Dr. O.Sergelen leads Mongolia’s battle against liver cancer
An interview from Undesnii Shuudan newspaper with the Head of the Liver Transplant Team of Mongolia, Principal of Surgery at the National Medical University of Mongolia Dr. O. Sergelen.
-Not much time has passed since the first liver transplant surgery was completed in Mongolia. Now it's time to see the results of the operation. How are the patients doing?
Last September and October we completed liver transplants in three patients for the first time in Mongolia.
-Recently, two patients had liver transplants during Tsagaan Sar. Were the operations successful?
-We did operations on two patients on the second and third day of the celebration. They have been transferred from the intensive treatment sector but they haven’t been discharged from the hospital. Their recovery is going well. Both of the patients are walking, eating, and sleeping well. There weren't any paroxysms after the operation, but there are some changes that have been revealed during the laboratory tests. They could be fixed.
-What changes were revealed by the laboratory tests?
-It means that the liver function changes. There is a period after the operation when it is possible to detect various changes through the tests. These changes could heal a few weeks after the operation.
One patient's changes have started to heal. The other patient's ALAT indicator is still high, we are treating this with medicine. Two donors are doing fine and have been discharged from the hospital.
-The patient who receives an organ transplant must take extra care of his or her body. I heard that these patients have to take medicine through out their whole lifetime. Is this true?
-A patient who has had a liver transplant must take extra precautions for five years after the surgery, be under a doctor’s care, and take immunity medication. After five years the liver becomes like their own liver.
-What about the donors?
-The liver is the fastest regenerating organ. It fully recovers within the year. In the first five or six months that passed after first surgery the first donor’s liver was at 60%. There weren’t any changes found to donor’s liver, because the donor must have a healthy liver and a healthy liver grows quickly.
-The first operations have been made with the equipment that the ASAN Medical Center of Korea brought with them. Then the State Great Khural gave 600 million MNT. Did you buy the necessary equipment?
-I could say that we completed the first few operations without any special equipment, because the ASAN Medical Center brought their equipment with them and also took it back. Then the Government gave 600 million MNT and these last operations were made with the new equipment and technology. Our operation equipment and operating rooms are close to the standards of highly developed countries. If extra money is received, we could buy the other missing equipment and we will be fully equipped.
-The operations are run jointly with Korean doctors. When will the Mongolian team do the operations independently?
-According to the contract, the first 10 operations must be done jointly with Korean doctors. We are preparing to operate on another three patients like this. To run the operations with the Korean doctors is important, it means we can learn many things and many techniques from them.
We do the healing process differently for each patient. Thus, we need to cooperate with the Korean doctors more. The doctors from the ASAN Medical Center have done this operation on 4000 patients, but we have done it on only 5 patients.
The result and the symptoms of the five patients after the operations are all different. It means we must use five different medications. We need to ask the Korean doctors questions. This is a very big surgery, high technology, and the healing process is completely different from operations like cutting the liver, stomach, pancreas, which we are doing everyday.
To learn the healing techniques completely we must cooperate with the doctors of the ASAN Medical Center as much as possible.
-Liver disease rates are high in Mongolia. Patients who need liver transplants will increase every year. The first operation was done very secretly. How did you choose the patients and when did you start to prepare?
-There are special directives used to choose the patient and also there is a patient waiting list. 43 patients are waiting on this list. We list the patients based on how long they have been on the list, test results, whether they have had cancer or not, had a Hepatitis B or C virus or not and other many things. After many tests and meetings we choose the patient.
-You said that you are preparing for the next three operations. When will the operations happen?
-We don’t have a date yet. We are choosing the patients. They will be chosen from the waiting list. Most of the patients under our survey are middle-aged citizens. The youngest one is 29 and the oldest one is 58. The five patients who have had the liver transplants were all female. They had one year to live before the operation. Now they will enjoy a full life.
-You said there are 43 patients on the waiting list. Now the patients who want receive liver transplants will increase.
-Generally, the number of patients will increase, because the liver cancer rate is high in Mongolia. Liver disease is very risky. The patients who don't need to have the operation right now might have it in one year. We have planned to operate on 10 patients this year, but because of lack of blood and blood products, and some important medicines not being available in Mongolia, the number may decrease.
-Not much time has passed since the first liver transplant surgery was completed in Mongolia. Now it's time to see the results of the operation. How are the patients doing?
Last September and October we completed liver transplants in three patients for the first time in Mongolia.
The patients are doing well. The regeneration process of the donor livers is 60%. The recipients’ liver growth percents are much lower. They are tested frequently and under the care of doctors. There isn't any change to the laboratory tests. The patients are living actively and happy like other healthy people.
-Recently, two patients had liver transplants during Tsagaan Sar. Were the operations successful?
-We did operations on two patients on the second and third day of the celebration. They have been transferred from the intensive treatment sector but they haven’t been discharged from the hospital. Their recovery is going well. Both of the patients are walking, eating, and sleeping well. There weren't any paroxysms after the operation, but there are some changes that have been revealed during the laboratory tests. They could be fixed.
-What changes were revealed by the laboratory tests?
-It means that the liver function changes. There is a period after the operation when it is possible to detect various changes through the tests. These changes could heal a few weeks after the operation.
One patient's changes have started to heal. The other patient's ALAT indicator is still high, we are treating this with medicine. Two donors are doing fine and have been discharged from the hospital.
-The patient who receives an organ transplant must take extra care of his or her body. I heard that these patients have to take medicine through out their whole lifetime. Is this true?
-A patient who has had a liver transplant must take extra precautions for five years after the surgery, be under a doctor’s care, and take immunity medication. After five years the liver becomes like their own liver.
After that the patient takes medicine only once per day. After 10 or 20 years they don’t need to take medicine.
-What about the donors?
-The liver is the fastest regenerating organ. It fully recovers within the year. In the first five or six months that passed after first surgery the first donor’s liver was at 60%. There weren’t any changes found to donor’s liver, because the donor must have a healthy liver and a healthy liver grows quickly.
-The first operations have been made with the equipment that the ASAN Medical Center of Korea brought with them. Then the State Great Khural gave 600 million MNT. Did you buy the necessary equipment?
-I could say that we completed the first few operations without any special equipment, because the ASAN Medical Center brought their equipment with them and also took it back. Then the Government gave 600 million MNT and these last operations were made with the new equipment and technology. Our operation equipment and operating rooms are close to the standards of highly developed countries. If extra money is received, we could buy the other missing equipment and we will be fully equipped.
-The operations are run jointly with Korean doctors. When will the Mongolian team do the operations independently?
-According to the contract, the first 10 operations must be done jointly with Korean doctors. We are preparing to operate on another three patients like this. To run the operations with the Korean doctors is important, it means we can learn many things and many techniques from them.
We do the healing process differently for each patient. Thus, we need to cooperate with the Korean doctors more. The doctors from the ASAN Medical Center have done this operation on 4000 patients, but we have done it on only 5 patients.
The result and the symptoms of the five patients after the operations are all different. It means we must use five different medications. We need to ask the Korean doctors questions. This is a very big surgery, high technology, and the healing process is completely different from operations like cutting the liver, stomach, pancreas, which we are doing everyday.
To learn the healing techniques completely we must cooperate with the doctors of the ASAN Medical Center as much as possible.
-Liver disease rates are high in Mongolia. Patients who need liver transplants will increase every year. The first operation was done very secretly. How did you choose the patients and when did you start to prepare?
-There are special directives used to choose the patient and also there is a patient waiting list. 43 patients are waiting on this list. We list the patients based on how long they have been on the list, test results, whether they have had cancer or not, had a Hepatitis B or C virus or not and other many things. After many tests and meetings we choose the patient.
-You said that you are preparing for the next three operations. When will the operations happen?
-We don’t have a date yet. We are choosing the patients. They will be chosen from the waiting list. Most of the patients under our survey are middle-aged citizens. The youngest one is 29 and the oldest one is 58. The five patients who have had the liver transplants were all female. They had one year to live before the operation. Now they will enjoy a full life.
-You said there are 43 patients on the waiting list. Now the patients who want receive liver transplants will increase.
-Generally, the number of patients will increase, because the liver cancer rate is high in Mongolia. Liver disease is very risky. The patients who don't need to have the operation right now might have it in one year. We have planned to operate on 10 patients this year, but because of lack of blood and blood products, and some important medicines not being available in Mongolia, the number may decrease.
Comments
Post a Comment