Renal transplant

Bir Hospital and Tribhuvan University Teaching Hospital hold the distinction of being the only two medical institutions providing kidney transplant surgeries in the country. But the two hospitals, and just 12 doctors in the country permitted to conduct such surgeries, hardly suffice to a growing number of patients needing transplants.

 

While needy patients who also have the cash to pay for the surgery face the choice of either waiting for months – possibly years – for their turns or going to India to receive transplants instantly, a growing number of willing donors from poor economic backgrounds are falling prey to profiteers of organ trade. Poor families in Hokse village of Kavre have proven particularly vulnerable to kidney traders who lure them to India promising big sums of money. Once there, the donors are operated upon in sub-standard facilities, given less than the promised sum of money, and sent back to Nepal. Many of such donors develop post-surgery complications, and some end up being unable to work for the rest of their lives. The kidney trade that started in Hokse 18 years ago has already claimed the lives of seven donors.



Nepal’s Human Organ Transplant Act allows organ transplant only between relatives. The Act might have been successful in preventing an unhealthy kidney transplant industry from flourishing in the country, like what has been reported in India. But the Act along with the limited number of medical centers providing the service has left the country’s poor more vulnerable to organ traders in India.



While it is easier said than done, it is nevertheless the government’s responsibility to prevent these poor from illegally donating organs at the cost of their health and lives. We are not in favor of a total revision of the Act, but we are in favor of a clause allowing those potential receivers who don’t have a willing donor in their families to be given a choice of accepting the organ from someone outside the family. After all, such donors will eventually cross the border for receiving kidneys from strangers if they are not given this choice back home. So it makes sense to identify such potential receivers and match them with donors from villages like Hokse under strict government mediation. If the poor are allowed to donate kidneys in the country itself, it will also ensure them post-surgery care.



In the meantime, the service has to be expanded and tests such as tissue matching should be made available in Nepal so that the transplant surgery becomes less costly.

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