Liver unit hit by departure of surgeons

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

Staff row raises questions over quality of transplant services

The services of Hong Kong's only liver transplant team could be compromised after two of its senior surgeons left after an internal dispute, doctors and patients groups say.

The departures are the latest manpower crisis facing the team, after its leader and University of Hong Kong chair professor in surgery Fan Sheung-tat tendered his resignation in October 2006 but later decided to stay on.

Spokesman for the Patients' Rights Association Tim Pang Hung-cheong last night said the Hospital Authority had made a 'wrong decision' to shut the Chinese University liver transplant centre in 2003. The association called on the authority to review if having only one liver transplant centre in Hong Kong made the service 'too fragile'.

Last night, Professor Fan said no services would be compromised by the reshuffle. 'We have never wasted any organs, and never will do. We have good manpower planning to ensure the stable provision of services ... I am indifferent to the idea of whether Hong Kong needs a second team. It will all depend on patients' needs,' the professor said.

The team plans to train at least one doctor a year who can conduct a liver transplant independently. Only five doctors can do so now.

Hospital Authority director of cluster services Cheung Wai-lun said last night the authority was concerned about the manpower situation on the transplant team. 'We will talk to Queen Mary Hospital and the University of Hong Kong on ways to enhance retention of talent. More doctors need to be trained for transplants,' Dr Cheung said.

Professor Fan confirmed that the team's associate consultant Barbara Chik Hsia-ying had resigned after a verbal dispute with another transplant surgeon, Maria Vanessa de Villa during a meeting on January 16 over patient management.

Dr Chik resigned two days later. Consultant surgeon Chan See-ching, who backed Dr Chik in the dispute, has since been deployed out of the transplant team to conduct other surgery.

Dr Chan and Dr Chik, who have five and two years of liver transplant experience respectively, have been replaced by a consultant with one year's experience in liver transplants, and a medical officer who has none.

Professor Fan said: 'There is no winner in this incident. I am the loser. We lose an experienced doctor.'

Some doctors have voiced serious concern over whether the politics troubling the team could compromise its services. They said that on January 18, the day Dr Chik resigned, there were potential donors at Princess Margaret Hospital and Queen Elizabeth Hospital. Doctors at Queen Elizabeth were told to support a brain-dead patient on an artificial ventilator until the transplant team had harvested a donated liver at Princess Margaret Hospital.

A transplant was conducted the next day by using the liver donated at Queen Elizabeth Hospital, while the one harvested earlier at Princess Margaret Hospital was found to be unfit for transplantation.

'There is always a risk that organs may fail while a patient is put on a machine. It is also disrespectful to the patient and their family. Obviously, the liver transplant team has a resources problem and there is a risk it might compromise our services to the public,' one senior medical source said. But Professor Fan said it had always been the practice not to do two transplants at the same time. There was always a four- to six-hour interval because of limits on resources.