As a doctor working in both the public and private sectors, I encounter patients from all walks of life with a wide range of medical and surgical issues. Expectations are understandably high, and all doctors strive to do their best to help patients return to their optimum health.
However, with rising rates of obesity, hypertension, and diabetes (the non-communicable diseases or NCDs), many people are now living at a suboptimal level of health. For some, this worsens over time, progressing to end-organ damage and eventually organ failure.
Which Organs Can Fail – And Which Ones Lead to Death?
Technically, any organ can fail. But which organ failures are life-threatening? That’s the more crucial question. People cannot survive the failure of the heart, lungs, or liver. Kidney failure will also eventually lead to death, even with dialysis. In Malaysia, it’s well known that over 50,000 people are currently on dialysis, and we’re seeing around 10,000 new cases each year.
But what about liver failure? Lung failure? Heart failure? Strangely, even within the medical community, the data is scarce or unclear. Are the numbers so low that they’re negligible or is it simply that we’re not tracking them well enough?
Where Can You Get a Transplant in Malaysia?
For kidney transplants, the active centres in Malaysia include:
Kuala Lumpur Hospital (HKL)
Selayang Hospital
University Malaya Medical Centre (UMMC)
Prince Court Medical Centre
Sunway Medical Centre
Mahkota Medical Centre in Melaka
Of these, HKL, Selayang, and UMMC also perform the occasional deceased-donor transplant.
What about liver transplants? A deep search points you to:
HKL’s Women’s and Children’s Hospital (HTA)
UMMC (for living-related liver transplants)
Selayang Hospital (for deceased-donor liver transplants)
Still, these cases are few and far between.
And the heart and lungs? The National Heart Institute (IJN) performs both lung and heart transplants, but again, the numbers are extremely small. There were also plans to establish Serdang Hospital as a sister facility to IJN for heart and lung transplants, but this project has yet to materialise.
Are Patients Waiting for Transplants?
Yes, they are. But who’s keeping track?
For kidneys, most of the public has heard of MyKAS, the national transplant waitlist. MyKAS initially had strong engagement with patients, dialysis centres, and doctors, but this has declined over time. Is MyKAS the only list?
No. For example, UMMC maintains a separate internal list, so UMMC patients are on two lists, while others are only on MyKAS.
Why the discrepancy? That’s a topic for another day.
When it comes to liver transplants, the situation gets even murkier. It’s understood that Selayang Hospital’s transplant coordinators maintain the list, but how patients are added or prioritised isn’t entirely clear. Once again, UMMC is said to maintain a separate list.
As for heart and lung transplant waitlists, we’ve found that IJN manages these. But reportedly, the list often has zero patients. Why? Possibly because the patients are too ill and pass away while waiting for an organ, the gift of life from a donor. Yet surely, many more patients need these organs. So why aren’t they on the list?
What Do the Numbers Say?
According to the National Transplant Resource Centre (NTRC):
9,658 adults and 344 children are waiting for kidney transplants
3 adults and 8 children are waiting for liver transplants
12 people are waiting for heart transplants
3 for lung transplants, and
9 for both lung and heart transplants
These are sobering numbers, especially when we consider the thousands on dialysis and the unknown numbers with liver or heart failure who may never make it onto a waitlist.
What’s Next?
For us doctors, it’s heartbreaking. We see the gaps every day: fragmented systems, lack of coordination, unclear referral pathways, and long waits that often end in death. For patients and their families, it’s even worse. They’re often left confused, with little information and no clear way to access the care they need.
Should patients remain on these lists indefinitely, hoping for a miracle, but more likely dying while waiting? Do their lives not matter? Do they have real options?
A Stark Warning for Malaysia’s Future
These patients are a mirror reflecting our future as a nation. NCDs have been rising despite years of prevention efforts. As more Malaysians develop chronic illnesses, we must ask:
What is the Ministry of Health (MOH), Ministry of Higher Education (MOHE), and Ministry of Finance (MOF, which oversees IJN) doing to address these issues?
