Latest update January 6th, 2025 4:00 AM
GPHC eyeing introduction of paired exchange programme –in quest to increase kidney transplant surgeries
Dr. Kishore Persaud, Kidney Transplant Surgeon
Deliberate efforts are being made to sustain a Kidney Transplant programme at the Georgetown Public Hospital Corporation [GPHC].
Just recently, the hospital completed two successful kidney transplant surgeries but according to Kidney Transplant Surgeon, Dr. Kishore Persaud, there are some 14 patients attending clinic at the GPHC who are still awaiting surgery.
While the surgery is completed at no cost to patients, they are however expected to pay the cost for the necessary cross matching test which is done overseas. This test is done in order to determine the organ and tissues compatibility for the recipient and donor.
According to Dr. Persaud, one of the major obstacles to carrying out these surgeries is the issue of incompatible matches.
He explained, “Many of these patients have donors but the blood group does not match.” But there could be a plausible remedy to this dilemma. According to Dr. Persaud, he is hopeful that it could be implemented during the course of this year with the blessings of the hospital’s administration.
The remedy to which Dr. Persaud alluded is that of a Paired Exchange programme to facilitate increase transplant surgeries. Paired Exchange, according to Dr. Persaud, essentially makes reference to a programme whereby patients are able to exchange donors once they are found to be a suitable match.
Based on information published at www.kidney.org “sometimes a loved one may want to donate a kidney but their blood type is incompatible. Some transplant centres will help incompatible pairs of recipient/donors through a process called paired exchange, which involves two living donors and two recipients.”
“If the recipient from one pair is compatible with the donor from the other pair, and vice versa– the transplant centre may arrange for a “swap”–for two simultaneous transplants to take place. This allows two transplant candidates to receive organs and two donors to give organs though the original recipient/donor pairs were unable to do so with each other,” it was explained.
However ahead of surgery, “Both donors and candidates are carefully evaluated and tested medically and psychologically to assure that the benefits outweigh the risks. It is important for both surgeries to be scheduled for the same time in case either donor changes their mind at the time of surgery…”
A move in this direction, Dr. Persaud said, will serve to ensure that more patients are afforded matches and therefore their lives will not have to be hanging in the balance as they await a suitable donor for a protracted period.
Currently, he disclosed, the most difficult blood types to find matches for are those who fall within the A Negative and O Positive categories.
However, there is yet another means that could help to address the need for kidneys for the purpose of transplant surgery. Dr. Persaud in this instance made reference to the possibility of cadaveric kidneys which he believes will allow for even more patients to be afforded needed transplant surgeries. Adopting this approach however will require legislative action.
“If we have the legislation in place so that we can do cadaveric kidney transplant so many more people could benefit,” said Dr. Persaud.
A cadaveric donor is in fact someone who is deceased but prior to death had registered to be a donor. With the permission of the family of the deceased, organs such as the kidneys can be extracted and prepped for surgery to help save lives.
But until a kidney becomes available and is found to be a suitable match, patients suffering from end stage kidney failure are required to remain on dialysis in order to retain a reasonably healthy condition. Dialysis, moreover, is a procedure that is a substitute for many of the normal functions of the kidneys. This process allows people with kidney failure a chance to live productive lives.
According to Dr. Persaud, currently there are in excess of 100 patients in Guyana who are on regular dialysis. He, however, noted that while the GPHC caters to emergency cases, using its seven dialysis machines, other patients are required to access this service at private institutions at a cost.
About 15 patients utilise the dialysis service at the GPHC on a daily basis.
“Most cases have to do dialysis two to three times per week and that cost privately is $12,000 to $15,000 per session but most of them can’t afford it and so they end up dying,” said Dr. Persaud.
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