Transplant unit needs bigger pool of surgeons

PUBLISHED : Tuesday, 29 January, 2008, 12:00am
UPDATED : Tuesday, 29 January, 2008, 12:00am

Hong Kong's liver patients face incredible odds - nearly half of them will die while waiting for a transplant. This is primarily because of a chronic shortage of donor organs. Nevertheless, for those who make it to the operating table, they can be assured that they are in safe and experienced hands. The city has a small but dedicated team of liver transplant surgeons whose expertise and pioneering techniques are recognised the world over.

It is therefore unfortunate that two senior members of the five-person team - Barbara Chik Hsia-ying and Chan See-ching - have left and are being replaced by far less experienced doctors. An excessive workload and infighting appear to have contributed to their departure. Between them the doctors have seven years of experience in the highly complex and expensive surgery. Their two replacements have together just one year of post-transplant training experience. The Hospital Authority must now make sure the quality of the team's work does not suffer as a result. This, however, may be easier said than done.

The departures coincide with the disclosure that two livers became available at the same time this month, yet only one was used. The two incidents appear unrelated, for now. The authority says the unused liver was unfit for transplant anyway. This may well be the case, but doubts have already been raised. The incident resembles a scandal in 2002 in which a healthy liver was wasted because the now-defunct Chinese University transplant team had used up its quota for operations, while the University of Hong Kong team was busy with another transplant.

Furthermore, it does not inspire confidence that the group's leader, Fan Sheung-tat, has admitted that tension contributed to the departure of the two doctors this month. Professor Fan, known as Hong Kong's 'father of liver transplants', resigned himself in 2006 after complaining of an overwhelming workload. He returned only after pleadings from the authority and patients.

The excessive workload of his elite team is a recipe for tension and infighting. It has to carry out 80 transplant operations annually and is on call throughout the year, in addition to administrative and teaching duties. The team came out of a merger between the two transplant centres from Chinese University and the University of Hong Kong. But the merger was controversial from the start. Members of both teams had been highly competitive, generating tensions that never seem to have entirely disappeared.

In the field of liver transplants, the city has created a truly significant and world-leading branch of surgery. The authorities must not allow it to be hampered by budgetary constraints and personnel problems. For the sake of our patients, a bigger pool of surgeons should be trained.