9
Year 2008
2009 2010
2011 2012
n n
n n
n
New transplant patients 130
141 128
122 94
Glomerulonephritis 41
32 53
38 50
39 33
27 33
35 Diabetes Mellitus
19 15
26 18
20 16
18 15
13 14
Hypertension 28
22 38
27 42
33 45
37 24
26 Obstructive uropathy
6 5
5 4
7 5
8 7
12 13
ADPKD 8
6 5
4 3
2 1
1 Drugs toxic nephropathy
1 1
Hereditary nephritis 1
1 Unknown
64 49
47 33
40 31
50 41
29 31
Others 6
5 1
1 5
4 6
5 2
2
5.3 TRANSPLANT PRACTICES
5.3.1 Type of transplant The proportion of commercial transplantation had gradually reduced from 79 at its peak in
2004 to 21 in 2012. This was predominantly due to the marked decline in commercial cadaveric transplantation 76 in 2004 to 3 in 2011, which was in keeping with the
implementation of restriction of cadaveric organ transplantation by the Chinese Ministry of Health. There was an increasing number of commercial living transplantation in 2010 which
contributed to 25 of all transplants performed. However, this number has dropped to 23 in 2011 and 15 in 2012.
Local live donor transplantation made up 55 of transplants 49 recipients in 2012, which was an increase from 42 cases 38 in 2011. However, the number of live donors has
remained low. Local cadaveric transplantation had shown a promising rise over the last 10 years with 15 transplants performed in 2003 rising to 34 recipients 31 in 2010 and 40
recipients 36 in 2011. Unfortunately, this rise was not sustained and the number of local cadaveric transplants dropped to 22 recipients 25 in 2012. The year 2007 marked the first
time in 20 years where there were more local transplants 56 compared to overseas commercial transplants 44. The proportion of local transplants continues to rise over the
last five years with 80 of transplantations performed locally in 2012. Table 5.3.1: Type of renal transplantation, 1993-2012
1993 1994
1995 1996
1997 Year
n n
n n
n
Live donor genetically related 37
27 36
18 41
41 36
24 27
22 Live donor emotionally related
1 1
Local deceased donor 2
2 2
1 4
4 2
1 8
6 Commercial cadaver
15 11
22 11
36 36
105 71
81 65
Commercial live donor 83
61 142
70 18
18 5
3 8
6 Total
137 100 202 100 99
100 148 100 125 100
1998 1999
2000 2001
2002 Year
n n
n n
n
Live donor genetically related 28
27 41
33 20
14 30
19 32
19 Live donor emotionally related
2 2
5 4
7 5
5 3
4 2
Local deceased donor 16
16 10
8 27
19 37
23 22
13
10
Commercial cadaver 53
52 64
51 80
56 83
51 103
60 Commercial live donor
4 4
5 4
10 7
7 4
11 6
Total 103 100 125 100 144 100 162 100 172 100
2003 2004
2005 2006
2007 Year
n n
n n
n
Live donor genetically related 25
16 21
11 37
22 25
17 21
19 Live donor emotionally related
6 4
2 1
4 2
4 3
13 12
Local deceased donor 15
9 17
9 10
6 26
17 27
25 Commercial cadaver
111 69
145 76
107 64
85 57
45 41
Commercial live donor 4
3 6
3 9
5 10
7 4
4 Total
161 100 191 100 167 100 150 100 110 100
2008 2009
2010 2011
2012 Year
n n
n n
n
Live donor genetically related 35
28 27
20 25
23 27
24 35
39 Live donor emotionally related
6 5
15 11
12 11
15 14
14 16
Local deceased donor 24
19 35
26 34
31 40
36 22
25 Commercial cadaver
60 47
35 26
12 11
3 3
5 6
Commercial live donor 2
2 24
18 27
25 26
23 13
15 Total
127 100 136 100
110 100 111 100 89
100 Commercial cadaver China, India, other oversea Commercial live donor living unrelated
5.3.2 Place of transplant Transplantation within local centers fluctuated in the last two decades with 39 cases in 1993,
remaining static for five years, increasing to a peak of 70 cases in 2001 but declining again with only 40 cases in 2004. This slowly increased again with a peak of 84 cases in 2011.
Unfortunately, this was not sustained and the number of renal transplants performed in local centers decreased in 2012. This is disturbing data as it underscores our failure to improve the
rate of transplantation within the country, which is mainly due to the lack of both living as well as cadaveric donors.
The number of transplants performed in Hospital Kuala Lumpur, which is the main transplant centre in Malaysia continue to fluctuate. A similar trend is seen in Hospital Selayang. Prince
Court Hospital initiated their transplant program in 2009 and had contributed a significant number of transplants performed in 2012 with 16 new cases 17.
Even though, transplantation in China continues to drop from 139 cases 72 in 2004 down to 19 cases in 2012 Table 5.3.2, China transplantation still contributes 20 of all
transplants in Malaysia in 2012. Table 5.3.2: Place of transplantation, 1993-2012
Year
1993 1994
1995 1996
1997 n
n n
n n
HKL 36
25.7 33
16.2 36
34.3 32
21.2 29
22.5 PPUKM
Prince Court Medical Centre UMMC
3 2.1
5 2.5
11 10.5
7 4.6
8 6.2
Selayang Hospital Other local
11
China 13
9.3 22
10.8 35
33.3 105
69.5 80
62 India
86 61.4
143 70.1
21 20
6 4
8 6.2
Other overseas 2
1.4 1
0.5 2
1.9 1
0.7 4
3.1 Unknown
Total 140
100 204
100 105
100 151
100 129
100 Year
1998 1999
2000 2001
2002 n
n n
n n
HKL 33
31.1 37
28.9 28
19.4 32
19.8 30
17.4 PPUKM
Prince Court Medical Centre UMMC
11 10.4
17 13.3
19 13.2
23 14.2
15 8.7
Selayang Hospital 4
2.8 11
6.8 11
6.4 Other local
1 0.8
3 2.1
4 2.5
1 0.6
China 52
49.1 64
50 80
55.6 83
51.2 103
59.9 India
7 6.6
5 3.9
9 6.3
8 4.9
12 7
Other overseas 3
2.8 2
1.6 1
0.7 1
0.6 Unknown
2 1.6
Total 106
100 128
100 144
100 162
100 172
100 Year
2003 2004
2005 2006
2007 n
n n
n n
HKL 26
16 20
10.4 31
18.1 35
23.2 36
32.4 PPUKM
1 0.5
2 1.2
1 0.7
2 1.8
Prince Court Medical Centre UMMC
6 3.7
7 3.6
8 4.7
5 3.3
4 3.6
Selayang Hospital 11
6.8 11
5.7 5
2.9 9
6 14
12.6 Other local
1 0.6
1 0.5
2 1.2
1 0.7
2 1.8
China 111
68.5 139
72.4 111
64.9 87
57.6 45
40.5 India
4 2.5
11 5.7
7 4.1
7 4.6
3 2.7
Other overseas 2
1.2 2
1 4
2.3 6
4 5
4.5 Unknown
1 0.6
1 0.6
Total 162
100 192
100 171
100 151
100 111
100 Year
2008 2009
2010 2011
2012 TOTAL
n n
n n
n n
HKL 32
24.6 36 25.5
26 20.3 37 30.3
26 27.7 631 22.2
PPUKM 5
3.8 3
2.1 3
2.3 3
3.2 20
0.7 Prince Court Medical Centre
4 2.8
7 5.5
13 10.7 16
17 40
1.4 UMMC
10 7.7
10 7.1
10 7.8
7 5.7
10 10.6 196
6.9 Selayang Hospital
10 7.7
18 12.8 19 14.8
26 21.3 16
17 165
5.8 Other local
3 2.3
3 2.1
1 0.8
1 1.1
24 0.8
China 64
49.2 62
44 50 39.1
38 31.1 19 20.2
1363 47.9 India
3 2.3
2 1.4
2 1.6
344 12.1 Other overseas
3 2.3
3 2.1
7 5.5
2 2.1
51 1.8
Unknown 4
3.1 1
1.1 9
0.3 TOTAL
130 100
141 100
128 100
122 100
94 100
2843 100
12
5.4 TRANSPLANT OUTCOMES
