Dubai: The formation of a national kidney disease registry with a proper cadaver organ donation in place is inevitable, after the successful completion of the first kidney transplant which also marks the first-time cadaver organ transplant in Dubai, Dr Ali Abdul Kareem Al Obaidli, chairman of UAE’s National Organ Transplant Committee, told Gulf News in an exclusive chat.
Dr Al Obaidli said: “For over 2,500 patients on dialysis in the UAE, the news of the first cadaver organ transplant in Dubai was a great relief. The logistics of the successful transplant surgery were arranged with the UAE’s own resources. It was a result of perfect coordination between many stakeholders and it demonstrated the willingness of the community and significant support from our multicultural society. A recent survey conducted by the Mohammad Bin Rashid University of Medicine and Health Sciences (MBRU) indicated that nearly 68 per cent of the respondents were willing to donate organs after their death. This shows the strong culture of donation that is present in the country. Our transplant team is ready and undergone rigorous training on simulators and through other resources,” said Dr Obaidli.
Logistics of organ transport
Dr Amer Ahmad Sharif, CEO of the education sector of the Dubai Health Care City Authority (DHCA), hailed this medical milestone and termed it a community coordination feat achieved by the transplant team at the Mediclinic City Hospital that included Dr David Hickey, a transplant surgeon and former director of National Kidney and Pancreas Transplant Programme in Ireland, and Dr Farhad Janahi, assistant professor at MBRU and consultant urologist at Mediclinic City Hospital, as all others who were involved in the process.
“From the deceased individual to the Saudi Centre for Organ Transplantation (SCOT) to Dubai via a medical emergency evacuation plane, the journey took six hours,” said Dr Sharif. “Once it arrived at Dubai Airport, to avoid tissue damage, the organ could not be scanned, so the Dubai Airport and the General Directorate of Residency and Foreign Affairs cooperated to get the organ in without scanning and with those accompanying it. It was transferred by the Dubai Ambulance within six minutes to the hospital where the transplant team could conduct the four-hour operation. The operation concluded at 7.25am on June 8.
“This is just the beginning in the story of organ transplant. This surgery proves our capacity for kidney transplant.“ Dr Sharif added.
He said that SCOT followed the international best practices in selecting the donor and recipient and keeping their identities confidential as per the Istanbul Declaration of 1995.
Emphasising on the importance of transplants to take the burden off dialysis systems available in the country, Dr Hickey provided an international overview. “On an average, in any country around the world, about 100 patients per million population undergo dialysis. About 30-40 of these patients on an average undergo kidney transplant. This is important, otherwise the dialysis facility of any country would be overwhelmed. Right now in the US, about 1.7 per cent of the total health budget is spent on renal therapy. People with acute kidney disease account for 0.04 per cent of the US population which indicates that less that one per cent of the population is utilising nearly two per cent of the health care budget,” said Dr Hickey, drawing parallels between the UAE kidney disease students and their US counterparts.
Pre- and post-operative care
Pre- and post-operative care is extremely important, said the experts. First, the recipient has to undergo antibody tests as per international transplant protocol to avoid tissue rejection. The doctors choose the recipient judiciously. After the surgery, the patient has to be on immunosuppressant protocol and must not miss the prescribed dosage. In addition, he or she should keep all other health parameters such as blood pressure, blood sugar, obesity under check. “The life expectancy of kidney transplant patients is nearly 90 per cent for the first year; it is 80 per cent for the next five years and 75 per cent for the next 10 years. A cadaver kidney can last up to 14 to 15 years or more, and the recipient experiences a surge of energy and is free of the painful dialysis that he or she requires every three days,” said Dr Hickey.
Insurance and costs
Worldwide, insurance companies willingly cover a kidney transplant surgery as increasing life expectancy by 15 years saves millions in terms of dialysis costs that the patient would have otherwise incurred, said Dr Hickey.
Dr Sharif said that in Abu Dhabi, insurance companies are covering costs of transplants and at the Dubai Health Care City, talks have been initiated with insurance companies for possible coverage. “One year of the cost of dialysis which is somewhere around Dh250,000 is equivalent to the cost of the surgery. After that, there is only the cost of immune suppressants which is far less than the cost of dialysis. So insurance companies are looking at covering the cost of the transplant. Besides the monetary savings, there is enormous economic and social benefit as the patient experiences increased productivity and participation in the community.”
How to register
Kidney disease patients who may be potential recipients for transplant organs can contact the transplant committee at the Mediclinic City Hospital in the Dubai Health Care City (DHCC), said Christian Schuhmacher, hospital director. “Our transplant coordinator will study the case and screen the patients and coordinate with MBRU for potential transplant opportunities.”
Timeline of organ transport conducted on June 8 in Dubai
- Medical evacuation plane leaves Saudi Arabia at 12.48am on June 8.
- Plane arrives at Dubai International Airport at 1.30am.
- A Dubai ambulance with the kidney on board leaves the airport at 1.38am.
- The ambulance reaches Mediclinic City hospital at 1.44am and the surgery starts immediately.
- Surgery concludes at 7.25am.
UAE’s first cadaver kidney recipient narrates her experience.
It was in 2013 that Fatima S., then a 24-year-old, received the first-ever cadaver kidney in a surgery conducted by the transplant team of the Shaikh Khalifa Medical City (SKMC) and the Cleveland Clinic Abu Dhabi, that began the kidney transplants in the UAE. So far, SKMC has conducted 168 transplants since 2007 of which 167 were live donor organs.
Saeed, 27, who is now in the second year of Business Administration at a college in Al Ain, spoke exclusively to Gulf News: “In the last three years, my life has undergone a 360-degree improvement. The freedom from pain of dialysis — that I bore for 16 long years — is too dear to me. I have resumed my life, have friends, and am studying to join the human resource team of any organisation one day after I graduate ... something I could not even imagine at 21.
“I do not know how I contracted kidney disease as no one else in my family had such a problem. From the age of seven, I was undergoing dialysis and had underwent the pain of dialysis for 16 years. I have suffered so much pain that it is surprising that I survived those years. I had to undergo so many surgeries for catheter placements that very often as I was wheeled into the operation theatre, I would tell doctors, ‘Let me die, at least I will be free of this pain’.
“I will forever be indebted to my Saudi donor who they say was a young man who perished in a traffic accident. I am so grateful to the Rulers of this country who chose me for the transplant and the transplant surgeons of SKMC who achieved the impossible for me. I have a surge of energy and am happy to get back my life.”