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Previously, if you needed to replace your heart valve with one from a human donor, doctors here would have to scour 70 homograft and heart valve banks worldwide. A homograft is a tissue graft from a donor from the same species — in this case, another human.

Finding a suitable tissue-matched, correct-sized valve and shipping it to Singapore could take between a few weeks and a few months.

Now, with the setting up of Singapore's first national heart tissue bank, patients can get a donated valve within a few hours.

The National Cardiovascular Homograft Bank (NCHB), established in February by the National Heart Centre, stores human heart valves and trachea tissue. By drawing from a local supply of heart valves, patients not only get timely treatment but also pay about $2,000 to $3,000 less.

A valve purchased overseas costs about $7,000. Singapore normally seeks valves from the United Kingdom, competing with their local demand. In total, a patient who undergoes a heart valve replacement and stays in a Class A ward in Singapore would pay about $28,000.

Dr Lim Yeong Phang, the medical director of the NCHB, said: "We hope to reduce the reliance on dwindling and expensive overseas sources in the long term, so that we can offer optimal and timely treatment to our patients. The lower cost of NCHB grafts also translates to lower healthcare costs to our patients.”

The heart centre sees up to 200 cases of heart valve replacements or repairs annually, with about 10 per cent needing a homograft. This small group of patients cannot opt for the cheaper and more available alternatives of a mechanical graft or a graft of animal origin.

They are usually born with congenital heart disease, have heart or vascular diseases caused by recurrent infections or dysfunctional valves that are either leaking or narrowed.

Dr Lim expects more patients to need homografts in the future. Many of these are adult congenital patients who were first treated in the '80s and whose original transplant valves no longer function properly, he said.

The bank has received funding of $1 million from the Ministry of Health (MOH) — to be spent over five years. So far, it has harvested eight heart valves, two of which have been used for treatment.

According to Dr Lim, there is a need to stock up the heart valve bank.

"We hope to get 20 to 40 more,” he said, noting that the Thailand heart valve bank stores 50 to 100 valves at any one time.

The centre is looking at harvesting the valves of all hospital deaths. Now it only gets valves from heart transplant patients and deceased donors, Dr Lim added.

Ms Sally Kong, senior manager of the MOH hospital services division, said: “The challenge is in counselling family members (of the deceased) to consider donation ... 
"A homograft requires an operation procedure of a couple of hours and has a surgical wound. The family has to be prepared for that.”


Source: Today © Permission required for reproduction.