year waiting for a liver transplant over the same period.

Hepatitis B, said doctors, remains the most likely reason for patients needing a liver transplant, but they have also noted a marked increase in cases where patients suffered from fatty liver and liver cancer.

Associate Professor Krishnakumar Madhavan, of the National University Hospital (NUH), attributed the growing waiting list to greater awareness among doctors of the effectiveness of liver transplants.

The public is also more aware and open to liver transplants because of educational campaigns organised by the Society of Transplantation (Singapore), said the head of and senior consultant with the hospital's hepatobiliary and pancreatic surgery division.

NUH performed 14 liver transplants last year, up from just four in 2005.

At the Singapore General Hospital (SGH), the only other public hospital that carries out liver transplants, there was an average of 10 such operations between 2005 and last year.

Associate Professor Tan Chee Kiat, director of SGH's liver transplant service, said the low number of cadaveric liver transplants could have contributed to the growing waiting list.

The average waiting time for a cadaveric liver at both hospitals is five to six months.

Dr Salleh Ibrahim, a liver surgeon with the Asian Centre for Liver Diseases and Transplantation, said there is still a lack of knowledge on the importance of organ donation.

There is still a perception of death being associated with the heart beating, he added, which makes it difficult for family members of brain-dead patients to agree to organ donations.

There are several causes of liver failure: Hepatitis B and C, fatty liver, and liver cancer - the fourth-most common cancer among Singapore men.

Dr Dan Yock Young, senior consultant in NUH's department of gastroenterology and hepatology, noted a doubling in the number of patients with liver cancer from the period between 1999 and 2006, to the period between 2007 and last year.

Prof Madhavan said more fatty livers, a condition that has no symptoms, are also being diagnosed now.

Although its data has not reflected it, the Health Ministry said yesterday that fatty liver 'is likely to become a main cause of chronic liver disease, following the trend of Western countries where obesity increases to epidemic proportions'.

Diabetics are at higher risk of developing fatty livers, said Dr Salleh. The number of such cases being diagnosed is concurrent with the rate of diabetes in Singapore.

Six years ago, field service engineer Mohamed Eusoph, 39, donated 60 per cent of his liver to his mother, Madam Hatheejal Beevi, 66, when she was diagnosed with liver failure.

'We decided to go ahead because, given my mother's age, we were not confident of being prioritised for the waiting list.'

But the family have absolutely no regrets, having seen their mother 'on the brink of death and back'.