OPERATION WORKED: After the liver donation, Mr David Poh is now able to play a light game of squash and badminton.
ONE YOUNG pilot opted for the best course of treatment for his cancer-stricken dad by donating part of his liver to him.
The one thought that raced through his mind as he was wheeled into the operating theatre at the Singapore General Hospital (SGH) in September last year was: I might not survive.
Mr Edwin Poh, then 32, was young, healthy and had no medical problems. But he was going to have a part of his liver cut out and transplanted into his father, Mr David Poh, who was suffering from liver cancer.
Doctors had told him that the procedure was a relatively low risk one, and that his liver would regenerate to 90 per cent of its original size after the operation. Yet, he could not stop thoughts of the worst-case scenario from flooding his mind.
Said the younger Mr Poh: “I thought I might die. I had written letters to my family. I was prepared for the worst.”
From hepatitis B to liver cancer
Mr David Poh was diagnosed with hepatitis B during a routine blood test about 30 years ago.
Hepatitis B is an infectious inflammatory illness of the liver, which can lead to cirrhosis, a hardening of the liver, and liver cancer. When his father was diagnosed with hepatocellular carcinoma (liver cancer) in December 2011, the younger Mr Poh knew that he wanted to do the right thing and give part of his liver to his father. “If anyone was to help him, it should be me.”
His older sister was married with two children, while his other sister was too young. “The size of the donor’s liver had to be big enough,” Mr Poh said.
A pilot for seven years, Mr Poh had to consider if he would be able to resume flying – his life-long dream – after the procedure. “I was very gung ho about the transplant initially, and it took some time to get my father to agree to it. Later, as I was going through the tests, I started to think about the risks and costs. It was then that I began to worry if I could still fly after that,” he said.
“But at the end of the day, the question was not just – ‘could I not go through with it?’ – but also, ‘could I continue to live with myself if I did not?’”
His company was supportive, assuring him that he would have a job if he was medically fit to fly after the operation.
His decision to donate a part of his liver was also bolstered by the knowledge that a fellow pilot, who went through the same procedure eight years earlier, was still flying.
Mr Poh stopped work for about two months to recover from the surgery, and received the green light from an aeromedical doctor to resume his flying duties in December last year.
The elder Mr Poh, who is semi-retired, said he found the strength to accept his illness – stage 2 liver cancer – in prayer. However, he wasn’t prepared to accept his son’s sacrifice at first.
“My family was not prepared to let me go. They begged me to go for a transplant,” said the 65-year-old. His wife, 62, works in the healthcare industry.
The older Mr Poh said the tumour in his liver was about 4.6cm long, but was inoperable as it was located too close to the main arteries.
Before the transplant, he had undergone other treatments, including a minimally invasive medical procedure called transarterial chemo-embolisation, or TACE, which managed to shrink his tumour down to 60 per cent of its original size. He also went through two rounds of chemotherapy, but with little progress.
Mr Poh was then told that he needed to have a transplant, but the wait for a deceased donor would take about a year.
After much pleading from his family, he decided to accept his son’s gift of life.
“I know that he (my son) is a good boy. I didn’t want to put him in any jeopardy, especially his career. I was worried he might not be able to fly again. I prepared myself and prayed and left it to God. I had confidence in the doctors and that the operation would work,” he said.
The older Mr Poh said he is now able to play a light game of squash and badminton. He added: “I have a new lease of life now, and I have better stamina.”
New transplant clinic offers convenience
Following a transplant, patients have to see several healthcare professionals for follow-up care. When the new Transplant Centre opens later this year at SGH, these patients only need to make a single appointment to see them.
“Transplantation is a highly complex field of medicine that requires different healthcare professionals coming together as a team to provide a collaborative and patient-centric approach to care planning and provision,” said Dr Terence Kee, senior consultant, Department of Renal Medicine, SGH. Dr Kee is also programme director, Renal Transplantation, SGH.
The centre will house a multi-disciplinary team involved in various aspects of transplantation. Dedicated to caring for patients who have undergone or are undergoing transplants, the Centre has clinics, counselling rooms, a phlebotomy cubicle and procedure unit. Among its many services are pre- and post-transplant education by transplant coordinators, donor and recipient assessment, post-transplant follow-up care, transplant pharmacist clinics, and intravenous drug infusions.
• This story was first published in Singapore Health, Sep/Oct 2013.