Kidney Transplantation in Nepal.

POST REPORT

KATHMANDU, Aug 14 - Kidney patients can now undergo kidney transplants within the country, and it is much cheaper than in India or elsewhere abroad.

Tribhuwan University Teaching Hospital (TUTH) on Thursday announced that it conducted three successful kidney transplants recently. Prof. Dr. David Francis, transplant surgeon from the Royal Melbourne Hospital in Australia, was involved in three transplants carried out on August 8, 10 and 13 by a team of Nepali doctors and health workers. Dr Guna Kumar Shrestha was license holder for the transplants. Transplant licenses are provisioned by the Kidney Transplant Regulations - 2058.

The first transplant was carried out on Hemraj Shrestha, 36, of Budanilkantha. His wife Gyani Pandey donated her Kidney for the transplant. The second transplant was carried out on Satya Shrestha of Sankhu Suntole VDC - 1, with a kidney from her husband Krishna Bahadur Shrestha. A third transplant was carried out on a woman from Ghaling VDC - 2 in Bhaktapur. She received a kidney from her father.

"I was thinking of taking my wife to India but god blessed me with the service here within the country," said Krishna Bahadur, who looked healthy in his hospital bed. "I feel normal except for a bit of pain where the kidney was removed."

At a press meet organized by the hospital, Dr Mahesh Khakurel, its executive director, said, "A transplant that would cost about Rs 1 million in India is now available here for about Rs 300,000."

Coordinator of the transplant team and team leader of the hospital's nephrology department Dr Divya Singh, who played a key role in making the transplants happen, said the life of a transplanted kidney could go up to 50 years depending on the age and health of the donor. "The younger and healthier the kidney the longer it works," Dr Singh said. She also said that even second and third transplants can be carried out on a patient. She said the hospital targets carrying out two transplants a week.

Dr Francis, who is to be involved in about seven more transplants before he returns to Australia, said, "I was confident of getting involved in the transplant here in Nepal." "Quality of doctors here is extremely high." He said he came to Nepal to assist the program because he was confident the transplants could go ahead and the hospital was well-equipped for the purpose.

The Transplant Coordination Committee had issued permission to the hospital on August 4 after amending the regulations. Only Bir Hospital had permission for transplants. But Bir does not provide the service since the very first transplant carried out there was a failure -- the recipient's body rejected the donor's kidney. However, the recipient is still alive and is on

dialysis.

After a transplant the patient has to take medication continuously, at a cost of about Rs 20,000 to 25,000 per month for the first few years. This would decline to about Rs 10,000 to 12,000 per month in later years.

Dr Khakurel said TUTH needs a huge amount of money to continue the transplant service. Dr Bhola Raj Joshi, one of the surgeons involved in the transplants, said, "We will try to divert the ministry's budget to support kidney patients at the hospital and ensure continuation of the service," he said