Organ and Tissue Transplantation

Abstract

There could not have been a more appropriate time as now for a special issue of the Annals dedicated to transplantation. The topic is in the lay press everyday for both the right and the wrong reasons. This special issue covers not only the science and art of transplantation but also many of the ethical and social issues that are inherent in this field of medicine. The issue provides an overview of the Singapore experience in transplantation of various organs and tissues and has also been enriched by the contributions from world leaders in the field. One common theme in this issue of the Annals is the success of the various solid organ transplant programmes in Singapore. Indeed, the results of renal (both adult and paediatric) and heart transplants in Singapore, as reported by Vathsala and Chow; 1 Ng and colleagues; 2 and Sivathasan, 3 are comparable to if not better, than those reported from North American or International Registries. The review of liver transplantation in Asia by Ng and Lo 4 further highlights the innovative techniques that have evolved specifically to address the problem of organ shortage and the high prevalence of hepatocellular carcinoma in Asia. Indeed, Asia is considered the world leader in liver transplantation with many centres in the Far East having pioneered these techniques. The reviews by Hwang and Ong 5 and Tan et al 6 on advances in haematopoietic stem cell and cornea transplantation respectively, further attest to the advancing field of tissue transplantation. In total, transplantation has come of age in Singapore, is no more an experimental form of therapy but is instead the standard of care for many life-threatening conditions. A second fact highlighted in this issue are the similarities in complications of transplantation across all solid organs. Infectious complications were the leading cause of death among both adult and paediatric renal transplants as well as heart transplant recipients. 1,2 On the contrary, chronic rejection and chronic allograft vasculopathy were the leading causes of graft failure for renal and heart transplants respectively. As suggested by Sir Roy Calne 7 in this issue, continued research in strategies to ameliorate chronic graft