Asian Journal of Research and Reports in Urology

Setting up of Renal Transplant Program in Private Setup: Our Experience

Wesh Ansari *

Nepal Mediciti Hospital, Baisepati Lalitpur, Nepal.

Birendra Prasad Yadav

Nepal Mediciti Hospital, Baisepati Lalitpur, Nepal.

Kaish Warish Ansari

Nepal Mediciti Hospital, Baisepati Lalitpur, Nepal.

*Author to whom correspondence should be addressed.

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Abstract

Renal diseases especially CKD (chronic kidney diseases) &ESRD (End stage renal diseases) incidence &prevalence is increasing day to day in developing as well as developed countries of world. Many modalities of treatment havebeen developed all over the world in the management of CKD. Developed countries have modern medical facilities especially renal replacement therapy like HD, CAPD& renal transplantation which benefits ESRD patients a lot. However in developing countries & poor countries patients have to struggle a lot to get such facilities and ultimately suffer with complications related to uremia. Renal transplantation brings significant improvement in quality of life [1]. Unfortunately renal transplantation has not flourished in many countries, especially in developing countries. Very low percentage of ESRD patients gets transplanted. There may be so many factors affecting renal transplantation [2-4]. This article focuses on setting up KT programme at Sumeru kidney hospital. The aim of this study is to highlight all the challenges faced to set up renal transplant programme. Total of 8 kidney transplants were done at this center with in 6 month of time frame. Renal graft as well as patient survival was 100%.The complications recorded included fungal infection 1 out of 5, surgical re-exploration and acute rejection episodes remains nil. We can conclude that renal transplantation can lead to improved survival. But due to lack of awareness, donor accessibility, affordability, poor financial as well as legislative support, immunosuppression availability, government help in funding renal transplantation is unable to flourish to its full extent in private settings. Formulation of proper government legislation with proper funding at private setting will help to improve transplant utilization and better outcome.

Keywords: Renal failure, renal transplant, kidney transplant, ESRD

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References

Arogundade FA, Abd-Essamie MA, Barsoum RS. Health related quality of life in emotionally related kidney transplantation: deductions from a comparative study. Saudi J Kidney Dis. Transplant. 2005;16: 311–320.

Haller M, Gutjahr G, Kramar R et al. Cost-effectiveness analysis of renal replacement therapy in Austria. Nephrol Dial Transplant. 2011;26:2988–2995.

Domı´nguez J, Harrison R, Atal R. Cost-benefit estimation of cadaverickidney transplantation: the case of a developing country. Transplant Proc. 2011;43:2300–2304.

Garcia GG, Harden P, Chapman J. The global role of kidney transplantation. Am J Nephrol. 2012; 35:259–264.

The World Bank. 2013 World Development Indicators.

[Cited 26March 2013]

Available:http://data.worldbank.org/country/Nepal

The Kathmandu Post. 2011 Per capita income up. [Cited 26 March2013.]

Available:http://www.ekantipur.com/thekathmandu-post/2011/07/07/money/per-capita-income-up/223737.html

Chalise PR, Shah DS, Sharma UK et al. Renal transplantation in Nepal: the first year's experience. Saudi J Kidney Dis Transpl. 2010;21:559-64.

Available:http://www.who.int/countries/npl/en/

United Nations General Assembly. Political declaration of theHigh-level Meeting of the General Assembly on the Preventionand Control of Non-communicable Diseases. A/66/L.1; September16, 2011.

Couser WG, Remuzzi G, Mendis S et al. The contribution of chronic kidney disease to the global burden of major non communicable diseases. Kidney Int. 2011; 80:1258–70.

Sakhuja V, Sud K. End-stage renal disease in India and Pakistan:Burden of disease and management issues. Kidney Int. Suppl. 2003;83: S115–18.

Modi GK, Jha V. The incidence of end-stage renal disease in India:A population-based study. Kidney Int. 2006; 70: 2131–3.

Kafle RK. Current trends of transplantation in Nepal. JNRT 2009;2: 89–93.

Hirachan P, Kharel T, Shah DS. Renal replacement therapy in Nepal. Hemodial. Int. 2010;14: 383–6.

Glazier AK, Delmonico FL. The declaration of Istanbul is moving forward by combating transplant commercialism and trafficking and by promoting organ donation. Am J Transplant .2012;12:515–516.

Shah D, Shrestha S, Kfle MP>Renal transplantation in Nepal: Beginning of a new era! Nepal. Nephrology. 2013;18:369–375.

Institute of Medicine. Renal transplant service. [Cited 26 March 2013.]

Available:http://www.iom.edu.np/index.php?option=com_content&view

Chalise PR, Shah DS, Sharma UK et al. Renal transplantation in Nepal: The first year’s experience. Saudi J Kidney Dis Transpl. 2010;21: 559–64.