It allows people to donate organs to those with incompatible blood groups
By Kash Cheong, The Straits Times, 29 Nov 2014
By Kash Cheong, The Straits Times, 29 Nov 2014
POLYTECHNIC student Mohamed Zarif Maarof was 18 when he found out he had kidney disease. That was in 2012.
"I was shocked, I used to run and play soccer so I thought I was healthy," he said.
The teenager had to give up evening outings with friends so he could be home by 8pm for his daily dialysis sessions.
His sleep was often disrupted because he had to attach a tube to his stomach to allow for water dialysis throughout the night.
His father, Mr Mohamed Maarof Ghani, a supermarket branch manager, said: "It was no way for a teenager to live. He still has a bright future."
The 49-year-old decided to donate a kidney to Zarif but their blood groups are incompatible.
However, thanks to a procedure called an ABO-incompatible transplant, Mr Maarof was able to donate a kidney to save his son in April.
Zarif was 19 when the transplant was carried out at the National University Hospital (NUH), making him the youngest person in Singapore to have gone through this procedure. He is now 20.
A week before the transplant, Zarif had to be hooked up to a machine which got rid of certain anti-bodies in his blood.This helped reduce the risk of the new kidney being rejected, said Professor A. Vathsala, co-director of the National University Centre for Organ Transplantation at NUH.
"Zarif was our youngest patient, so we were concerned that the rejection... could be particularly strong as younger patients usually have better immune systems," said Prof Vathsala.
The transplant went well but Zarif still had to be treated to suppress his immune system after the procedure to prevent rejection.
NUH has done seven such transplants since 2009, including that for Zarif.
The Singapore General Hospital (SGH) has carried out 11 of these transplants in five years, including one for a 62-year-old patient, its oldest to go through the procedure. Mount Elizabeth Hospital has done at least 10 of these transplants and Gleneagles about five of them.
Most ABO-incompatible transplants done locally have been successful.
"Some patients have returned to their usual jobs and one is even trying for a baby," said Dr Terence Kee, director of SGH's renal transplant programme.
Doctors hope more patients can have ABO-incompatible transplants for a better quality of life.
There are more than 400 kidney disease patients waiting for a new organ, although not all of them may be suitable for ABO-incompatible transplants, doctors say. Also, some do not want to attempt such transplants, fearing the higher risk of rejection.
The chance of a patient rejecting organs from an ABO-incompatible transplant is 10 per cent, while it is 5 per cent for a normal transplant, said Dr Vathsala. "But if we pick up signs of rejection early, we can treat them," she added.
Patients might also have to be on life-long medication to suppress their immune systems, which may make them more susceptible to infections. But doctors try to prescribe drugs to counter this.
Also, patients may be put off by the higher costs. An ABO-incompatible transplant may cost $50,000 more than a normal one, Dr Vathsala said.
For instance, Mr Maarof's bill came to more than $100,000. But with insurance, he paid only $11,000 from his Medisave and $6,000 out-of-pocket expenses.
It was money well spent for Mr Maarof, who said: "My son can go back to having a life, and that is priceless."