NKTI ready for liver transplant program with gov’t support

FILE: National Kidney and Transplant Institute – formerly known as the National Kidney Foundation of the Philippines (NKFP), Quezon Avenue, and on Elliptical Road, Quezon City, circling the Quezon Memorial Circle. (Photo By Judgefloro – Own work, Public Domain)

MANILA – After more than 30 years since it first performed a liver transplant operation, an official of the National Kidney and Transplant Institute (NKTI) said it is ready to resume the transplant program with the help of the national government.

NKTI Executive Director Rose Marie O. Rosete- Liquete, in a recent position paper, said the lead government agency for organ transplantation is now ready, with the help of the Office of the President, to provide accessible liver transplantation to the Filipinos.

The NKTI, she said, used to have a liver transplant program but was not sustained, and she supports its revival.

“It is our thrust to gain back the trust and confidence of the patients who are now traveling abroad for liver transplant,” she added.

The first adult liver transplant at NKTI was performed in 1988. It is also the first hospital in Asia to perform a simultaneous kidney-pancreas transplant in 1988 and liver-kidney double transplant in 1990.

The first pediatric liver transplant at the hospital, wherein a mother donated a segment of her liver to her child, was performed in 1996 with the help of specialists from Kaohsiung Chang-Gung Memorial Hospital (KCGMH) of Taiwan.

“Unfortunately, we did not have the opportunity to sustain our liver transplant program due to lack of government support, financial reasons, refusal of family members to become living donors and lack of cadaver donors,” Liquete said.

For the past years, she added that Filipino pediatric patients have been going abroad for liver transplants, mostly in Taiwan, Hongkong and, recently India, but it is the NKTI that provides many of their post-operative follow-up and care.

“As of the present, we have more than 30 pediatric patients who were transplanted (with liver) abroad and have their post-operative laboratories (tests) done at NKTI,” she said. “We want to reinvigorate the liver transplant and revive the Pediatric Liver Transplant Program.”

Patients sent to India

With affordable medical services, hospitals in India have been a primary option for Filipinos who need to undergo liver transplant, especially children with biliary atresia.

As of January 2020, Senator Bong Go helped 46 children, who were provided assistance from the Office of the President for their families’ round-trip tickets and accommodation in New Delhi, India. Go also provided the families allowance for their food and basic necessities.

He has kept close contact with at least two of the patients’ families. One is 10-month old Dionifer Zephaniah Itao, whom he met when he visited fire victims in Cebu.

Dionifer, along with 11-month old Eren Arabella Crisologo, was sent to India in June 2019. However, unlike Eren, Dionifer’s operation was successful.

In October 2018, Go met Xia Kazumi Ngo at a gathering in Taguig City, and he helped her undergo the needed operation in India and has been in good health since then.

When Indian President Ram Nath Kovind visited the Philippines for five days in October 2019, he spent some of his time with at least 40 Filipino children who had successfully undergone liver transplant in his country.

Biliary atresia is a condition in infants in which the bile ducts outside and inside the liver are scarred and blocked. Bile cannot flow into the intestine, so bile builds up in the liver and damages it.

A recent study shows that biliary atresia occurs in approximately 1 for every 18,000 live births in Western Europe. In the world, the reported incidence varies from 5 to 32 for every 100,000 live births and is highest in Asia and the Pacific region. The cases in the Philippines cannot be determined because the country has yet to start its own registry.

“Maraming lumalapit, humihingi ng tulong para maoperahan ang mga bata. Namamalimos sila para maka-raise ng funding for the operation,” Go said.

He added that patients need not seek medical treatment abroad if we have the equipment, more specialists, and affordable transplant operation in the Philippines.

Government support

Go, in a recent consultation with health officials and practitioners, came up with short-term and long-term solutions to the problem that were presented to the President.

The short-term solution is to form a consortium composed of the Office of the President (OP), Department of Health (DOH), Philippine Children’s Medical Center (PCMC), and The Medical City (TMC), a private hospital.

The long-term solution involves acquiring equipment, developing the facilities of NKTI, and sending its specialist staff to Kaohsiung Chang-Gung Memorial Hospital (KCGMH) in Taiwan for training.

Under the consortium, the estimated budget for each beneficiary is PHP3.6 million, PHP2.9 million which will be spent on the operation at TMC while the rest will be for pre-operation and post-operation care at the PCMC.

The consortium takes advantage of an existing partnership between the PCMC and TMC and will last until NKTI is capable of solely performing pediatric and adult living donor liver transplantation.

The government will spend P58.1 million for the equipment that NKTI needs and P1.3 million for a batch of twelve specialists who will be trained for one to two months in Taiwan. Each specialist will have to serve at NKTI for two years in exchange for the training.

The long-term solution, which is expected to raise the standards of health care and uplift the morale of Filipino medical practitioners, also takes advantage of an established relationship between NKTI and KCGMH.