Liver patient list 'based on urgency'
The Hospital Authority's surgery chief says the controversial queue for transplants is fair, transparent and objective
The waiting list for liver transplant patients is fair, transparent and based solely on a person's medical condition, a Hospital Authority official said yesterday.
Andrew Yip Wai-chun, chairman of the authority's co-ordinating committee for surgery, said the new system had been running 'smoothly'. The committee set up the controversial central registry for liver transplants last July.
'We only look at the patient's urgency for a transplant, based on a set of objective medical parameters. The system is fair and transparent,' Dr Yip said. 'How long a patient has been waiting for a transplant or whether the patient has been admitted to the intensive care unit are not considerations.'
The central registry combined two waiting lists - one at Chinese University and another at the University of Hong Kong liver transplant centres.
But some patients have criticised the system's lack of transparency and also dispute the medical criteria used for their ranking.
Dr Yip said the authority has adopted the model of end-stage liver disease from the US.
About 100 liver patients in Hong Kong have been assigned scores, from zero to 40, corresponding to their risk of dying. A patient with a 'mortality risk' score of 40 faces a 100 per cent certainty of dying within three months. The risk for a patient scoring 10 is estimated to be from 10 to 20 per cent.
Dr Yip said priority was given to patients suffering from the highest mortality risk and to those whose recent liver transplants had failed to work. 'These patients will die within seven days if they don't have a transplant,' he said.
Liver patient Leung Chi-ming has challenged the Hospital Authority to explain why a liver initially meant for him was given to another patient. He has complained about the cancellation of his operation at the Prince of Wales Hospital on September 10, 2002.
The operation was cancelled a few hours after he was admitted to the hospital, which said it did not have the resources to do the operation. The liver was used on another patient at the Queen Mary Hospital, who was said to be 'more urgent' than Mr Leung.
Dr Yip said: 'I fully understand his [Mr Leung's] feeling. One individual patient may only look at his own interest, but we have to maintain overall fairness to all patients.'
While dismissing Mr Leung's case, the Office of the Ombudsman has found 'maladministration' at the Hospital Authority. Its one-year investigation found that the Prince of Wales Hospital failed to inform Mr Leung in a timely way that the operation would not go ahead.
Ombudsman Alice Tai Yuen-ying defended the finding, which has been criticised by patient rights activists and lawmakers.
'We have recently had a number of cases where we found the complainant allegations to be unsubstantiated but in the investigation process, had discovered other aspects of significant maladministration,' she said.
'In such [an] event, I have criticised those other deficiencies, even in the absence of a specific complaint point, and regarded the case as 'substantiated [rather] than alleged'. I have also felt duty-bound to make recommendations for improvement where appropriate.'