BY: Salma Khalik

THE number of kidney transplants needed here could be halved - if diabetics control their illness before it causes organ failure.

Kidney expert A. Vathsala said that diabetics - 300 of them are currently waiting for kidneys - could sidestep the queue altogether by taking their medicineand following better diet and exercise plans.

Close to 600 people here are queueing for a kidney from a dead donor and they face an average wait of nine years, since there are fewer than 50 available annually.

Many would be too old, too sick or have died before they get near the top of the list.

Dr Lee Chung Horn, a diabetes specialist in private practice, said diabetic patients have seven to 10 years' warning that their kidneys are heading for failure. "Lots of people whose kidneys start malfunctioning will never face kidney failure, if they put in the effort," he said.

More than 1,000 people here lose the use of their kidneys every year - in over half the cases, uncontrolled diabetes is the culprit.

Professor Vathsala, who is head of the kidney transplant programme at the National University Hospital, said Singapore could learn from countries such as Iceland.

There, diabetics account for only 5 per cent of kidney-failure patients because of successful control of their illness.

One in 12 people here suffers from diabetes. Half do not even know they have it. Of those receiving treatment, one in four fails to keep his illness in check.

High sugar levels in the blood erode the ability of the kidneys to clear poisons from the body, eventually causing them to stop working altogether.

Some desperate patients have resorted to buying organs illegally.

Last month, two Indonesians were convicted in the courts here of selling their kidneys. Yesterday, two more men were charged - one for allegedly buying a kidney and the other for acting as a middleman.

Dr Kenneth Mak, head of surgery at Alexandra Hospital, believes that shrinking the number of kidney-failure cases will be an uphill battle, and one which will take decades.

With increasing numbers of people getting "diseases of affluent living" - such as diabetes - caused by a rich diet and little exercise, kidney-failure rates will continue to soar for now, he said.

Rich buyers tap black market for organs

THE World Health Organisation (WHO) said that one in 10 organ transplants around the world involves the buying of an organ.

The buyers are generally rich and dying. They are paying for organs on the black market, regardless of whether the body parts come from a willing seller or someone who has been kidnapped or otherwise coerced into giving up his kidney or liver, the WHO said.

In May this year, more than 150 government, medical and ethical representatives from 78 countries met in Turkey to declare war on the organ trade.

Professor A. Vathsala, a kidney specialist here, was part of the steering committee that wrote the resulting Declaration of Istanbul, which opposes all forms of organ trading, tourism and trafficking.

She told The Straits Times that the declaration was to allow the world's transplant community "to stand together and to firmly declare that all forms of transplant commercialism are abhorrent".

This article was first published in The Straits Times on July 11, 2008.