Singapore rolls out first national pancreas transplant service in South-east Asia

The national programme was approved by the Ministry of Health in April, making Singapore the only South-east Asian country with a pancreas transplant service. PHOTO: NATIONAL UNIVERSITY HOSPITAL

SINGAPORE - Patients who need a pancreas transplant will now be placed on a national wait list to get the operation, with Singaporeans and permanent residents eligible for subsidies under a new national programme.

This will ensure that potential patients at all hospitals are identified and screened for pancreas transplant suitability. Those on the wait list can expect to wait around two years to receive a new pancreas.

This organ produces insulin, a hormone that helps control blood glucose levels.

For severe diabetics who do not produce sufficient insulin, a pancreas transplant can improve their quality of life and reduce long-term diabetic complications such as kidney failure, blindness and stroke.

After a successful transplant, the pancreas should be able to produce sufficient insulin to control the patient's blood sugar.

The national programme was approved by the Ministry of Health (MOH) in April, making Singapore the only South-east Asian country with a pancreas transplant service.

The National University Hospital (NUH) and Singapore General Hospital (SGH) transplant units first collaborated on a pilot pancreas transplant service in 2012.

A pancreas transplant is most commonly performed with a kidney transplant - known as simultaneous pancreas-kidney (SPK) transplant, Associate Professor Tiong Ho Yee, director of the National Pancreas Transplant Programme, told the media on Saturday (Dec 11).

He explained that diabetes is a major cause of kidney failure.

An SPK transplant improves the quality of life for diabetic patients compared with a kidney transplant alone, as they will no longer need to take regular insulin injections or undergo dialysis treatments, Prof Tiong said.

"This is the only treatment to establish normal sugar levels in patients with diabetes without the need for external insulin injections," said Prof Tiong.

One SPK transplant has been performed since April, while four such operations were successfully carried out during the pilot. The national programme also offers pancreas-only transplants and pancreas after kidney transplants.

About 19,000 people here are diagnosed with diabetes each year.

According to the Singapore renal registry annual report 2019, diabetes is the number one cause of kidney failure here, accounting for about two in three new patients needing dialysis.

Speaking at an event to mark World Diabetes Day on Nov 14, Health Minister Ong Ye Kung said one in three individuals in Singapore is at risk of developing diabetes in their lifetime.

"If nothing is done, by 2050, it is estimated that about one million Singaporeans will be living with diabetes," said Mr Ong.

Only Singaporeans and permanent residents are covered by the national programme, and eligible patients will benefit from MOH subsidies for the transplant operation, which will be carried out at NUH in the next two years.

Without the subsidies, patients may have to fork out around $80,000.

Mr Halim Anuwar was the first to undergo an SPK transplant under the national programme in July this year.

Dr Valerie Gan, Deputy Director, National Pancreas Transplant Programme, speaking with Mr Halim Anuwar. PHOTO: SINGAPORE GENERAL HOSPITAL

The 39-year-old ambulance driver, who began dialysis treatments in early 2020, said: "It was shocking and unexpected to receive the call from NUH that I could undergo the transplant."

He added: "I'm recovering well now and in fact, I'm back at work. I no longer have to attend dialysis treatments and can now lead a normal life."

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