Surgery in progress (Photo credit: JDWNRH)

34-year-old and 26-year-old kidney recipients and their donors recovering well in first kidney transplant surgery in Bhutan

The collaborative effort between Bhutan and Thailand to conduct the first kidney transplant surgery in Bhutan is a success. 

On 18 September, a 34-year-old woman received a kidney from her 26-year-old sister. Also on 19 September, the second transplant involved a 26-year-old female recipient whose 40-year-old brother donated his kidney to her.

As per doctors, both the patients now have normal kidney functions and are recovering extremely well without any complications. The donors are also on the path to recovery.

The entire transplant team consisted of experts from the Rajavithi Hospital, Thailand and Bhutanese team had the Prime Minister Dasho Dr Lotay Tshering, Dr Sonam Dargay who is a urologist, Dr Kunzang P. Wangdi, an anesthetist, and there were also skilled nurses and technicians from Rajavithi Hospital Bangkok to assist.

The Thai expert teams will be here till 28 September.

A nephrologist in JDWNRH, Dr Minjur, shared that the outcome of living donor transplant is better than deceased donor transplant.

He also said that the most important eligibility criteria for those who want to undergo the surgery is that the kidney donor should be willing to donate the kidney voluntarily, without force, coercion, emotional blackmail or exchange of money or gifts. No selling or buying of kidney should happen.

He said, “Age of donor should be at least 18 years and generally less than 60 years. The donor and the patient should have compatible blood group. The donor should have no comorbidities like high blood pressure, diabetes, kidney disease, kidney stones, cancer, active infections, or any conditions that would put donors’ health at risk during or after surgery.”

“The patient also should be fit to undergo surgery and should be free of active infections, cancers, any serious heart and lung conditions. They should be mentally sound and should not have any disease conditions that would put them at serious risk during surgery. They should also be adherent to post transplant treatment and follow up. The patients age generally should be 10 to 60 years,” Dr Minjur added.

He mentioned that the first priority of surgeon and nephrologist are the donors. If there are any slightest doubt about donor’s safety, transplant cannot proceed. The donors are followed up properly and regularly on yearly basis, so that any potential health issues arising due to kidney donation is properly and timely treated.

The JDWNRH further has plans to do kidney transplants surgery by Bhutanese doctors in the country in about one and half to two years’ time without having to rely on outside experts.

He shared, “We would do 2 to 4 cases every 3 to 4 months without any help from outside experts by then. Once we take over completely, we would have kidney transplant at least 1 in every 1 to 2 weeks.”

Doctor Minjur also shared that although the two operations were successful, some of the important challenges they faced were mobilizing adequate post-transplant ICU nurses, non-availability of some of the medications, shortage of surgical equipment, transplant surgeons and transplant nephrologists among others.

However, they overcame the challenges by mobilizing nurses from different districts, who had experience in ICU care. As expediting medicines and surgical equipment were not available, they had to bring them in from India and Bangkok. They also had to bring in experienced transplant surgeons, nephrologist, anesthetist and other skilled nurses and technicians from the Rajavithi Hospital Bangkok.

It was known that currently there are about 375 patients undergoing dialysis in the country and over 400 individuals living with different stages of kidney problems.

The first successful kidney transplant was done in 1954 in Boston, USA, with a monozygotic twin as the donor. Since then, with new effective medications and other new treatment for acute rejection, the success of kidney transplant has improved tremendously.

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