DREAMERS AND DOERS
Thanks to help from a French expert, doctors in Northwest China are leading the fight against a hepatic disease. Fang Aiqing reports.
It is now 21 years since Georges Andre Mantion, 71, first visited Urumqi in Northwest China’s Xinjiang Uygur autonomous region.
The French surgeon, an academician at the French Academy of Medicine and a recent winner of the Chinese government’s Friendship Award, is an expert in the treatment of digestive tumors, and he is a specialist in treating alveolar echinococcosis, or AE.
AE is a hepatic disease caused by a kind of parasite of one or two millimeters and is also known as “parasite cancer” as its symptoms and disease progression is similar to hepatic cancer.
According to 2016 statistics of the disease prevention and control bureau of the National Health and Family Planning Commission, echinococcosis is widespread mainly in pastoral areas of western China’s 350 counties, threatening a population of about 50 million.
In some plateau areas, the incidence is 12 percent. And the 10-year case fatality rate of AE, if not treated in time, exceeds 90 percent.
For years, Mantion’s footprints have been seen beyond Xinjiang, covering major echinococcosis-prevalent regions in China like Qinghai and Gansu provinces and the Ningxia Hui, Inner Mongolia and Tibet autonomous regions.
He has also worked in major hospitals in Beijing, Chongqing, Sichuan and Yunnan.
In 1997, Mantion, then on his first visit to Urumqi, performed the first anatomical liver resection surgery in Northwest China, which later drastically improved surgical techniques and management of hepatic AE as well as other hepato-pancreatic-biliary, or HPB cancers, at the First Affiliated Hospital of Xinjiang Medical University.
Before that, surgical resection in Northwest China was not so anatomic and precise.
Since his first visit, Mantion has kept returning to China every year.
Within three years of his first visit, the hospital’s team of doctors that focuses on organ transplantation was built up, and Mantion’s student Wen Hao, current director of the hospital, pioneered China’s first successful liver transplantation for an endstaged AE patient in 2000, giving the patient a new lease of life.
Meanwhile, Mantion helps promote exchange programs that allow HPB surgeons, anesthetists, nephrologists and other specialists in organ transplantation from Xinjiang to visit his transplantation center in France.
The annual group training programs, which started in 2004 and are sponsored by the State Administration of Foreign Experts Affairs in China, are of great help to the hospital team.
“With their help, our international visibility has improved,” Wen says.
In 2016, WHO set up in Xinjiang its first Collaborating Center for Prevention and Care Management of Echinococcosis in Asia, which aims at providing methodological support and expert advice, especially for the Central Asian area.
But, the academic link between Mantion and Xinjiang was bridged years earlier. In 1986, the medical center at University of Franche-Comte, Besancon, France — the hospital Mantion works for — launched the world’s first liver transplantation for AE patients.
Wen, then pursuing his doctorate in Britain, got to know about the technique from an international conference booklet in 1991 and the year after, receiving his degree, he went to the medical center at Besancon for further surgical training on liver transplantation.
“I studied there for one year as a visiting scholar, and then a few years later as a guest professor. The experience laid a solid foundation for my surgical innovation,” says Wen.
Back in Xinjiang in late 1995, Wen started facilitating the international cooperation, and in 1997, Mantion and three of his colleagues were invited to China.
It was the first time since the reform and opening-up that a group of foreign surgeons had visited Xinjiang.
Speaking about Mantion, Wen says he is a highly sophisticated surgeon.
“Observing and learning from him is like watching a work of art,” says Wen.
Mantion, now in his 70s, regularly takes part in meetings for doctors to discuss therapeutic regimens for complicated cases, during every visit to Xinjiang.
“Younger doctors would like to stress on techniques, but he is more considerate to the patients,” Wen says.
During the past 21 years, Mantion has seen Xinjiang’s leapfrog in developing medical care.
And he says: “They still ask me, but I believe they can do it by themselves. This was not the case 20 years ago.”
One of the key developments happened in 2010, when Wen’s team managed the world’s first liver autotransplantation for treating an end-staged AE patient, during which the patient’s whole liver was taken out, dissected, repaired and reimplanted.
It is now eight years since the surgery, and the patient is still alive.
According to Wen, 78 of the approximately 150 cases of liver autotransplantation worldwide were done in Xinjiang.
When Wen’s team reported the first case in the English version of the Chinese Medical Journal, Mantion, in his editor’s note, wrote: “We dreamed of it; they did it!”
Speaking about the achievement, Wen says: “We move forward by standing on the shoulders of our predecessors.
“He (Mantion) hopes to apply the technique back in France, and two cases are being discussed. Whether they come or we go there, we are working on it.”
Mantion says he is proud that Chinese surgeons have grown from devout students to leaders in the field.
“When you are an academic surgeon and professor, you may do big things. But most important as a teacher is to help the younger generation accomplish more and be proud of them,” he says.