KIDNEY TRANSPLANT IN GHANA

Front Page: Daily Graphic, May 14, 2012. Story: Albert K. Salia DOCTORS at the Korle-Bu Teaching Hospital (KBTH) will begin undertaking kidney transplantation in the last quarter of this year. This will bring great relief to many kidney patients in the country who need kidney transplant but cannot afford the high cost of travelling and transplantation abroad. Since 2008, the nation’s premier hospital has undertaken 12 kidney transplants with the assistance of a team of transplant surgeons from Birmingham in the United Kingdom and the Transplant Links Community. Three of those transplants were performed in April this year. The Birmingham team is expected to perform another batch of transplants in October this year, after which the Ghanaian team will take over. However, Korle-Bu has sponsored the training of a consultant urologist, Dr Bernard Morton, as a transplant surgeon to lead a local team to bring hope to many kidney patients. Currently, the Dialysis Unit at Korle-Bu, which used to operate three times a week, now runs 24-hour, seven-day-a-week service because of the increasing number of chronic patients. An excited Chief Executive Officer of the hospital, Professor Nii Otu Nartey, in an interview with the Daily Graphic, said Korle-Bu would endeavour to provide the logistics and facilities to ensure a smooth take-off and sustenance of kidney transplantation by the Ghanaian team. Throwing more light on the preparation, Dr Morton said the hospital had come a long way since 2008 after the first transplant. He said the initial idea was for the local team to start the transplants after a period of assistance from the Birmingham team, but there had been a lot of ups and downs. He said he was grateful to the CEO of the hospital for standing firm and providing all the encouragement and support for the national project to be realised. He said the team would continue with the usual living donor practice where a living person would agree to donate one of his or her kidneys to a recipient. Dr Morton was hopeful that with time, the country would come up with an elaborate legal framework to support the cadaveric donations. Cadaveric donation is where the kidney of a brain-dead person but whose heart continues to beat is harvested and given out to someone who needs a kidney transplant. He said what the hospital needed was a complete centre, either as part of the Urological Centre or a separate transplant unit, which could be expanded to a tissue transplant centre. Asked about the availability of the requisite human resource, Dr Morton said, “We have demonstrated that we can do it after the first transplant in 2008.” He recalled how he and Dr Charlotte Osafo, a nephrologist consultant at the hospital, had to virtually plan and implement — preparing patients, counselling them and their relatives and handling the post-transplant management issues. He said the team of local personnel had continued to be around and actively taken part in the other transplantations and said the only new development was his training as a transplant surgeon. Dr Morton was hopeful that with time, a complete centre like the National Cardio-Thoracic Centre, the Burns and Plastic Surgery Centre would be set up. That, he explained, was necessary because as the number of patients increased, there would be the need for a separate clinic to handle the cases, stressing that “all those having the kidney transplants will need close monitoring by the doctors and compliance by the patients”. For her part, Dr Osafo, who is the Head of the Dialysis Unit of Korle-Bu, said the local renal team had built the needed experience to support kidney transplant locally. She said besides the transplant, some of the nephrologists at the unit were considering developing a peritoneal dialysis programme, a form of self-administered dialysis, to help ease the pressure on the dialysis machines. She expressed worry over the alarming rate at which people in their productive ages of between 20 and 50 years were developing kidney problems in Ghana. Dr Osafo said the University of Ghana Medical School, in collaboration with other centres in Africa and the USA, had applied for a grant from the National Institute of Health (NIH) to study the genetic causes of kidney disease in Africa. The outcome of that important application, she said, should be known later this year. If successful, then patients with kidney disease would be studied at the Korle-Bu Teaching Hospital.