Opening Ceremony Of The 6th Congress Of The Asian Society Of Transplantation

20 Sep 1999

By Mr Lim Hng Kiang

Good evening, Dr Enrique Ona, President, Asian Society ofTransplantation, distinguished guests, ladies and gentlemen.

I extend a warm welcome to the participants of the 6th Congress of theAsian Society of Transplantation. We are proud to play host to thisdistinguished audience of transplant professionals who have come fromacross Asia, Europe and America to attend this Congress. I am told thatmore than 60 distinguished faculty members from over 20 countries havealso agreed to share their experience, expertise and knowledge on thesubject at this congress.

Since the first successful human kidney transplant in 1954, there havebeen tremendous advances in the field of transplantation. We are nowable to successfully transplant the kidneys, liver, heart, lung andmany other organs and tissues.

In Singapore, the first cadaveric kidney transplant was performed in1970 on a 30 year old housewife with end-stage renal failure. She livedon for 21 years with normal kidney function and died from other causesin 1991. Since then almost 1000 renal transplants have been carried outin Singapore with good patient survival. Transplantation of otherorgans and tissues are also done in Singapore: corneal transplantssince 1962, bone marrow since 1985 and heart and liver transplantssince 1990.

Transplantation has opened up new opportunities for patients.Transplantation of kidneys can free kidney failure patients frombondage to a dialysis machine. Transplantation of the heart or livergives a new lease of life to patients. Bone marrow transplants can curemany diseases of the blood, corneal transplants can help restore sight,while bone transplants can help a crippled man to walk. Transplantationhas no doubt helped many patients to lead an almost normal life andenjoy many things that most of us take for granted. By saving lives andallowing successfully transplanted patients to continue to livenaturally and to contribute to society, transplantation is a gift oflife that benefits not only the individual and his family but thecommunity as a whole.

All these would not have been possible without the advances in medicaltechnology and the sharpening of medical and nursing skills that keptpace with these advances. Indeed, transplantation could not have beenmade possible without the efforts of those committed to the cause andpromise of transplantation. Many of you who were involved with theresearch and development of transplantation are in the audience and Iwould like to take this opportunity to pay tribute to your manycontributions.

While medical technology and skills have developed at a rapid pace, theattitudes of society towards organ donation have not changed quite sofast, to keep up with the demand. Although there have been manyadvances in transplantation options, sources of organ and tissuedonation are limited and the number of donors has not kept pace withthe increased need. World-wide, the waiting lists for patients needinga transplant are long and growing longer. In Singapore, for example,there are 400 to 450 new cases of end-stage renal failure every year,and about 200 new patients suitable for kidney transplant. Sadly, manyorgan failure patients die while waiting because of a lack of donors.

And this is despite having legislation to make it convenient foreveryone to pledge their kidneys for organ transplant in the event ofdeath by accident. In Singapore, we support and enable organtransplantation and organ donation through legislative initiatives. The1972 Medical (Therapy, Education and Research) Act allows opting-in forthe donation of any organ and tissue for treatment, education orresearch purposes upon one's death. In addition, the 1988 Human OrganTransplant Act legislates kidney donation from Singaporean accidentvictims, except for those who have opted-out.

The greatest challenge facing all of us involved in transplantation isto find ways to meet the organ shortage problem. Cultural and socialbarriers to organ donation still prevent many individuals from saying'yes' to organ and tissue donation. It is clear from the experience ofmany countries that with better public education, such barriers can beovercome. Therefore, public education efforts must continue so as toincrease the awareness of all segments of the population on thebenefits of transplantation. We need to persuade the public to perceiveorgan and tissue donation as an act of altruism to our fellow man, anda way of life.

In the meantime we can try to optimise scarce resources. Medicalinterventions which have been shown to be cost-effective and resultingin improvement in the quality of life are being supported and organtransplants done appropriately will fall into such a category. It isthe responsibility of the transplant professionals to ensure thatlimited health care resources are used wisely to provide the mostcost-effective treatment and do the most good. Appropriate selection ofpatients for transplantation is necessary to maximise benefits to thepatients and the community.

The challenge facing the professional is to ensure that every organ andtissue transplant done is successful. It is clear that the improvingsuccess of transplantation can be attributed to the technological andmedical advances that have occurred over the last few decades. Theintroduction of the immunosuppressive drug, Cyclosporine, in the 1970'sled to dramatic improvements in the success rates. In the last fewyears, other newer immunosuppressive agents are entering the arena andmay contribute to further improvements in outcome in the future. Thedawn of the biotechnology century promises a new era in which newdrugs, genetic engineering and bioengineering are all likely tocontribute in some way to treat organ failure. It is the responsibilityof all transplant professionals to keep pace with these advances.Continuing professional development is therefore necessary to ensurethat optimal treatment is used in every organ and tissue transplant.This congress is an important venue for transplant professionals toexchange knowledge and learn from one another.

I am confident that all participants of the 6th Congress of the AsianSociety of Transplantation will benefit greatly from the Congress. I amsure all of you will learn from your shared experiences and take thisscience one step forward.

It is now my pleasure to declare this Congress open.