Liver Transplant Surgery in Malaysia: Cost and Best Hospitals in Malaysia 2020

Liver Transplant Surgery is used to replace a damaged, diseased, or non-functional liver. The liver is an important organ in the body involved in the digestive process, detoxification process, and more. In a liver transplant surgery, the patient is placed under general anesthesia. The doctor will make an incision in the abdominal area, remove the patient's liver, and replace it with another healthy liver from a donor. In some cases, portion of a liver, rather than an entire liver, can be replaced.



Liver Transplant Surgery Cost in Malaysia

Liver transplants, which normally cost RM350,000 in private hospitals or overseas, costs only RM500 at the Selayang Hospital. The fee is heavily subsidised by the Government. The RM500 fee is for patients in third class wards while first class patients pay RM3,000. It is free for government servants and their dependents. However, the waiting list is long.

According to Associate Professor Yoong Boon Koon, of the Department of Surgery, Faculty of Medicine, UM, a liver transplant procedure in UMMC (University Malaya Medical Centre) costs around RM120,000—much more affordable than RM900,000 as compared to Singapore. Aside from the surgical cost, the immunosuppressant medication cost about RM1, 000 per month.

The charges for liver transplant surgery package at SJMC (Subang Jaya Medical Centre) starts from RM265,000 and can exceed RM350,000 if there are post-surgery complications.

Department of Hepato-pancreatico-biliary (HPB) Services at Selayang Hospital (Government)

Address: Hospital Selayang, B21, Lebuhraya Selayang - Kepong, 68100 Batu Caves, Selangor, Malaysia.
Contact: 03 6126 3333

Selayang Hospital in Selangor, Malaysia introduced liver transplants from living donors in the end of 2016 or early 2017 in order to increase the current number of donations they are getting, according to Krishnan Raman, head and consultant of the Department of Hepatopancreaticobiliary (HPB) Services at Selayang Hospital.

The hospital’s current liver transplant programme was dependent on people who were willing to donate their organ when they were brain dead. “It is hard to sustain the programme (liver transplant) because the donation rate is very low,” said Krishnan.

Because of this, the Department of HPB Services plans to embark on liver transplant from living donors, which involves removing part of the liver of a living donor and transplanting it into the patient.

“The donors are usually healthy people, typically younger and thus the results are very good,” he said in an interview after the National Gastrointestinal Assistants (GIA) Conference recently held in Kota Kinabalu.

Krishnan, who is also the national advisor of HPB Services to the Ministry of Health, said the Department of HPB Services at Selayang Hospital was the only one undertaking liver transplant surgery in Malaysia.

The first liver transplant was carried out on a boy from Kuching, Sarawak in 2002. Since then, Krishnan said the department had performed 80 liver transplants. The Department of HPB Services has trained 20 surgeons in the field of liver transplant since it was set up in the Selayang Hospital. Upon completion of their three-year training, the surgeons are sent to different locations to serve in the country.

“We have HPB centres in Penang, Alot Setar, Malacca, Kuching and until recently, QEH,” Krishnan said, adding that the HPB surgeon at QEH had resigned recently to enter the private sector.

Source: http://mjn-e-news.com.my/sept2016

Liver Transplant Unit, Department of Surgery, Faculty of Medicine, University Malaya (UM Liver Transplant)

Address: Department of Surgery, Faculty of Medicine,
University Malaya Medical Centre, Lembah Pantai, 59100 Kuala Lumpur, Malaysia.
Tel : 03-7949 2070
Tel: 03-7949 4422 (General line)

A multi-specialty team of healthcare professionals in University of Malaya (UM) has successfully carried out their first living donor liver transplantation in 2017.

According to Associate Professor Yoong Boon Koon, of the Department of Surgery, Faculty of Medicine, UM, the liver transplant unit in UM is composed of members from many fields, with every member being passionate and dedicated to the cause.

“As you can see, we have a team of surgeons, anaesthesiologist, hepatologists, intensivists, pathologists,psychiatrist, nurses and more.” Yoong, a hepatobiliary and pancreatic surgeon, was speaking at a multidisciplinary meeting involving members of the newly established liver transplant unit in University Malaya Medical Centre.

While the adult living donor liver transplant unit is relatively new, Yoong said it was important to note that a paediatric living donor transplant unit has been in existence for much longer. It is hoped that, with the availability of an adult living donor liver transplant programme in place, the number of end-stage liver disease patients who can be treated will increase exponentially.

According to Yoong, the living donor transplant effort is meant to bring more awareness to the public and to healthcare professionals about the importance of organ donation. Unlike cadaveric donor transplantation in living donor transplantation, two persons must undergo surgery and this means risking a healthy donor. Yoong urged doctors to start educating patients and public about pledging their organs after death. Cadaver liver donors have dropped over the years, according to Dr Ganesalingam Kanagasabai, a consultant gastroenterologist who was formerly attached to Selayang Hospital’s liver transplant unit. Professor Sanjiv Mahadeva, consultant gastroenterologist, UMMC, said referrals are made to Selayang Hospital should a patient requiring liver transplant be unable to find a living donor in UMMC. Unfortunately, cadaver donors are rare and the liver transplant list is long. Sanjiv said: “As you know, donors are few and far between. The situation isn’t unique to liver alone but for all organs eg, kidneys, hearts and so on. We are encouraging people to come forward to pledge their organs for transplant.”

The liver transplant unit in UMMC handles living donor transplants exclusively while the more established cadaver transplant unit is housed in Selayang Hospital. When asked about the reason for this separation, Yoong said it was because the team at Selayang was already an established cadaver donor transplant unit and hence, it was decided to keep it that way unless situation changed.

Directing a message to local healthcare professionals, Yoong said everyone should be actively looking at brain dead patients to be cadaver donors. Due to the shortage of donors in the country, many patients undergo liver transplantation overseas in countries such as India and China. Undergoing such a major operation overseas can come with many problems, chief of which is the risk of complications during or after surgery.

Professor Lee Way Seah, paediatric gastroenterologist and hepatologist, UMMC, said: “You never know when a complication will arise and if you happen to be back home (in Malaysia) and need to get a follow up for a complication, it’s not likely you can make it in time to go back to the country where the surgery took place.” Additionally, Lee said having patients undergo transplants overseas represents a ‘dead end’ to the medical fraternity as there is no skills transfer and the local healthcare professionals will never gain enough experience to treat the general public.

On top of the risks involved in overseas liver transplant procedures is the factor of cost. As an example, Yoong said a liver transplant procedure in Singapore would easily cost S$300,000 or close to RM900,000. “This usually ends the conversation for most patients,” he said. A transplant procedure in UMMC costs around RM120,000—much more affordable than RM900,000. “We want to create more awareness (in the public and among doctors) that liver transplantation can be done in Malaysia, and to get more doctors to recommend or refer their patients for transplant within Malaysia.”

UMMC is also keen to start its own paediatric liver transplant unit, said Lee. He said: “We would like to start as soon as possible—as soon as our surgeons feel comfortable and safe. There’s never a shortage of patients, and unlike adult patients, our potential donors are much younger, with very little comorbidities.” These donors are, of course, the parents of the children and often there is no problem of incompatibility and there is no hesitation to donate a part of their liver to their child. In his population of patients, Lee noted that the most common factor requiring a transplant is biliary atresia, where patients commonly fail to survive beyond 15 months of age should they fail surgical procedures.

The number of Malaysians living with a liver graft was 90 in a 2014 census. The number is small compared to our population of approximately 30 million people. Yoong said: “Compare ourselves to Hong Kong, which has one-third of our population. They have performed about 70 transplant procedures in a year and even then, this is insufficient.”Much rests in the success of the liver transplant unit in UMMC. The team hopes that the success of UMMC’s living donor liver transplant unit will pave the way for a increasing rate in cadaveric donor liver transplantation in Malaysia.


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