LOCAL doctors have been steadily improving their ability to perform organ transplant operations over the past decade, according to Professor Khin Maung Htay, an urologist who heads the Department of Nephrology at Yangon General Hospital.

However, the country’s kidney and liver transplant programs have been on hold since 2007 and 2005 respectively and doctors involved in the programs were unable to say whether any transplants would take place in 2009.

The main problem, according to the doctors, was a lack of organ donors. However, it is also difficult to find surgical team members – including specialists, surgeons and anaesthetists – who have time to perform the operations. The health and financial situations of prospective recipients was also an issue, they said.

“Myanmar doctors can do a good job performing kidney transplants but at present, we can only do them once a year. But we’re trying to get to the point where we can do them two or three times a year,” Dr Khin Maung Htay said.

Most organ transplant operations in Myanmar have been kidney transplants. The country’s kidney transplant program was instituted in 1997 and, by 2007, 34 transplant operations had been performed, with a success rate of more than 90 percent.

The program has also received assistance from abroad, with hospitals in Thailand and Singapore sometimes sending specialists to perform the operations, Dr Khin Maung Htay said.

Patients who receive a kidney under the program are required to pay K5 million as part of a cost sharing system and must return for health checks for six months after the operation.

Many of those who have been through the procedure say the outlay is worth it. Ma San San Soe, 45, who underwent a kidney transplant operation at Yangon General Hospital in 2007, said she is in good health at present and makes monthly visits to a kidney specialist for checkups.

“At first, I planned to go to India for the operation. But then Myanmar doctors held their 15th kidney transplant program and I decided to have it done in Myanmar. I think doing the transplant in Myanmar is better than overseas [for Myanmar people] because we can then have medical check ups with the doctors who participated in the operation.”

Myanmar doctors successfully performed the country’s first – and only – liver transplant in 2005. The life-saving operation was performed on 40-year-old Ko Khin Zaw Latt, who suffered from cirrhosis.

Dr Khin Maung Win, head of the Liver Unit at Yangon General Hospital, said that liver transplants are performed on patients suffering from either cirrhosis or liver cancer.

“Our doctors have done liver transplants successfully. But because of various reasons, we are unable to perform transplants at the current time,” Dr Khin Maung Win said.

The procedure involves removing the diseased liver and replacing it with a healthy liver from a donor. While most liver transplant operations use organs from deceased donors, they liver can also come from a living donor, he said.

“[If it’s a live donor], we take two-thirds of the donor’s liver [to transplant]. Unlike the other transplantation, the donor and recipient of liver can get the normal size two months after the surgery.”

Like kidney transplants, a liver transplant is expensive – as well as K5 million for the operation, patients need to take drugs to remain healthy after the transplant, at a cost of K500,000 to K1 million a month. They must also return for regular checkups for the first six months after the procedure, he added.

“The expense is very large, both before and after the transplant. People need to think about the financial cost in the long term before they go ahead with the operation,” he said, although he conceded the cost is much lower than in neighbouring countries.

A liver transplant can cost K60 million in India, K100 million in China and K150-200 million in Singapore, he said.

He added that most patients experience a significant improvement in their quality of life after the operation.

“After the six months, people can live relatively normally – but they need to make sure they don’t undertake any risky behaviour that can affect the liver.”