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Mulago conducts first kidney transplant
A team of medical experts from Uganda and India performed a kidney transplant at Mulago Hospital on Wednesday, the first in the country, sources have revealed.
The surgery to place a healthy kidney from a donor into a 24-year-old male whose kidneys no longer functioned, was done at the newly-established organ transplant unit at the national referral hospital. Sources familiar with the four-hour operation said it was deemed a success and both patients were stable after the operations.
Asked for comment on Thursday, Dr Rosemary Byanyima, the acting executive director of the Hospital said: “We have been planning, planning, we will let you know when we have done it.”
Sources told this newspaper that Prof Frank Asiimwe, a consultant urologist and transplant surgeon at the hospital, led the team of Ugandan surgeons and other specialised medical professionals.
They were assisted by a team of specialist doctors from Yashoda Hospitals in India where Ugandan doctors received intensive training earlier to do organ transplants.
They were among 15 specialists including urologists, nephrologists and nurses trained in aspects of kidney transplant in India following an agreement between Mulago and Yashoda in 2014.
The takeoff for the actual transplant was delayed with the doctors at Mulago Hospital blaming it on lack of equipment and legal framework to start the life-saving surgeries.
However, the renovation works at the facility, purchase of modern equipment to establish world-class organ transplant unit, and the enactment of the Uganda Human Organ Donation and Transplant law this year, paved way for kidney transplant to begin in the country.
Under the new law, unlawfully selling an organ from your body and paying for one have the same penalty as that of human organ trafficking, which is life imprisonment. The law also prescribes which facilities should do kidney transplant, who should do kidney transplant, and who shall ensure transparency and accountability.
“A person shall not remove any human organ, tissue or cell from any living person who doesn’t have the capacity to give valid consent in accordance with this Act and any other applicable law,” provisions in the law read.
“A person who transplants an organ, tissue or cells from a living donor without prior authorisation of the Council commits an offence and is liable, on conviction, to a fine not exceeding 150,000 currency points (Shs3 billion) or imprisonment not exceeding twelve years, or both,” the provisions in the law read further.
Following the enactment of the law, Dr Robert Kalyesubula, a kidney specialist at Mulago Hospital and president of Uganda Kidney Foundation (UKF), told this publication that they are ready to start doing transplants while observing the above laws.
“This is a big landmark for the transplant world. We have been working on this for the last 10 years. So, we are very excited that it has been signed into law. That now opens all the other doors because whatever we are going to do, is going to be legal,” he said then.
He added: “We are hoping that any time from now, we can begin transplant because we already have a theatre in Mulago Hospital on the sixth floor, which is dedicated to transplant. We had already lined up a few people who were waiting for transplant but we couldn’t move them forward without the law.”
Having this law in place has also seen other hospitals show interest in conducting organ transplants. Dr Moses Muwanga, the assistant commissioner for clinical services at the Ministry of Health said the public and private hospitals will be allowed to do organ transplants as long as they meet standards. “…there are some private hospitals which have also shown interest. For kidney transplant, Rubaga Hospital has applied, but we have not assessed [their capacity],” Dr Muwanga said in July.
The burden of kidney disease
Dr Kalyesubula said they have over 350 patients on dialysis and that most of them cannot afford the procedure which uses artificial equipment to clean a patient’s blood as a normal kidney does.
“Everyone on dialysis, unless they have a contraindication should go for a transplant but most of them cannot afford. There are 350 people on dialysis but those who need are more than 1500,” he said.
After the successful transplant, another three surgeries are planned in the coming weeks, this newspaper has learned.
About 400,000 Ugandans have some form of kidney disease according to Dr Joseph Ogavu Gyagenda, another kidney specialist in the country.
Dr Kalyesubula said dialysis goes for around Shs150,00 to Shs500,000 per session in Kampala and a patient needs two to three sessions per week to remain in minimal health status as they await transplant.
“We should prevent kidney disease rather than try to treat it. Kidney transplant [abroad] goes for as high as $35,000 (Shs128m), depending on where you go,” he added. But sources within the Health Ministry said the government or individuals would spend around Shs50 million per patient for a kidney transplant in Uganda, the amount they said would be enough.
