Time is of the essence for patients awaiting kidney transplant – but donors not readily available

Jan 12, 2021 News

“The trouble is and always has been that kidney donors are not easily identified, even if they find someone who is willing to give them an organ, in many cases these persons are not compatible or match the patients.” – Dr. Kishore Persaud

By Rehanna Ramsay

GPHC’S Transplant Surgeon, Dr. Kishore Persaud.

Kaieteur News – While adolescents and young adults constitute a small percentage of patients diagnosed with End-Stage Kidney Disease (ESKD), their stories of survival can be just as impactful as that of an older person battling the illness.
In Guyana, at least 15 persons below the age of 25 are listed among the patients who are in need of urgent transplants due to acute kidney failure.
These young persons, like 23-year-old Rahaim François and his 18-year-old cousin Riquan Robertson, have an average of two to three years on dialysis treatment before their condition worsens and becomes fatal.
Both Francois and Robertson have been living on dialysis treatment, which is administered three times per week at $12,000 per session. Together, the two young men have been on treatment for more than a year. They are both listed for transplant operation, but are having trouble identifying compatible donors.
The two young men are patients of local Kidney Transplant Surgeon, Dr. Kishore Persaud, who has been using his portfolio to highlight their plight with the hope of getting them the help they need to recover and lead normal lives.

On dialysis: Rahaim François.

Recovered: Malika Dey is one of the fortunate ones to benefit from a transplant operation.

Dr. Persaud recently spoke to Kaieteur News about the problems faced with the treatment of his young patients. He explained that like most acute kidney failure cases, these youngsters would each have to undergo a transplant operation.
“The trouble is and always has been that kidney donors are not easily identified, even if they find someone who is willing to give them an organ, in many cases these persons are not compatible or match the patients,” said Dr. Persaud, who heads the Kidney Transplant Department at the Georgetown Public Health Corporation (GPHC).
Dr. Persaud has been pushing for a legal framework to cover cadaveric or brain dead organ donor transplants; a mechanism he believes can be highly effective in helping to ease the burden of finding compatible donors.
With the legislation in place, he explained that organs will be more readily available for patients in need of transplants.
In the meantime, given the scarcity of organ donors, he noted that in some instances, if patients are lucky, they would be able to switch donors and get a match. This process is called pairing. According to Dr. Persaud, having a compatible match is critical to a successful operation. It is so important that if the patient and donor are not compatible then the operation cannot be conducted.
In instances where patients would have to switch donors just to get a match, Dr. Persaud said this ends in the successful completion of the transplant exercise.
An example of this is the case of Malika Dey, who was diagnosed with ESKD approximately two years ago. Dey was one of the more fortunate patients Dr. Persaud has had.

On dialysis: Riquan Robertson.

Though her journey to survival was not easy, she told Kaieteur News that she is grateful to have successfully pulled through. Dey said that she noted that it was not without prayers, dedicated family members and the transplant team from the GPHC.
“I had no health complications prior to the diagnosis with kidney failure,” said Dey who started experiencing dizziness and vomiting before she found out about her life-threatening condition. She noted that she was skeptical about going on the treatment given the cost attached to it but she had no choice after she suddenly collapsed and fell into a coma.
She was placed in the Intensive Care Unit of the GPHC for close to two weeks.
The renal failure survivor noted that it was then she was immediately placed on dialysis.
“I had no choice but to go on dialysis until I was able to undergo the surgery,” she shared.
Her father, Mark Nelson, decided to be her donor but he was not a match. However, she explained that she was paired with another patient Michael Totaram, whose donor matched her and her father, was able to donate to him.
“Our respective donors did not match us but we were able to help each other because when we compared my father matched Totaram and his donor matched me.” Dey added.
Given her experience, the kidney transplant survivor is highly supportive of legislation that will facilitate cadaveric or brain dead patient donor transplants, an undertaking that Dr. Persaud and his team have been pushing for more than eight years.
At present, Dr. Persaud is in consultation with the European-based Donation and Transplant Institute (DTI). The organization based in Spain, is a leading authority on organ harvesting and transplant worldwide.
Last November, Executive Director of DTI, Dr. Maria Paula Gómez, told a virtual roundtable discussion that a series of planned action is expected to be rolled out before Guyana‘s first donor transplant legislation is introduced and implemented.
Dr. Gomez is among an international team lending support to local doctors lobbying for the passage of the new law. Dr. Gomez, via the virtual meeting, noted that while transplant law is important for the country, it is equally important for policymakers and citizens to be educated and aware of the subject.
As such, Dr. Gomez said that a series of webinars will be conducted to assist in spreading awareness to policymakers and other types of stakeholders on the issue.
The virtual discussion was facilitated by Dr. Persaud and his team at the Kidney Transplant Department from GPHC, as well as Dr. Hassina Mohamed of Trinidad and Tobago, an anesthesiologist and lobbyist for organ donor transplant in the twin Island Republic.