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Heart transplantationDr Cheng Lik Cheung Heart transplantation beyond 2011- continuous evolution and new challenges in Hong Kong The first heart transplantation was performed by Professor CK MOK in December, 1992. Up to May 2011, a total of 113 patients underwent heart transplantation in Hong Kong. There were 89 men with a mean age of 43.8±12.5 years. The cumulative 1 year survival rate is 92%. In Hong Kong the two leading causes for end-stage heart failure required heart transplantation are dilated cardiomyopathy and valvular heart disease. In contrast to developed countries, ischaemic heart disease is third on the list. Due to limited organ availability, donor and recipient selections are being continuously reviewed and updated so as to encourage better utilization of donor heart that may go unused. Criteria for heart donors were revised in 1997 to include those up to the age of 60 years and marginal donors who have had previous cardiopulmonary resuscitations or high-dose inotropic therapy, provided that transthoracic echocardiograms performed by cardiologists are satisfactory. No significant coronary artery disease must be demonstrated on coronary angiogram for those donors over 45 years old and with known risk factors for ischemic heart disease. Since 2008, the recipient’s criteria were extended to include patients up to 65 years old and those who were chronic Hepatitis B carrier (low infectivity and without evidence of liver injury). Lung Transplant in Hong KongDr. CF Wong Introduction Since the first successful clinical lung transplant in the early 80’s, this procedure has evolved greatly over the past 2 decades and now it has been a well-accepted therapeutic intervention for patients with advanced pulmonary or pulmonary vascular diseases. Over the past years, there has been an increase in the number of transplants performed worldwide and the improvement in outcome was evident. From the registry of International Society of Heart and Lung Transplantation ( ISHLT ), there have been over 20,000 lung transplants performed worldwide and about 2,000 cases done annually. Cardiac Transplantation in Hong Kong
April 2007
In Hong Kong the first heart transplant operation was performed at Haematopoietic Stem Cell Transplantation (HSCT) in childrenDr. Li Chi-Kong January 2008
The principle of HSCT in children is same as adult HSCT, however the disease spectrum and the choice of stem cells is quite different from adult patients. Children are not mini-adults and attaining normal growth and development after HSCT is of great concern to paediatric transplanters. Since the number of children receiving HSCT is still far less than that of adults, paediatric transplant units always have to learn from the experience of adult colleagues especially on the management of complications. Read more: Haematopoietic Stem Cell Transplantation (HSCT) in children |