Kidney Transplant: LASUTH Rekindles Patients’ Hope Of Survival

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Minister of Health, Dr Isaac Adewole
Minister of Health, Dr Isaac Adewole

When doctors from the

Lagos State University Teaching Hospital (LASUTH) successfully conducted the first kidney transplantation in the institution in November, it further raised the hope of survival for patients living with kidney conditions.
The surgery carried out on a 56-year-old man on November 11, 2015 by a team of nine doctors, involved the patient’s 26-year-old nephew who donated one of his kidneys.
From statistics, it is known that no fewer than 37 million Nigerians, representing 23 per cent of the population are suffering from various stages of kidney diseases.
Simply put, one in every seven Nigerians is suffering from one form of kidney disorder, according to Dr Ebun Bamgboye, the President, Nigeria Association of Nephrology and Chief Medical Director, St. Nicholas Hospital, Lagos.
The virulent nature of the diseases has left Nigerian patients with many challenges in treating kidney problems, leading to many who are indigent dying untimely.
The few who are wealthy travel overseas for treatment on regular basis leading to capital flight of several millions of Naira from the country.
The burden and the belief in the old dictum that “health is wealth’’ led the former governor of Lagos State, Mr Babatunde Fashola-led administration to move to alleviate the plights of those suffering from kidney disease.
The administration then conceived a modern Cardiac and Renal Centre (CNC) in the state.
To realise the feat, the government upgraded the Ikeja General Hospital to a University Teaching Hospital, the Lagos State University Teaching Hospital (LASUTH), affiliated to the Lagos State University (LASU).
And subsequently, it upgraded the Gbagada General Hospital to an annex of LASUTH.
Sooner than later, it started the N5 billion CNC project in 2008 and completed it in 2013 at the Gbagda Annex of LASUTH.
The centre today offers hope of survival to the many Nigerians suffering from kidney disease.
Patients can now heave a sigh of relief as they will not have to source for millions of Naira to travel for treatment overseas before they can find solutions to their ailments.
It is in the public domain that between 2008 and 2014, the Lagos State Government under Fashola, sponsored very sick people overseas at tax payers’ expense.
There were 28 renal cases that benefited from the state’s gesture. Also there were 11 renal cases that were sponsored for kidney transplant, dialysis and post-transplant immunosuppressant at St. Nicholas Hospital in Lagos.
It is pertinent to state that prior to the LASUTH, Ikeja, achieving the breakthrough, St. Nicholas Hospital was the only institution offering the service in the country.
But with the realisation of the dream by LASUTH, the pains of raising so much money to go for treatment overseas will be reduced.
The CNC operation has begun to attract the best medical personnel in the treatment of renal treatments to return to Nigeria to render their services.
Thus, brain gain is beginning to garner momentum as against the brain drain syndrome the country suffered from some years ago.
Fashola at the inauguration of the centre described it as the best in Africa, built and equipped with the best modern facilities obtainable in the developed countries of the world.
“The centre is equipped with 24 dialysis bed stations, 20 beds for recovery and general ward use, two high dependency wards with five beds each for patients who have come out of the intensive care.
“Five beds for patients in intensive care, four post-surgery beds for patients who just finished surgery, two post cathlab beds and two surgical theatres built to the most contemporary standard to cater for people who are critically ill.
The theatres will also serve as lecture rooms for students and where kidneys and hearts can be removed and transplanted.
“There are cameras fitted into the surgical scumps which will project images and voices of what is happening in the theatre to the ground
floor,’’ he said.
The Commissioner for Health, Dr Jide Idris, says the idea of establishing the CNC was to lessen the burden of communicable disease in the state.
Before the successful transplantation, barely seven months after the CNC was opened, the centre, arguably a pacesetter in Nigeria’s health industry, was already offering services to renal patients.
The giant strides of Mr Babatunde Fashola’s administration, in the health sector of Lagos State, has today opened a new vista for saving the lives of people with kidney conditions.
The team of LASUTH doctors who performed the unique feat are Dr Jacob Awobusuyi, who led them, Dr Oduanyo Ikuero, Dr Funmilade Omisanjo, Dr Kayode Abolarin, all Neophrologists.
Others are Dr Theophilus Umeizudike, Dr Mumuni Amisu, Dr Tunde Akinola, Dr Biyi Majekodunmi, Dr Adebanjo and Matron Adamson and LASUTH pharmacists among others.
They were unambiguous in telling the world that they were set to conduct more of such surgeries; so, it is for Nigerians to take advantage of that and help to save people dying of kidney diseases.
In doing that, they also believed that it would to an extent save the country the huge capital flight and attract medical tourism to Nigeria.
Some members of the team spoke about their experiences, future of transplantation in Nigeria and other sundry issues on kidney disease.
The Head of the transplant team, Dr Jacob Awobusuyi, a Consultant Nephrologist and Associate Professor of Medicine, said the experience was quite educative, satisfying and rewarding.
Awobusuyi, who obtained his Bachelor of Medicine and Surgery at University of Ilorin in1983, said: “I never thought I could enjoy the cooperation of the entire hospital and this made me appreciative of a fully motivated staff, who contributed immensely to the success of the first kidney transplant.
“ The team is composed of highly motivated doctors, surgeons and nurses who were all up to the task.
“The nurses had to sacrifice a lot by staying back for three days without going home to take care of the kidney transplant recipient. We are ready for future transplants.
“We already have some lined up for the next transplant; we are looking at the middle of January for the next set of transplants if  they pass the test,’’ he said.
Awobusuyi had his post-graduate studies at University of Ilorin Teaching Hospital, after which he started working with the Lagos State Health Management Board in 1994 as a Consultant Nephrologist.
Awobusuyi is also the pioneer Head of Gbagada Dialysis Centre and many general hospitals in Lagos State.
Dr Theophilus Umeizudike, Consultant Nephrologist, LASUTH, said it was meant to be the flagship of his career and a way of contributing to the society by giving life to people.
“After my experience in Germany, I said to myself this can be adapted to our local practice here. So, I and my colleagues started tinkering on this for about three years.
“Sometime last year, we had a team from Sao Paulo in Brazil that told us that what we have in facilities are comparable to what they have in Brazil.
“With this we are told, we can have transplant in LASUTH. We signed a Memorandum of Understanding (MOU) for them to give us technical support and help us with the procedure.
“We went to Brazil for some training and returned home. This year we realised that we have garnered enough experience to be able to have the first transplant.
“This we proposed with a team of indigenous doctors and surgeons who are working in LASUTH. We want to give Lagosians the opportunity of local content,’’ he said.
Umeizudike said they were confident about this because those that often travelled to India came back home to continue with their recuperation with some coming back worse off.
“We offer a comparative cost-advantage over treatment done abroad, and people need also to be convinced that treatment here is
guaranteed, of quality and cost-effective.’’
Umeizudike also said that carrying out the transplant here could put a check on medical tourism associated with kidney transplant in Nigeria.
“If people can be honest with themselves, they should appreciate that kidney transplant is available locally at a cheaper cost. We are confident about our capability when it comes to the operation.
“Before we had the operation, we were confident that the operation would be successful and we are happy to see that the patient who had been on dialysis is now normal.
“ It is a success story and we are happy that the patient is recuperating well.
“It is not easy to do a transplant because things may go wrong but we thank God we are able to overcome and the complication rate at low level,’’ he said.
On the future of transplant and the risk factors of kidney disease, he said that “in most transplant centres abroad like Cambridge in England, they do one live transplant donation every week which is usually on Tuesdays and that is about 50 to 52 in a year.
“Apart from that, there is deceased donation where someone dead can have the kidney harvested and given to people on waiting list, which happens anytime.
“Here, we may look at having at least one in every month and when we are more stable and have the capacity we will look at having two in a month.
“As time goes on, we can then have one every week which is what we are aiming at ultimately,’’ he said.
Umeizudike said the prevalence of kidney disease in Nigeria was largely due to the lifestyle of the people and dietary habits.
“Studies done in Nigeria showed that about 15 to 25 per cent of the Nigerian population may likely have kidney problem because of their style of living.
“In Nigeria, the major cause of renal failure is hypertension followed by diabetes, and also a condition of infectious disease and inflammation affecting the kidney function and structure.
“Also our diets are beginning to move away from what it used to be, we now consume complex carbohydrates and simple sugar. Other causes are HIV and urinary tract infections.
“The age susceptible to renal failure is usually, in developed world, about 60 years and above but in Nigeria it is between 30 and 40 years,’’ he said.
Comparing the cost between dialysis and transplant, Umeizudike said transplant is cost-effective and manageable compared to dialysis.
“Dialysis is initiated in people with renal failure. It is a process whereby the patient’s blood is passed through blood filter which removes nitrogenous waste from the kidney.
“A dialysis for the first time costs about N60, 000 to N70, 000 because of various tests that will accompany it but after the first
session, it drops to N20, 000 and N25, 000.
“Renal failure is not a death sentence, but very expensive to manage and treat. After treatment, we look at the survival rate of the graft
between 95 and 98 per cent.
“After five years it drops to 80 per cent and by 10 years between 60 and 70 per cent and if the first one failed there is option to have a second transplant,’’ he said.
Umeizudike said that transplant allowed the patient to recover from erectile dysfunction and for the females they would be able to conceive again.
He started his journey in medical practice by obtaining his first degree in 1995 at University of Ibadan, and had his post-graduate at Lagos State University Teaching Hospital in 2007.
He was awarded the Fellowship of West African College of Physicians in 2008.

Olarenwaju writes for News Agency of Nigeria (NAN)

 

Akojede Olarenwaju