Why do Philippines liver transplant patient travel to India and other country for liver transplant?

1.)    Lack of Liver Transplant surgeon in Philippines

2.)    Lack of facilities

3.)    Cost

The rates of deceased donor organ donation in Asia, and in particular the Philippines, are far lower than those in the United States and Europe. The graft shortage is often the result of cultural and religious barriers, inefficiency of government funding and support, and the low acceptance of brain-death due to poor information.

The development of living donor liver transplantation (LDLT) in the Philippines, similar to other countries in Asia, was driven by the limited deceased organ donation and a response to the growing demand for the option of liver replacement.

In LDLT, the partial liver graft is taken from a healthy individual (donor) and is usually the patient’s parents, sibling or relative. Therefore, donor safety, altruistic intent, and informed consent are paramount in any LDLT operation.

The first liver transplant (LT) in the Philippines was performed on August 6, 1988. The graft came from a deceased donor (brain-dead donor)

The first pediatric LDLT was done on April 12, 1996 in a biliary atresia patient. This mother-to-child LDLT operation was performed by Prof. Chao-Long Chen, a pioneer LT surgeon from Taiwan, upon the invitation of Dr. Enrique T. Ona. After a long hibernation, renewed enthusiasm in LT in the country was rekindled with a successful pediatric LDLT   on January 7, 2011.

According to the latest WHO data published in 2018 Liver Disease Deaths in Philippines reached 7,491 or 1.23% of total deaths. The age adjusted Death Rate is 9.88 per 100,000 of population ranks Philippines #128 in the world. Review other causes of death by clicking the links below or choose the full health profile

According to the latest WHO data published in 2018 Liver Cancer Deaths in Philippines reached 7,500 or 1.23% of total deaths. The age adjusted Death Rate is 10.48 per 100,000 of population ranks Philippines #37 in the world. Review other causes of death by clicking the links below or choose the full health profile

Cardiac Profile of Filipino Patients with Liver Cirrhosis: A 10-Year Study

Cardiac complications among patients with liver cirrhosis have not yet been described among Filipinos. Cirrhotic cardiomyopathy is a rarely described complication that has not been extensively described in literature. This is the first study to describe the electrocardiographic and echocardiographic findings of Filipino patients with liver cirrhosis.

PH must act to eliminate hepatitis - WHO

Chances are someone in your family is infected with hepatitis virus, but might not be aware of it. In the Philippines, around one in 10 people have chronic hepatitis B, and six in 1,000 have chronic hepatitis C. Hepatitis is a huge public health concern in the Philippines, but due to lack of awareness, many of those who have this viral disease may not even know they have it until it’s too late.

Hepatitis is a silent killer. Caused by a virus that has no symptoms, it quietly damages the liver for decades before ending in liver cancer and cirrhosis (scarring of the liver that reduces its ability to detoxify blood). Deaths due to hepatitis have increased over the past two decades, with 1.4 million lives lost every year. But many leaders and members of the public are still not well-informed about the disease.

Without proper care, the two most common types of hepatitis—B and C—cause about 60 percent of liver cancer. This is why liver cancer is one of the top causes of cancer deaths in the Philippines.

Any deaths from preventable diseases are unacceptable, and hepatitis is no exception. Nowadays, we can prevent and treat the disease. Hepatitis B vaccine is highly effective when the first dose is given to babies within 24 hours of birth and followed up with two further doses. People living with chronic hepatitis B can be treated with highly effective medicines to stop the disease from progressing and reduce the risk of it developing into liver cancer. People with hepatitis C can now be cured within three months by taking new oral medicines called direct acting antivirals. However, many people with hepatitis do not know they are infected and thus do not seek treatment.

To eliminate this deadly disease, the Philippines must invest in hepatitis testing and treatment services. Aside from a program like this being the right thing to do for people’s health, it is also a very wise investment, as it saves money by avoiding much more costly care for liver cancer and cirrhosis.

Globally, we are aiming to reduce new viral hepatitis infections by 90 percent and deaths from chronic hepatitis by 65 percent by 2030, from the baseline of 2015. To reach that goal in the Philippines, hepatitis services must be covered by the Philippine Health Insurance Corporation (PhilHealth) much like it covers outpatient HIV/AIDS treatment.

The Philippines must also continue to strengthen the hepatitis B immunization for infants and adults. Current estimates indicate only 50 percent of newborn infants are administered with the hepatitis B birth dose within 24 hours after birth. The hepatitis B vaccine is a cost-effective measure to prevent hepatitis B. Those who have completed their immunization schedule are likely to be protected for at least 20 years, and probably longer.

Another vital action is to improve awareness of the problem. Put simply, if people don’t know about hepatitis, they won’t avoid infection or seek testing and treatment. Instead, their health will be damaged and they may be unwittingly infecting others. In some countries, misunderstandings about hepatitis have led to stigma and discrimination toward people living with the disease, meaning that people may be less likely to seek the life-saving treatment they need. Lack of awareness about the health impact of hepatitis also means not enough resources are allocated to tackling the disease.

We are supporting the Department of Health in translating commitments to reality, such as a high-impact project launched this year in Bataan and some parts of Metro Manila to integrate hepatitis services at the primary care level and strengthen referral systems. We are also providing technical assistance to the DOH in developing treatment guidelines, information, education and communication strategies, the development of training materials and a PhilHealth package for viral hepatitis.

But this is just a start; a lot more needs to be done. It’s not only the DOH’s job to eliminate hepatitis in the Philippines, we all have a role to play. So, on World Hepatitis Day tomorrow, July 28, I call on everyone to be more proactive in fighting hepatitis. Make sure your children and other kids in your community get fully vaccinated. Educate yourself and others about the risk of viral hepatitis and how to get tested. If you have been diagnosed with hepatitis, speak with a health worker about your treatment. Join local advocacy events to increase awareness in your community, and show your support for more investment toward eliminating the disease.

Let’s work together to eliminate hepatitis

A team of 36 doctors were involved

It was a free surgery

Donor brain dead patient

First Adult Living Donor Transplant in Philippines

PHL makes first successful adult liver transplant

Dr. Ian Homer Cua

Consultant, Internal Medicine, Gastroenterology and Hepatology, St. Luke's Medical Center-Global City and Quezon City

FELLOWSHIP TRAINING

Fellowship in Gastroenterology, Institute of Digestive and Liver Diseases, St. Luke's Medical Center Quezon City,

Fellowship in Hepatology, Storr Liver Unit, Westmead Hospital, Sydney, Australia,

Fellowship in Transplant Hepatology, Center for Liver Disease and Transplant. Columbia University Medical Center, New York, USA,

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Dr. Allan Concejero

Chief, Liver Transplant Surgery

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Dr. Willie Polido

Head St Lukes Liver Transplant Surgery

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Dr. Juliet Gopez Cervantes

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The Medical City announced its landmark achievement of the first successful pediatric liver transplant surgery performed in the country by an all-Filipino team. The patient is three-year-old Catherine Erica Buenaventura, who was diagnosed with end-stage liver disease complicated by portal hypertension, or an increase in blood pressure in a system of veins within the stomach, intestine, spleen and pancreas.

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https://www.youtube.com/watch?v=tM2WfHCfg5M.

Dr de Villa the lead transplant surgeon at the Medical City

The Medical City announced its landmark achievement of the first successful pediatric liver transplant surgery performed in the country by an all-Filipino team. The patient is three-year-old Catherine Erica Buenaventura, who was diagnosed with end-stage liver disease complicated by portal hypertension, or an increase in blood pressure in a system of veins within the stomach, intestine, spleen and pancreas.

As COVID-19 swept through Metro Manila, then two-year-old Sophie’s biliary atresia worsened. A liver transplant performed at The Medical City Ortigas saved her life. Two operations took place simultaneously on November 17, 2020 − Sophie’s diseased liver was removed, after which she received a graft taken from the liver of her mother who was her liver donor. Sophie is the first patient of the Pediatric Access to Liver Transplant (PAsLiT) Program which was born out of the government’s genuine desire to help the growing number of pediatric patients in need of the life-saving procedure. Learn more about Sophie’s new lease on life in this video.

In January 2020, Sophie's parents met with president Rodrigo duterte senator Bong Go, and liver specialists from PGH, PCMC, NKTI and The MedicalCity (TMC) regarding the government's pediatric Access to Liver Transplant(PAslit)Program

https://www.pressreader.com/philippines/the-philippine-star/20201218/281565178356992