Category Archives: Organ Transplant

SIUT carries out country’s first cadaveric kidney transplant

 

By Zubeida Mustafa      

: Pakistan joined the ranks of a number of other Islamic countries in medical technology when the first cadaveric kidney transplantation was carried out at the Sindh Institute of Urology and Transplantation (SIUT) on Thursday.

Although Pakistan has had a transplantation programme (thanks to (SIUT) for more than a decade now, and organs from cadavers have been obtained from Europe, this was the first case of a cadaveric donation in the country.

Navid Anwar, a young man of 24, the son of Anwarul Haq Fatmi, made history by becoming the first cadaveric donor. A student of Chartered Accountancy, Navid was critically injured in a road accident on Saturday. He was admitted to the ICU of the Liaquat National Hospital where he was put on a ventilator. Despite the best efforts of the neurological team, Navid could not survive. He was pronounced brain dead by the neurologists there.

On the family’s request his kidneys and corneas were donated for transplantation. The transplantation team of SIUT grafted the kidneys in two patients who were being dialyzed at the Institute for the last two years and had no family donors. Wajid (25) and Farhan (19) were selected as the recipients on the basis of tissue matching. There are 500 or so patients of renal failure at the SIUT who need transplantation but have no donors. Farhan became the 647th transplantation recipient at the SIUT. Mohammad Rashid from Azad Kashmir had been the first in 1986.

Navid’s grief-stricken family are aware of the importance of organ donation to save the lives of patients with endstage renal failure. They thought of donating his organs when they were told that this young man could not survive.

“We knew how it felt to lose a family member in the prime of his life. We wanted to save other families from this agony by saving the life of some other young person. Now we have the satisfaction of knowing that my brother will live on through the four other people who have received his organs,” Navid’s sister, Shazia, said.

About 35,000 people suffer from endstage kidney failure in Pakistan every year. Only a fraction of them (nearly 100 every year at SIUT) receive an organ from a live related donor. The other survive on dialysis but the quality of their life remains poor.

In other Muslim countries such as Saudi Arabia, Iran, Oman, Jordan, Turkey, Lebanon, Egypt, Tunisia, Kuwait and Bahrain, which have national cadaveric organ donation programmes, transplantologists obtain organs from cadavers to meet the need of their patients with endstage renal failure. Pakistan has been slow in this respect. Though some corneal donations have been made in the country, until now no case of cadaveric kidney donation has been recorded.

According to neurologist, nearly 150 people are admitted to the ICUs of the public hospitals in Karachi every year who are declared brain dead. If people could be motivated to donate cadaveric organs, the transplantation programme could be expanded and liver, heat and lungs could also be transplanted. At present the kidney transplantation programme depends on live related donors whereas the Eye Bank imports corneas from Sri Lanka.

Source: Dawn, 6  November 1998,

 

 

 

SIUT on life-saving mission

94-20-01-1996a                                                                                                                                     KARACHI: The light at the end of the tunnel for Karim Dad is growing dim-. He is a 36-year-old farm worker from Tando Jan Mohammad and has lived on dialysis for the last five years. A patient of end-stage kidney failure, Karim Dad could not have survived had he not been visiting the Sindh Institute of Urology and Transplantation, Civil Hospital, Karachi, twice a week to be hooked on to the dialysis machine which removes impurities from his blood. (This function is normally performed by the kidneys in a healthy person.)

SIUT has spent Rs 400,000 on Karim Dad so far and not charged him a penny. In the private sector, Karim Dad would have had to pay Rs 1,000,000 for dialysis to stay alive — something beyond his means.

Nizamuddin, a 30-year vegetable vendor from Orangi Town, is in the same boat. A patient of kidney failure, he has been coming for free dialysis to SIUT since July 1990. Continue reading SIUT on life-saving mission

At SIUT the dead help the living

Shehnaz: A gift of life from the Netherlands
Shehnaz: A gift of life from the Netherlands

By Zubeida Mustafa

The story begins five thousand miles away in the Dutch city of Maastricht. In mid-January a 14-year old girl slips into a coma and dies due to a ruptured cerebral aneurysm. Her grief-stricken parents decide to gift her organs to the dying. Thus they would have the satisfaction of knowing that a part of their child has not died.

That is how the central registry of the Eurotransplant Foundation in Lieden gets an AB+ blood group donor.

It is noon in Karachi. At the Sindh Institute of Urology and Transplantation (SIUT) in the Civil Hospital there is a call for the director, Dr Adibul Hasan Rizvi, from Dr Ganke Kootstra of the University of Maastricht. There is a cadaveric kidney available. Does Karachi have an endstage renal failure patient who needs the organ and has the matching tissue type?

Thus begins the miracle for Shehnaz, a young woman of 24 and a resident of New Karachi. She has been haunted by the spectre of death for the last four months since her kidneys stopped working. She has survived with the help of dialysis — a procedure in which the function of cleansing the impurities in the blood is performed by a machine to which the patient’s artery is hooked. But life has been robbed of all joy. Since October Shehnaz has had to come to the Institute thrice a week for a four-hour dialysis session. Then too, she feels fit for only a day, after which the nausea returns. She also gets breathless. Continue reading At SIUT the dead help the living

Why not organs from cadavers?

By Zubeida Mustafa

75-18-06-1993.AOrgan transplantation technology was introduced in the West in 1904 when the first corneal graft operation was performed in a New York hospital. The first kidney was transplanted in Boston in 1954. Today, surgeons in the Third World have adopted the technology with a growing measure of confidence and success. Nearly 40,000 transplantations are being performed every year all over the world and this technology has come to stay.

As happens in the case of any scientific breakthrough, many related issues, especially of an ethical nature, are now being debated. The 1 Institute of Urology and Transplantation, Civil Hospital Karachi, which has kept up a constant exchange of views and expertise with transplantation surgeons in Western centres, recently played host to two eminent gentlemen from the Royal Free Hospital, London. Dr Oswald Fernando, a surgeon from Sri Lanka, and Dr Zac Verghese, a basic scientist from India, have worked in Britain since 1963. They are therefore well placed to understand the challenges transplantation technology faces in the socio-economic conditions of the Third World. Continue reading Why not organs from cadavers?

Gift of Life

By Zubeida Mustafa

69-27-11-1992Two hundred children in Britain who faced certain death from liver failure are alive today and leading a normal, healthy life. They owe their recovery to the miracle of transplantation: the technology that allows surgeons to graft wholesome organs from one person to another.

Behind every milestone in medical science there is invariably a human story of sustained commitment and caring effort. In the case of these 200 British children the man who has made liver transplantation possible is Sir Roy Calne, a pioneer in the field of transplantology. A professor of surgery in the Cambridge University and president of the. International Transplantation Society, Dr Calne has contributed to the science of transplantation by his research on the immuno-suppressive drugs, without which no organ graft can be successful.

The defence mechanism of the human body normally ensures that it rejects foreign objects, which include organs taken from another person. Hence the use of drugs to suppress the immune reactions but in such measured doses that infections do not kill the patient. Continue reading Gift of Life

Organ transplantation has come to stay -Dr Adib Rizvi

By Zubeida Mustafa

68-04-08-1992a
Dr Adib Rizvi

In the early 1970s a magistrate from the interior of Sindh died of kidney failure in Civil Hospital, Karachi. This should normally not have merited a mention, especially twenty years later. Nearly 10,000 people in Pakistan come down with kidney failure every year.

But Mr Shaikh’s death, that was the magistrate’s name, proved to be an event of far-reaching consequences. In those days there were no facilities in Karachi for dialysis (let alone transplantation) — the only process by which the life of a patient of end-stage renal failure can be sustained. Mr Shaikh was sent to London where he was dialysed for a few weeks until his budget was exhausted. He was sent home with the false assurance that he was cured. He returned to Pakistan very pleased with himself looking forward to a new life. He brought as a token of his gratitude a small gift of handkerchiefs for the urologist who had attended to him in Karachi. Continue reading Organ transplantation has come to stay -Dr Adib Rizvi

Transplantation of kidney: Indian professor’s views

By Our Special Correspondent

KARACHI, March 23: While condemning the unethical practices associated with kidney transplantation from unrelated living donors. Prof Kirpal Singh Chugh made a fervent appeal to the medical profession to spread the message to the public for the need for cadaveric transplantation of organs.

Dr.chughHe was speaking on the “Ethics of Transplantation” at a symposium organised at a local hotel on Friday. Dr Chugh, who is the Professor of Nephrology at the Postgraduate Institute of Medical Education and Research, Chandigarh, India, was in Karachi to attend the Dow Medical College Annual Symposium on March 20-22. Continue reading Transplantation of kidney: Indian professor’s views

I was determined to live — and live normally

By Zubeida Mustafa

Dr Rukhsana Parveen is a Senior House Officer in the Nawabshah Civil Hospital. Her job in the 73- bed medical ward is considerably demanding entailing as it does six hours of morning duty every day and four emergency duties a week — twice in the afternoon and twice at night.

For 27-year-old Rukhsana, her work as a physician is most satisfying. She speaks enthusiastically about her profession, narrating animatedly her experiences with her patients. She is proud of her achievements: in the last few weeks she has cured six patients suffering, from the deadly disease Hepatitis-B. Continue reading I was determined to live — and live normally

Helpful donors come to the rescue

By Zubeida Mustafa

When ‘ the first kidney transplant operation was performed at the Civil Hospital, Karachi, on November 20, 1985, few expected it to be more than a rare surgical feat accomplished once in a blue moon. After all, the obstacles to be surmounted were several, the most significant being financial constraints. Could a hospital in the public sector with a limited budget, sustain a programme which cost Rs 140,000 to provide postoperative care and drugs to one patient for one year?

40-10-03-1989-AThere were other limiting factors as well. Even though the availability of surgical skill could be taken for granted, without an infrastructure of specialised nursing, extensive dialysis services and laboratory facilities, kidney transplant surgery could not be made routine. At that time arrangements did not even exist in the country for tissue matching, the first prerequisite for a transplant operation, and blood samples had to be sent abroad for this purpose.

Then there was the question of social acceptance of an idea that was quite radical for a society where life and death have a religious sanctity about them and are not. to be tampered with. Would donors be readily available and how would the people react to the concept of cadaveric donation, which has to be the ultimate endeavour of a transplant programme. Continue reading Helpful donors come to the rescue