Singapore’s National Pancreas Transplant Programme, the only one in Southeast Asia, is set to help more diabetes patients on insulin and dialysis.
Mr Md Halim Anuwar underwent a simultaneous kidney and pancreas transplant in June 2021, the first person to do so after the National Pancreas Transplant Programme (NPTP) was set up two months earlier.
With the double transplant, the Singapore General Hospital (SGH) patient recovered well and was discharged nine days after. The ambulance driver has returned to work.
“Mr Halim had immediate graft function following surgery, meaning that he did not require a single session of dialysis or insulin post-operatively,” said Dr Valerie Gan, Senior Consultant, Department of Urology, SGH.
Mr Halim had to inject himself with insulin every day for 20 years after he was diagnosed with type 1 diabetes at the age of 18. He later had to have regular dialysis when he developed end-stage kidney failure as a result of his diabetes.
Kidney damage occurs over time with diabetes. In type 1 diabetes, the pancreas does not make or makes very little insulin. In type 2 diabetes, patients become resistant to insulin.
The NPTP is an SGH-National University Hospital (NUH) collaboration following a pancreas transplant service pilot that began in 2012. During the pilot, five simultaneous pancreas-kidney transplants were performed on patients with type 1 or type 2 diabetes.
“Having been involved in the development and growth of the pancreas transplant service, I am glad to see it become a national programme. This is a timely addition to the range of transplant services that patients have access to. Patients in need of such a transplant will benefit greatly from the combined knowledge, skills and experience of the teams at NUH and SGH,” said Dr Gan, who is also Deputy Director of the NPTP.
Three types of pancreas transplants are available under the NPTP — pancreas alone, pancreas after a kidney transplant and simultaneous pancreas-kidney transplant. A simultaneous pancreas-kidney transplant is the only treatment to establish normal sugar levels in patients with diabetes, without the need for external insulin injections.
“It is now widely acknowledged that a simultaneous pancreas-kidney transplant improves quality of life and long-term survival, compared to current available medical treatment in patients with type 1 or certain type 2 diabetes and who are on dialysis,” said NUH’s Associate Professor Tiong Ho Yee, Director of the NPTP.
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With the NPTP, potential patients from all public hospitals can be identified and screened for pancreas transplant suitability. At the same time, the team will work on improving organ availability for transplant. Those on the wait list can expect to wait one to two years to receive a new pancreas, and only Singaporeans and permanent residents are eligible for subsidies under this programme.
Every year, some 19,000 people in Singapore are diagnosed with type 1 or type 2 diabetes. Diabetes is the number one cause of kidney dialysis in Singapore, accounting for about two-in-three new cases.
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