President of the Transplant Association of Nigeria, Professor Jacob Awobusuyi, who made known this grim situation, said there was a need for the Federal Government to revitalize the dormant centers through funding as it moves to unveil policy and guidelines on organ transplants.
Awobusuyi, a Professor of Medicine at the Lagos State University College of Medicine, stressed the need for access to kidney care for patients in Nigeria. The Coordinating Minister of Health and Social Welfare, Professor Ali Pate, on Saturday, announced that the Federal Government was set to launch national policies and guidelines on organ transplants to address unethical practices in organ donation and transplantation.
He spoke during the Living Kidney Donor Day event organised by Nisa Medical Group in Abuja.
Nephrologists in recent times have been expressing concern at the rate at which many Nigerians are coming down with kidney disease, with many requiring dialysis and transplantation amid the soaring cost of healthcare and manpower shortage. They identified hypertension, diabetes, and glomerulonephritis as some of the common causes of kidney disease in the country, which they further linked to poor lifestyle.
The nephrologists also said the cause could be idiopathic (cause unknown) or infections and other health challenges in the body. According to the Nigerian Association of Nephrology, out of the 12 per cent of the Nigerian population with chronic kidney disease, one per cent has severe forms of the disease, which is stage 4 and 5 and would require dialysis or transplantation as treatment.
Speaking in an exclusive interview with PUNCH Healthwise about the Federal Government move, Awobusuyi, a Consultant Nephrologist at the Lagos State University Teaching Hospital, Ikeja, said the national policy and guidelines were long overdue. He stated that the policy would curb unethical practices in organ transplantation in the country.
Kidney transplant involves the placement of another kidney usually by a donor at the lower abdominal cavity connected to the bladder and blood vessels.
A permanent cure for kidney failure has not yet been found but continuous treatment such as dialysis or kidney transplant is used in maintaining the functions of the kidney.
The nephrologist told our correspondent that a few of the tertiary hospitals in Nigeria offering kidney transplants are not functional. He said, “Out of the eight tertiary hospitals doing transplantation in the country, only three are functional. The three are Aminu Kano Teaching Hospital, Kano; Federal Medical Centre, Umuahia; and the Lagos State University Teaching Hospital, Ikeja.” He listed the Lagos University Teaching Hospital; University College Hospital, Ibadan; Obafemi Awolowo University Teaching Hospital; Delta State University Teaching Hospital; and the University of Maiduguri Teaching Hospital, as government hospitals offering kidney transplantation in the past but are now dormant.
Giving reasons why the centres are dormant, the nephrologist said, “The personnel are there, they have surgeons and nephrologists but the issue is that patients don’t have money to access the centres and some could have money but no donor. Most government hospitals will not accept commercial donors because nobody wants to get their hands stained. “In government hospitals generally, we don’t accept paid donors unless the unit does not know anything about it. But in the private setting, you can’t rule that out entirely. “So, we can’t say those government hospitals are not functioning due to lack of expertise. The doctors and the team are still intact.”
Awobusuyi identified the issue of funding, the procedure involved, and getting appropriate donors as the two major challenges faced by kidney transplantation in Nigeria.
He added, however, that about eight private hospitals in the country offer kidney transplants, adding that it costs about N15m for kidney transplantation in Nigeria. Commenting on patients requiring kidney transplantation, the don, who is also President of the Nigerian Association of Nephrology noted that most people, who are on dialysis are candidates for organ transplantation.
This, he said, was because what they have is end-stage kidney disease, which is “why they are on dialysis, an indication for kidney transplantation. “Provided the person is eligible, anybody with end-stage kidney disease can have kidney transplantation. People with cancer, severe heart failure or infection are not eligible. As we have previously said, about 10 to 12 per cent of Nigerians have kidney disease.”
Giving insight into the national policy and guidelines on organ transplantation, the nephrologist said the policy will introduce an authorization for kidney transplantation by establishing two committees that will monitor the process of transplantation to avoid unethical practices. “Before you do a kidney transplant, somebody has to authorize it and two committees will review it. But the challenge is if it will delay that process. But we believe that over time, things will fall in place”, he said. He called for the awareness of common causes of kidney disease and the introduction of grassroots screening to reduce the alarming cases of kidney disease in the country.
Also, a Consultant Physician/Nephrologist and Head of the Nephrology Unit at the Aminu Kano Teaching Hospital, Professor Aliyu Abdu, said carrying out organ transplantation in Nigeria is challenging. Abdu, who is the Vice President of TAN said, “For kidney transplant, the majority of the centres that are active now, more than six or eight are private, while only two or three public hospitals are actively transplanting or offering kidney transplantation in Nigeria. “If the government is interested, they can select one or two or a minimum of six, one in each geopolitical zone, and equip it to the maximum standard, so that transplant tourism will stop. “If you look at the money Nigerians spend going outside for this transplant, it’s more than enough to invest in our centre, and it will attract people from neighbouring countries to come to Nigeria for transplant.”
