PATHWAY FIRST OFFICE VISIT WITH DR FRANCISCO
1. Upon booking an appointment, you will receive an automated confirmation email/SMS with all the details of your appointment and our centre's location and contact details.
2. You will receive a reminder by email/SMS for your appointment one day before your appointment.
3. If wishing to save time at the counter you can pre-register. For this, we will send you a form to fill all your information before the appointment (optional).
4. You can also send us by email any referral letter, blood results or any other information that you require pertinent.
5. After your clinic visit, we will print a copy of the clinical and administrative documents produced during your visit (clerking, medical history, notes taken during the visit and the invoice; and if applicable: a prescription, medical certificate, memos and referral letters.
6. Details of a follow-up appointment and investigation forms will be given to you, too.
7. You can choose to pay by several methods (currently, cash, credit card, NETS, Union) at our concierge desk, but you can pay also by paypal in your phone in real time going to our website. Again, if wanting to save time, you can pre-pay online using paypal on our website, so you do not need to wait after seeing Dr Francisco.
-GST is charged for all our in-office consultations and services.
PATHWAY REGISTRATION FOR ELECTIVE ADMISSION TO MOUNT ELIZABETH NOVENA HOSPITAL
1. You will be given an appointment to see Dr Francisco in his centre few the days before your admission for 'Pre-Assessment' check-up.
2. After the 'Pre-Assessment' check up and if Dr Francisco confirms your admission, you will be given the following documents/forms:
-Admission form filled by Dr Francisco
-Financial counselling on Dr Francisco's in-patient fees (all explained by Dr Francisco)
-Any forms for laboratory or imaging investigations (if applicable)
You need to bring these forms with you on your admission day.
3. On the admission day, you need to go for registration at the Business Office counter on the lobby of Mount Elizabeth Novena Hospital and get a queue number.
Please note that the registration procedures can take up from 30-120 minutes, so we recommend you to arrive two hours in advance.
-The Business Office will give you financial counseling on all hospital charges, excluding Dr Francisco's in-patient fees.
-You will need to give the details of your insurance plan(s) to the Business Office staff.
-The Business Office will explain any other important details pertaining to your admission.
4. The Concierge will escort you to your room.
NOTE: You can also pre-register at the business office few days in advance, so to save time on the day of admission.
If it is your preference, we can also arrange admission into any other of our affiliated hospitals: Mount Elizabeth Hospital Orchard, Gleneagles Hospital or Parkway East Hospital.
PATHWAY OVERVIEW OF THE PROCEDURES FOR KIDNEY TRANSPLANTATION
1. Patients willing to have their kidney failure managed at our centre, potentially with a kidney transplant, need to book an appointment in our clinic to assess -through a series of investigations and examinations by various specialists- their overall medical condition and eventual fitness to undergo the transplant surgery or to take anti-rejection medications.
2. Potential donors will need also to be examined and have several investigations to assess their compatibility with the recipient and their overall health and fitness to undergo donation surgery.
-In cases where several potential donors are willing to donate (eg several family members), we recommend assessing all the willing donors in order to select the most suitable donor, not only from the immunological point of view but also from the social aspect, while also taking into account specific family dynamics, age-matching and social factors.
-In our centre, as in many others worldwide, we are aware that transplantation between highly compatible individuals (typically within family members) is most likely to be associated with more prolonged transplant survival and less chances for rejection; and, as a consequence, better quality of life. Therefore, in our centre, we prefer to find the most compatible donor first within the family. Spouses are also considered and other emotionally-related donors, applying priciples of best possible match, and if not, at least permissible mismatches. If good compatibility is not found, we advise patients to consider joining an exchange programme before considering transplantation where the risk for rejection is high and the patients need to be subjected to de-sensitisation, as de-sensitisation is not 100% effective. But indeed, undergoing a high-risk transplant for rejection seems overall better than remaining on dialysis forever, in case there are no compatible donors.
3. Both patient and donor would also need to be counseled about all the treatment options for end-stage kidney disease, the rationale and benefits of kidney transplantation over dialysis, but also the potential side-effects or complications of kidney transplantation. We will address all their queries and worries, so they proceed only if they are convinced this is the best option for them, balancing risks and benefits, and they would be content for the rest of their lives.
4. Once the patient and donor are found to be healthy enough to undergo their respective surgeries and once they have given informed consent, their case is assessed by our ethics committee.
-A demonstration of relationship (genetic or emotional) between the donor and recipient is necessary, as well as the demonstration that donation is altruistic and not coerced or influenced by any sort of financial gain or trade between donor and recipient.
5. Upon approval by the ethics committee, the donation and transplant surgery will be arranged.
Overall, the assessment process usually takes several weeks, but this is necessary to minimise risks and ensure the best possible outcome and experience.
The business office of any of our affiliated private hospitals and the involved surgeon, anaesthesiologist and nephrologist (Dr Francisco) will counsel the patient and donor about their charges.
At present we can arrange the kidney transplant surgery at Mount Elizabeth Novena Hospital and other Parkway Pantai Hospitals in Singapore. These private hospitals offer package prices, that apply to standard and uncomplicated cases. Cases requiring special treatments or complicated cases can have surcharges. The charges are not very different from other hospitals in Singapore charging private rates.
EXTRA NOTES ON KIDNEY TRANSPLANTATION
Performing a transplant in Singapore (or in other parts of the World) incurs significant costs as transplantation involves the use of sophisticated technologies and special medications, and involves the technical and intellectual expertise of many professionals and specialists. However, we believe transplantation is an important investment in your health as you are most likely to live longer and better in comparison to remaining on dialysis forever. Furthermore, in the long run transplantation is also cheaper than undergoing dialysis. Having greater life-span and quality of life is simply priceless.
Indeed, transplantation is not free of complications and the anti-rejection medications are not free of side-effects. But despite this, in the majority of patients, kidney transplantation offers to patients the highest chances for life rehabilitation and to live longer and fuller lives, regaining great degree of freedom to enjoy things you used to enjoy before developing kidney failure.
These benefits can be greater if transplantation is performed before undergoing dialysis (pre-emptive transplantation) or as soon as possible after starting dialysis
In cases, where a relative or spouse could donate a kidney, we do not recommend to remain in the waiting list (in Singapore almost a decade). During those years the kidney failure keeps draining your health and increasing the chances of complications that can preclude transplantation in the future or have worse outcomes...only when no living donor is available.
Please do not hesitate to contact us for further queries or clarifications on these matters. We would be honoured if you choose our centre as care provider to your kidney failure and to assess whether you are medically suitable for kidney transplantation (not every patient is suitable).
If you choose another centre, we respect your decision and we hope the best for you. Do discuss actively with your nephrologist the option of kidney transplantation, to check if you are eligible and have no contraindications. Even if not arranging the transplant surgery with us, Dr Francisco can and would be very happy to give you advice and recommendations (as first or second opinion), even if you choose to perform your transplant surgery elsewhere.
Dr Francisco is an eager promoter of live kidney donation, wishing you the best possible health and helping you to take the best possible decision for the entire family, because not only the recipient benefits from kidney transplantation but the entire family. Transplantation is also a beautiful experience that brings families closer and allows families to have a wife, a husband, a son, a father, etc for longer, contributing for longer to the family with love, support and all the things a family member does for the family. That is again priceless.
Dr Francisco is not only a nephrologist, a transplant physician and a transplant immunologist, but also a philanthropic and empathic doctor, who appreciates your struggles and worries when living with kidney failure and simply wishes the best for you. So, please do not hesitate to book an appointment with us to know more about transplantation and whether kidney transplantation is suitable and feasible for you.