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Death following liver transplant 'a tragic accident'
Monday, Aug 11, 2014
The Straits Times
By Walter Sim
SINGAPORE - A diabetic man died of acute liver failure after his adult son donated part of his liver to him, in what the State Coroner has termed a "tragic medical misadventure".
In his written findings issued on July 25, State Coroner Marvin Bay said that there was "no basis to suspect foul play" behind the death of 57-year-old Chua Kiang Hock, director of a food catering business, at Singapore General Hospital (SGH) last October.
Rather, it resulted from "an unfortunate string of complications, and attempted but unsuccessful interventions, following an unanticipated mishap", said Mr Bay.
In April last year, Mr Chua was diagnosed with liver cancer. The family was told a liver transplant from a living donor was the best option. His son Chua Aik Wing, 25, was found to be a match.
The 12-hour operation last September was led by transplant expert Koichi Tanaka and assisted by SGH director of transplant surgery Cheow Peng Chung.
In pre-operation tests, doctors found that the younger Mr Chua's liver had some irregular features, which made a conventional living donor transplant more dangerous.
Doctors then made the "fateful decision" to cut a small portion of the right posterior section of the liver, to prevent "potentially hazardous" damage to the younger Mr Chua. This, however, would yield a smaller graft for his father.
Dr Cheow said the medical team made an error when harvesting the donor's liver. The team had cut off part of the right hepatic vein, which drains deoxygenated blood from the liver.
Initial signs showed that the procedure had gone smoothly, but the elder Mr Chua remained unconscious. A routine scan a day later showed that blood was staying in his modified liver instead of draining out as it should have done.
An emergency operation was conducted on Sept 13, which Mr Bay said showed the doctors were "demonstrably proactive in attempting to resolve the problem". Even so, blood in the inactive vessels started to clot. Despite attempts to clear the clots, blood flow remained poor.
The elder Mr Chua later developed two bacterial infections, and complications.
Attempts for an urgent liver transplant were unsuccessful. Direct intervention to prevent the narrowing of the hepatic artery led to further complications.
"This combination of mounting complications followed by infections proved too much for Mr Chua's body to handle," said Mr Bay. Mr Chua died on Oct 8.
"Notwithstanding the sad outcome, all parties involved appear to have been driven to do their utmost for Mr Chua in the wake of his grim prognosis," Mr Bay said.
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Monday, Aug 11, 2014
The Straits Times
By Walter Sim
SINGAPORE - A diabetic man died of acute liver failure after his adult son donated part of his liver to him, in what the State Coroner has termed a "tragic medical misadventure".
In his written findings issued on July 25, State Coroner Marvin Bay said that there was "no basis to suspect foul play" behind the death of 57-year-old Chua Kiang Hock, director of a food catering business, at Singapore General Hospital (SGH) last October.
Rather, it resulted from "an unfortunate string of complications, and attempted but unsuccessful interventions, following an unanticipated mishap", said Mr Bay.
In April last year, Mr Chua was diagnosed with liver cancer. The family was told a liver transplant from a living donor was the best option. His son Chua Aik Wing, 25, was found to be a match.
The 12-hour operation last September was led by transplant expert Koichi Tanaka and assisted by SGH director of transplant surgery Cheow Peng Chung.
In pre-operation tests, doctors found that the younger Mr Chua's liver had some irregular features, which made a conventional living donor transplant more dangerous.
Doctors then made the "fateful decision" to cut a small portion of the right posterior section of the liver, to prevent "potentially hazardous" damage to the younger Mr Chua. This, however, would yield a smaller graft for his father.
Dr Cheow said the medical team made an error when harvesting the donor's liver. The team had cut off part of the right hepatic vein, which drains deoxygenated blood from the liver.
Initial signs showed that the procedure had gone smoothly, but the elder Mr Chua remained unconscious. A routine scan a day later showed that blood was staying in his modified liver instead of draining out as it should have done.
An emergency operation was conducted on Sept 13, which Mr Bay said showed the doctors were "demonstrably proactive in attempting to resolve the problem". Even so, blood in the inactive vessels started to clot. Despite attempts to clear the clots, blood flow remained poor.
The elder Mr Chua later developed two bacterial infections, and complications.
Attempts for an urgent liver transplant were unsuccessful. Direct intervention to prevent the narrowing of the hepatic artery led to further complications.
"This combination of mounting complications followed by infections proved too much for Mr Chua's body to handle," said Mr Bay. Mr Chua died on Oct 8.
"Notwithstanding the sad outcome, all parties involved appear to have been driven to do their utmost for Mr Chua in the wake of his grim prognosis," Mr Bay said.
[email protected]
