Liver transplant in Singapore--coming of age.
OBJECTIVE
Liver transplantation was first performed in 1967, and has become an accepted form of treatment worldwide for chronic liver diseases, acute liver failure and certain metabolic diseases. We document our experience in Singapore over the last 7 years since the first transplant was performed in 1990.


METHODS
Retrospective study at National University Hospital, Singapore.


RESULTS
Twenty-two operations (10 paediatric and 12 adults) have been performed with the last 17 having been performed in the last 17 months. Currently, there are 15 survivors (68%) since 1990, and percentage survival is even better if one considers the cases from the last 17 months when the majority of cases (17 transplants-77%) were performed (77% survival). The most common indication for transplant was biliary atresia for the paediatric group, while the adults were transplanted for hepatitis B and C cirrhosis, primary biliary cirrhosis, and fulminant liver failure. Tacrolimus is the main immunosuppression (10 patients), with the remaining 5 patients on cyclosporine. Various surgical techniques (living donor, graft reduction) have been employed successfully to provide a complete transplant service. Hospital and ICU stays are within normal limits and the hospital charges range from a low of S$30,000 to S$141,000.


CONCLUSIONS
Liver transplantation has become a reality in Singapore with outcomes comparable to other transplant centres. The shortage of donors remains the greatest stumbling block for further expansion.
Lee
K H
KH
Department of Medicine, National University Hospital, Singapore.
Lo
S K
SK
Quak
S H
SH
Prabhakaran
Tan
K C
KC
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D005260:Female; D017048:Health Care Costs; D006801:Humans; D015994:Incidence; D007223:Infant; D007902:Length of Stay; D008107:Liver Diseases / Q000453:epidemiology / Q000601:surgery; D016031:Liver Transplantation / Q000009:adverse effects / Q000191:economics / Q000401:mortality / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012846:Singapore / Q000453:epidemiology; D014019:Tissue Donors / Q000600:supply & distribution; D016896:Treatment Outcome