BAGUIO CITY, Benguet, Philippines — The Department of Health (DOH) will start listing potential organ donors in the Cordillera to support the first liver transplant and treatment services center being developed in the region, a health official said.
Baguio General Hospital and Medical Center (BGHMC) is putting up the center for liver patients in the region and in neighboring towns, including those who underwent or would get transplants abroad, said Dr. Rio Magpantay, director of the DOH in the Cordillera.
Speaking at a news briefing early this week, he said the move was in collaboration with top organ transplant experts from India.
BGHMC is the designated apex hospital in the region under the universal health-care system. Special services like pretransplant surgery and postsurgery care would expand its capabilities to treat most ailments and traumas that local hospitals are unable to handle, Magpantay said.
Magpantay said that the DOH would start next year gathering the necessary data, like how many people have liver conditions and how many are willing to be organ donors.
“That doesn’t just involve liver cancer but also related diseases like cirrhosis. We know that the intake of alcohol in the region is high, and that contributes to the weakening of the liver,” Magpantay said.
Registry for referrals
He said the Universal Health Care program required all hospitals to set up a cancer registry for quick referrals and for hospitals to be able to access or share expertise.
“At the moment, we lack that data,” Magpantay said. “Organ donors sign documents that authorize medical personnel to use their organs to save other patients should they pass away, but few people in the country make these arrangements. We should explain why that is important in the Cordillera.”
Speaking at a medical forum held on Dec. 13, BGHMC chief Dr. Ricardo Ruñez Jr. said the hospital had partnered with New Delhi’s Indraprastha Apollo Hospital, where babies and young children had been operated on to replace damaged livers with portions of livers taken from their mothers or other donors.
Almost all liver transplants are done abroad because of the high surgical risks that require specialists from India, Taiwan and the United States, pediatric hematologist Dr. Germana Emerita Gregorio told the forum. In some cases, patients die due to complications after or during surgery, she said.
From 2017 to 2021, at least 122 Filipino children received new livers at India’s Apollo Hospital in Mumbai and the Max Super Specialty Hospital in New Delhi. Three children underwent surgery in Hong Kong’s Queen Mary Hospital between 2006 and 2008, Gregorio said.
Liver surgeries were done on 49 children at Taiwan’s Kaohsiung Chang Gung Memorial Hospital from 2001 to 2018, she said.
Prohibitive costs
Philippine hospitals have been conducting liver transplants since 1988 but the cost has been prohibitive, she said.
“So why are liver transplants still being done abroad? Purely because of the steep cost [locally],” Gregorio said, citing the P3 million charged by one big hospital in Metro Manila as an example.
Surgical costs in Taiwan are higher at P5 million, but the cost in India was somewhere between P1.4 million and P1.6 million, she said.
Ruñez said the surgeries on Filipino children have been subsidized by Indian foundations.
Surgeries abroad are done by a dedicated staff and area, and requires only a two-week waiting time for operations, Gregorio pointed out.
A BGHMC liver transplant clinic could address pre- and postsurgery treatment, which is crucial, particularly for toddlers and young children, who will require sustained medication to boost their weakened immunity, Gregorio said.
Organ transplant science continues to evolve, according to Apollo Hospital’s transplant surgeon Neerav Goyal, who told doctors and parents during the forum that his team had been innovating surgery techniques to reduce the risks for children.
Goyal said the number of liver disease patients was increasing throughout the world, including in South Asia and Southeast Asia.