Singapore conducts region’s first living donor liver transplant on stage 4 colorectal cancer patient

SINGAPORE – Madam Lim Gek Meng’s life was turned upside down in October 2020, when she was diagnosed with terminal colorectal cancer, which had spread extensively to her liver.

The 61-year-old’s prognosis as a stage 4 colorectal cancer patient was grim – with chemotherapy, less than 20 per cent, or fewer than one in five such patients, survive beyond five years.

Doctors at Ng Teng Fong General Hospital immediately put her on chemotherapy to limit the spread of the cancer.

To everyone’s relief, she responded well to chemotherapy, the standard treatment used for patients like her. The tumours in her colon and liver shrank.

However, Madam Lim, who is currently unemployed, still had many tumours that could not be removed by surgery.

She also could not rely solely on chemotherapy as patients do develop resistance to the treatment, which would result in the cancer spreading, her doctors said in a media briefing on Friday.

In April last year, Madam Lim was given a chance at a new lease of life by oncologists, liver transplant surgeons and colorectal surgeons at the National University Health System (NUHS).

The experts picked her to be Singapore’s first person to undergo a liver transplant from a living donor.

The donor would be none other than her own 22-year-old son, Mr Goh Jun Le, an only child who is currently in national service.

Surgeons would cut out 60 per cent to 70 per cent of Mr Goh’s healthy liver and replace Madam Lim’s cancerous liver with it. Before the transplant, doctors removed the one tumour left in her colon.

On July 28 this year, Madam Lim successfully underwent liver transplant at National University Hospital’s National University Centre for Organ Transplantation.

Hers was also the first such transplant in South-east Asia. There had been similar transplants in other countries, such as Norway and Finland, and studies have shown a survival rate of 83 per cent at two years and more than 60 per cent at five years.

With her transplant, Madam Lim’s survival rate has drastically improved. She now has a more than 60 per cent chance of living for more than five years.

She is now cancer-free for the first time since her diagnosis in 2020.

Professor Chng Wee Joo, director of the National University Cancer Institute, Singapore, said: “This success highlights a new treatment paradigm, where specific patients with stage 4 colorectal cancer who fulfil the necessary criteria may be candidates for liver transplantation.”