TT not ready for kidney transplants

The Medical Professionals Association of TT (MPATT) said Government would have to increase the Budget for health, if kidney transplants are to be done in TT on a large scale. Speaking to Newsday yesterday, Dr Lakhan Roop, acting president of MPATT, said such a programme “cannot be established on the current infrastructure. It has to be vastly upgraded.” He said equipment is required for typing donors and managing brain-dead patients before the transplant was done. He said two surgical teams are needed, “one for the brain-dead patient and the renal team for the transplant.”

Dr Roop said the number of ICU beds available would also have to be increased. At San Fernando General Hospital where he works, there are only three ICU beds. He said ten beds are needed to accommodate high dependency and coronary care units. “More people die of heart attacks and (of) not getting coronary care.” Dr Roop said “at least” four beds should be allocated to the kidney transplant programme if it is ongoing. “Our population is riddled with hypertension and diabetes, and many go on to renal failure.” After surgery, additional care is required in the form of anti-rejection drugs and renal biopsies must be done regularly to determine if the kidney is being rejected.

Roop said anti-rejection drugs can compromise the immune system of transplant patients and is prone to infections. He said a transplant is not a simple procedure of going to another country and returning home. Roop said a patient can spend between three and six weeks in the ICU after having kidney transplant surgery. In response to media reports that some patients who had surgery done in Pakistan died after returning to TT, Roop said he could not comment since he did not know if kidney transplants were regulated in that country or if appropriate care was instituted. He said even if people had surgery in Pakistan, when they came home they still needed “a whole gamut of follow-up care.”

Urologist Dr Philip Ayoung-Chee said even before the establishment of a transplant programme, “the first step” is an adequate system of dialysis which, he said, is lacking in TT. He said if a problem developed during surgery for either the donor or the recipient of the kidney, then dialysis would be needed. Dr Ayoung-Chee said without a proper dialysis system, both the donor and recipient were at risk. Health Minister John Rahael last week said that a nephrologist was working with the Chief Medical Officer and legal personnel of the Health Ministry to establish a facility for harvesting of organs and transplants. He told Newsday the delay in the regulations for the Human Tissue Transplant Bill was due to technical aspects including “storage, how we are going to do it, and the manner in which it would be done.” The Ministry also expects its evaluation team to have decided on a preferred bidder to establish two dialysis centres.