SINGAPORE: Singapore surgeons have successfully performed the country’s first simultaneous pancreas and kidney (SPK) transplant.
The team from the National University Hospital and Singapore General Hospital carried out the transplant last month on 29—year—old Shawn Huang, who was suffering from Type 1 diabetes and renal failure.
Mr Huang had been on insulin for more than 15 years and was on dialysis for more than a year.
He was then registered on the pancreas and kidney transplant waiting lists in August 2011.
With the transplant, Mr Huang is potentially cured of diabetes, especially Type 1.
"Without the donation, I wouldn’t have a new life because I’ll be living like a normal person from now on, just that I’ve to take the medication everyday. But this is nothing compared to injection and dialysis," said Mr Huang.
The five—and—a—half hour surgery at NUH was led by Associate Professor Krishnakumar Madhavan, Director of NUH’s Adult Liver and Pancreas Transplantation Programme.
He performed the operation with Dr Victor Lee, Director, Pancreas Transplant and Consultant, Department of General Surgery, SGH; and Dr Tiong Ho Yee, Director, Kidney Surgery and Transplantation, NUH.
Doctors say patients who undergo such a transplant have an expected five—year survival rate of more than 90 per cent, compared to 38 per cent without.
Associate Professor Krishnakumar Madhavan said: "Simultaneous pancreas kidney transplant is not going to impact a huge number of people in any country. But for these small number of people, the impact is tremendous because suddenly from a regular routine of dialysis and injecting insulin and looking after their blood sugars, they suddenly become independent of both these and have quality of life."
Being the first such surgery, Associate Professor Krishnakumar Madhavan adds the team had its concerns.
"About 15 to 20 per cent complications are inherent in this operation so that’s what worries us all the time. Bleeding is a problem and if bleeding is a problem, very often, one may have to go back within the first 24 to 48 hours, that means as well as the patient and the family concerned, doing yet another operation."
The two hospitals, along with the Ministry of Health, said on Thursday that the patient is recovering well and will continue to receive follow—up care at NUH.
A pancreas transplant provides a potential cure for diabetes, particularly Type 1, as well as improve the quality of life and reduce long—term diabetic complications such as kidney failure, blindness and stroke.
The transplant was supported by the government’s Health Services Development Programme, which promotes innovation and the adoption of advanced medical technology in public healthcare.
The main objectives of pancreas transplant are to help Type 1 diabetics to be insulin free, improve quality of life and reduce long—term diabetic complications.
It has been shown to prolong survival in patients with Type 1 diabetes and renal failure.
For Type 1 diabetic patients with kidney failure, SPK transplant requires only one surgery to cure diabetes and kidney failure.
Having both pancreas and kidney from the same donor will minimise the risk of rejection as both organs are of the same tissue type.
The pancreas transplant service is currently piloted in NUH with the collaborative surgical and medical pancreas transplant team from SGH and NUH.
The patients can go back to their original physicians at NUH and SGH for long—term follow up treatment.
SPK is one of three types of pancreas transplant.
It is for Type 1 diabetics who have end—stage renal disease requiring dialysis and may already be waiting for a kidney transplant in Singapore.
SPK will significantly increase their chances of survival.
With successful dual pancreas kidney transplant, there’s a 90—per—cent chance that patients can survive five years.
The second type of pancreas transplant is Pancreas after kidney (PAK) transplant — for Type 1 diabetics who had a successful kidney transplant, and intend to be insulin—free to avoid long—term diabetic complications
The third type is Pancreas transplant alone (PTA) — for those with significant diabetic complications or have life—threatening complications such as frequent and severe episodes of hypoglycemia (abnormally low level of glucose in the blood) or have hypoglycemic unawareness.
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