What you need to know:
Doctors prefer relatives donating the kidneys
- Experts say it is cheaper for a person suffering from kidney failure to have a transplant than do dialysis. But the donated kidney need to, preferably, come from a very close relative to minimise chances of rejection.
- The donor should ideally be a first degree relative — brother and sister, mother and daughter or son, or father and son or daughter.
- Second in the order of preference are an individual’s children and second degree relatives like cousins.
- When such close relatives are used, medics say the kidney has a 96 per cent probability of working well, with the recipient losing it after 20 to 30 years of service.
Kenyans can now cancel trips to India or South Africa for kidney surgeries, and instead head to Kenyatta National Hospital where doctors have transplanted 14 kidneys in less than a year.
Normally, they do one or two a year. Another 20 patients are on the queue after new kidney donors were found.
Dr Antony Were, the hospital’s head of renal unit was upbeat that patients who have been going to India now no longer need to leave home.
“Since March this year, we have witnessed an unprecedented number of patients coming for kidney transplants,” he says.
In March this year, doctors in collaboration with kidney specialists from Hospital Clinic de Barcelona in Spain, carried out six transplants within one week.
In the past, patients have avoided Kenyatta, and preferred to go to India for three main reasons: it is easy to buy a kidney from a person who is not related to the patient; the cost of transplant has largely been cheaper; India has had an impressive transplant success rate.
But recently, the hospital seems to have turned the tables on India, improving on its success rate and sharply reducing the cost of a transplant compared to what is charged in India. With Sh300,000, a person can do a kidney transplant at Kenyatta compared to over Sh1.5 million in India.
This cost is higher if the patient travels with the donor, personal doctor and family members. “Our success rate is equally good with. None of the 14 kidneys were rejected by the patients,” says an upbeat Dr Were. This is because of the use of modern drugs which have significantly reduced the chances of rejection after the transplant.
An agreement with drug manufacturers Novartis and Roche pharmaceuticals has helped the hospital to get quality and branded drugs at a cheaper price than their generic versions. The hospital also boasts of better follow-up when the transplant is done locally than in India or South Africa.
One month after the transplant, a comprehensive follow-up is required to establish how the patient is doing. “We have attended to some patients who consult us with problems such as kidney rejection six months after the transplant has been done abroad,” says Dr Were.
The other problem local medics experience with such patients is all the medical details about the donor and the procedures and drugs used are locked up in India and rarely get released to the patient. The only area the Kenyan doctors cannot rival India is the ease with which a patient can buy a kidney or get a donor.
Under Kenyan laws, a person can only donate a kidney and not sell it. That is why the hospital is very strict if the donor of the kidney is not related to the recipient. “It is very difficult for someone who is not closely related to you to agree to donate a kidney without getting some incentive. And whenever non-related persons are involved in kidney transplants, we do a lot of screening to make sure money has not changed hands,” says Dr Were.
It is this strictness that makes people to opt for India where the rules and the environment have, until recently, been conducive for transplants for non-related persons. Locally, the difficulty in getting donated kidneys is one of the factors to blame for the long queue of people needing transplants but who are not getting them.
The other reason for the long waiting list at Kenyatta has been the few experts involved in kidney transplants. In Kenya, there are 27 urologists and 20 nephrologists. Of these, only five are involved in kidney transplants. Yet, with Uganda and Tanzania having only one neurologist and Burundi and Rwanda with none, Kenya is the best performer in the region.
Because of this, patients from these countries are seeking services at Kenyatta, contributing to the long-waiting list and putting more pressure on the hospital. The cost of carrying out tissue matching tests is another area forcing patients to wait for long before getting a kidney transplant. This matching is done in South Africa at a cost of Sh60,000.
This cost would however be much lower if the tests were done locally. Equipment that does tissue matching costs Sh15 million.
— An AWC Feature