First kidney transplant at GPHC deemed a success

Jul 13, 2008 News

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After nearly six hours of intense and intricate medical procedures, the first kidney transplant in Guyana, hosted by the Georgetown Public Hospital Corporation (GPHC), was completed yesterday with claims from the operating team that it was a major success.
This was the disclosure made at a press conference to update the media on the operation.
The medical operation, which was spearheaded by Indian-born Dr Rahul Jindal, saw 18-year-old Munesh Mangal, of Lusignan, East Coast Demerara, who has for many years suffered from renal failure, receiving a kidney from his mother, 41-year-old Leelkumarie Nirananjan Mangal.
In addition to Dr Jindal, an Attending General Surgeon at the Brookdale University Hospital, the team consisted of Dr Edward M. Falta (Transplant Surgeon of the Walter Reed Army Medical Centre (WRAMC), Washington); Dr Melenie Guerero, (Pulmonary Care Physician), Laura Owens (Transplant Coordinator) and Dr Arthur L. Womble, attached to the Athens-Limestone Hospital, Athens, Alabama.
Members of the local supporting team included Dr. Ravi Purohit (Surgeon),  Dr. Ramsundar Doobay (Consultant, Internal Medicine), Dr. Anita Florendo (Registrar, Internal Medicine), Dr. Vivienne Amata (Anaesthesiologist), Dr. Pheona Mohamed-Rambaran (Laboratory Director), Mr. Delon France (Medical Technologist) and Dr. Wilson (Radiologist).
And, according to Dr Jindal, the process, which commenced at around 07:30 hours yesterday, was quite challenging in many regards.
He said that it was in fact a challenge to work in another hospital and in another country with some nurses and surgeons and others not acquainted with him, thus making it a process of securing their trust and confidence as well.
 “It is always a challenge; it is a very difficult operation, and we only get one chance because, if there is any problem and that kidney is dead, there would be no organs available like that.”
The doctor said that “another challenge was the fact that the team was placed under the microscope by the Health Minister, who brought in the press, and the expectations were very high…We know that we had to make it work…”
But the task was made easier, according to Dr Jindal, since the operating atmosphere was one of excellence. He said it was impressive to see that the place was neat, clean, and everything that was needed was provided as requested.
The doctor said that he and his team did everything possible to make the operation a success, a reality which was realised soon after the 14:00hour conclusion of the process. According to him, the process was completed in less than the time expected — a feat which was probably due to the excellent collaboration of the team.
“Everything so far was done very well. Both the mother and the kid (boy) are awake, and he is making urine; so we don’t expect any problems in the immediate future, but there are always challenges later on in terms of rejection of the kidney.”
However, he noted that measures will be put in place by the local health sector to provide anti-rejection medication for the boy for the rest of his life, which was regarded as a great burden on a poor country.
According to Dr Jindal, it is expected that the patients will remain hospitalised for another few days, during which they will be monitored closely.
He said that the mother will stay in the Intensive Care Unit (ICU) for another day, then be transferred to the general ward for another three to four days.  The recipient, he said, will remain in the ICU for a couple of days; and once he is stable, he will be admitted to the general ward. However, serious precautions will be taken to protect him from infections from other patients, he added.
The initiative to have the operation done in Guyana was spearheaded by New York-based Guyanese Mr George Subraj.
Mr Subraj, who is President and founder of Zara Luxury Apartments and Homes, took great interest in Munesh’s case after he saw a flyer which was being circulated for financial assistance.
After some investigation, Mr Subraj said, he solicited the assistance of Dr Jindal, who in turn organised the medical team of renowned experts.
With no financial assistance from anyone, Mr Subraj sought the assistance of Caribbean Airlines, which sponsored the tickets for the team; the owner of Buddy’s International Hotel, who accommodated the team at a reduced rate; and a few others who have helped in the area of providing meals for the team since their arrival here in Guyana.
And, according to Mr Subraj, yesterday’s undertaking could be regarded as the beginning of an ongoing programme of assistance, even as he estimated that he would probably be able to bring the team back a few more times to conduct about five more operations.
The medial team has already examined about six patients, two of whom may be eligible for surgery, according to Dr Jindal.
Speaking at the press conference, too, Health Minister Dr Leslie Ramsammy regarded the operation as another truly historic day for Guyana.
He said that, ultimately, the successful completion of the surgery represents a celebration of local and international partnership to truly achieve what is a miracle.
The minister pointed out, though, that while the undertaking was one of success, there will still remain challenges for a mother and a child who will need prayers and understanding.
He, however, assured that the health sector has in fact gained much, and by extension the country has gained.
He also commended Dr Jindal for finding the courage to even consider taking on the operation.
But, according to the minister, it sometimes takes more than just professionals to complete a good job, thus other kinds of assistance were required.
In addition to the undertaking being a partnership of expertise, the minister said that yesterday’s operation also shows how the Diaspora can help in development.
“The Diaspora has been an important component in Guyana’s development for over a decade now. Many of our programmes are tied to this contribution…”
In the end, we have succeeded in another milestone in our country, with a great bit of dignity and integrity of the process in place, and with two people having the chance at better lives and a promise in our country of a better health sector.

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