Relatives blank corpse kidney transplant

Choosing to remain anonymous, a source at Mt Hope admitted this happened because the relatives were concerned when doctors were reportedly “unsympathetic” to the deceased.

“They felt the body would have been treated like garbage and they just changed their minds,” the source revealed.

This is just something unpleasant that happened, Undine West-Wooding of the National Organ Transplant Centre (NOTC) said. “But there are different reasons for the next of kin to refuse donating the organs. Sometimes the time frame does not work out, and it can also be difficult to ask for organs when someone is dying.”

The Deceased Donor Programme permitting this type of procedure was launched in March 2007 by the Ministry of Health and since then, there has been one kidney transplant from a deceased donor Jacqueline De Matas, described by doctors as a “cadaveric” transplant.

West-Wooding explained that there is a process to follow for this type of organ donation. First, the donor must be considered “brain dead” and be in the Intensive Care Unit. Then two physicians unattached to the ICU must confirm this before any decision is made about donation.

“When we have a donor, then we contact about five possible recipients, since we have two kidneys.

“Relevant testing then begins to determine compatibility and then we schedule surgery,” she stated.

The single cadaveric transplant took place in August last year. “One of the deceased’s kidneys was good, but there were problems with the other.”

She added that there are 88 registered donors who have been tested and are in possession of donor cards, in case their organs become available.

However, she stated that the next of kin still has the final say.

“So it is still up to the donor to alert their relatives about their wishes for organ donation. And still the next of kin may refuse.”

The NOTC is at present trying to implement policies for situations such as a coroner’s case, where the person is not brain-stem dead, and permission for organ donation must be given by the coroner.

Due to the time delay, she said, this has resulted in some organs not becoming available for safe transplant.

West-Wooding also admitted that there is need for co-operation between personnel at the various ICUs around the country.

“Sometimes people forget to call the NOTC until it is too late, because we don’t have proper systems in place. And some people are not even aware that we exist for this service.”

She explained that when a deceased donor becomes available, there is a time factor of about 24 to 48 hours, if the patient remains stable and is on life-support machines. “Recipient testing takes just about two days also, so it can come down to the final minutes.”

Before the NOTC was establised in January 2006, kidney transplant patients were forced to seek treatment abroad, including the late Presbyterian Minister Allison Nobee and Dr Rawle Edwards, who both had transplant surgeries in Pakistan.

Nobee had a kidney transplant in that far east country in 2004 and returned to Trinidad.

After a few weeks of resuming his services at his Penal church, he died of renal failure.

Edwards, Chief Medical Officer of the Ministry of Health in 2005, died about one week after returning from his surgery in the same country.

In addition to the cadaveric transplants, there are many transplant operations involving donors who are relatives of the patients.

Shennelle Sydney, 26, received a kidney from her brother Kern, 22, last September and she said she has a new outlook on life since the diagnosis and operation.

During an interview last week, she admitted that when she was first diagnosed, she was shell-shocked. “I thought they had made a mistake. I couldn’t believe it and didn’t fully understand the implications until the doctors outlined what dialysis treatment entailed.”

Sydney started peritoneal dialysis at home, and doctors also suggested a transplant. “My twin brothers, Kern and Keron, along with my mother, were tested and Kern was the most suitable.

“He agreed, although I was still reluctant since I didn’t want him to feel pressured into giving up a body part,” she admitted. “But he wasn’t worried at all”.

She described her treatment at the NOTC as “fantastic”.

“They were very thorough in preparing us for the surgery. We even visited a psychologist.

“The hardest part for me was adjusting to a new diet, which now my entire family has adopted.”

After surgery, Shenelle spent about one week in hospital recuperating, while Kern had a shorter stay. “He went back about a week later for a general check-up to make sure his remaining kidney was working well. But I have had to follow stringent guidelines on proper medications and their usage.

“I also have regular tests to make sure the kidney is functioning properly.

“I had to wear a face mask for about six weeks after the surgery to prevent infection and doctors gave me permission to resume normal activities since January this year,” she added.

Now Shennelle is back at her workplace and has also resumed classes for her Master’s Degree in Human Resources.

Though transplant recipients are generally pleased with their treatment at Mt Hope, this is not the case with other renal failure patients, who are faced with numerous setbacks in accessing treatment.

Dialysis patient 50-year-old Inniss Toussaint said he has been undergoing treatment for the past 16 years and has experienced regular frustration at the outpatient dispensary at EWMSC, where basic medication is often out of stock.

In a recent interview with Sunday Newsday, he said doctors would write prescriptions, and when patients go to the dispensary, medication would not be available.

“This has been going on for years and it is ridiculous. The Ministry of Health is aware of the volume of medication needed on a monthly basis, so why don’t they order enough to be able to supply patients’ needs,” he stated.

Toussaint said patients had to resort to purchasing the drugs at pharmacies, and many times when they can’t afford it, they just do without, which only aggravates their health.

“There are possibly patients who may have died without medication, because they couldn’t afford the price,” he admitted.

The issue of accessible dialysis treatment was brought up in the House of Representatives recently by opposition MP Dr Tim Gopeesingh, who questioned the delay in delivering two renal treatment centres promised by Government since 2004.

He said these centres, each with 200 dialysis units, would be able to facilitate treatment of over 400 patients simultaneously, with one unit being able to dialyse at least 20 or 30 patients per week.

Minister of Health Jerry Narace admitted then that questionable tendering procedures had stalled the construction of the two promised renal dialysis centres, but he was unavailable for a comment when Sunday Newsday called last week.