He saves his twin brother’s life twice

alvin n allen

TWICE, he has saved his brother’s life. And twice did this pair of twins make medical firsts in the process.

In May, senior customer service executive Alvin Ang donated part of his liver to his brother, Allen, who is younger by 12 minutes.

It was the first identical twin living related donor liver transplant performed here.

About 30 years ago, the now 41-year-old twins were also involved in the first bone marrow transplant in Singapore. They were then 12 years old and Allen had leukaemia.

“Back then, our mother asked us to do the transplant, and so we did,” said Alvin, who is married with no children.

He added: “For the liver transplant, my mum didn’t insist on it. But I had been prepared for the day that at some point, Allen’s liver would fail.”

Allen, also married with no children, was diagnosed with hepatitis C in 2007. The viral infection causing liver inflammation is passed through contaminated blood, which he could have received from the numerous transfusions given during his treatment for leukaemia.

The senior operation executive’s condition had been kept stable through medication but it started to deteriorate early this year. His eyes and skin were turning yellow – signs of liver damage – and hospitalisations became more frequent.

In March, his doctor at the National University Hospital (NUH) suggested he go on the waiting list for a cadaveric liver.

It is standard procedure for a patient to be put automatically on the waiting list once he is deemed to be suitable for a transplant.

But Allen already had a potential donor in his brother, who would have to undergo a medical fitness test, and be counselled on the various aspects of the donation.

A cadaveric liver became available in early May, but after a few hours of deliberation, Allen turned it down.

“Because I wanted to give others a chance,” he said half-jokingly. “Because I had my brother to donate part of his liver to me.”

As identical twins, they would be a “complete match” for the transplant. Furthermore, they had a history of having had a successful bone marrow transplant.

Unlike most transplant patients, Allen would probably not need to take immunosuppressant drugs to prevent rejection of the donor liver.

This was important, as the hepatitis C virus remains in the body even after a transplant and immunosuppressants can actually accelerate the activity of the virus.

If the hepatitis C recurs after a transplant, treatment is given. However, in a few patients, the virus’ recurrence may be rapidly accelerated, destroying the transplanted liver in the process as well, said Associate Professor Krishnakumar Madhavan, director of NUH’s Adult Liver and Pancreas Transplantation Programme.

On May 31, the Ang brothers underwent their second historic transplant.

In Allen’s case, the risk of the hepatitis C returning is lower than usual, as he is not on immunosuppressants. But he needs regular follow-ups and tests to check for a recurrence.

Although the operation was a lot more painful than Alvin had expected, there was never any doubt that he would help his brother.

“What is most important is him. I wanted to volunteer, there was no concern about my health as I’ve always been well,” he said.

The twins, who have a 45-year-old brother in Shanghai, have always been close. Even their mobile numbers are different only by the last digit.

Growing up, they shared a room, were classmates at Bukit Batok Primary School, then schoolmates at Shuqun Secondary School. They had different friends but always hung out together even though Allen was a year behind from having to take time off for cancer treatment.

Alvin, the more outspoken of the two at the 45-minute interview at NUH last week, has felt like the big brother ever since Allen had cancer, and the later diagnosis of hepatitis C only reinforced his sense of responsibility.

After getting married in 2008, he bought a five-room flat in Woodlands for the extended family – Allen, his wife, and their 69-year-old widowed mother – to live under one roof.

“My mum can cook for him, and there are more people looking after him,” said Alvin, who regularly accompanies Allen to the doctor.

The pair hope to go on a holiday together, when Allen’s condition is more stable.

NUH transplant coordinator Priscilla Wee, who has known them for almost a year, said the twins were very close, and asked a lot of questions that demonstrated concern for each other.

“I thank him in my heart,” said Allen, when asked if he was grateful to his brother for saving his life twice. “I don’t have to tell him, he knows.”

Alvin chimed in: “I think that is more than enough. I think we work in such a way, it’s all in the heart. We have that understanding; it doesn’t have to be spelt out.”

The Straits Times

Published on Saturday, December 15, 2012

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