After nearly six hours of intense and intricate medical procedures, the first kidney transplant in Guyana, hosted by the Georgetown Public Hospital Corporation (GPHC), was completed yesterday with claims from the operating team that it was a major success.
His condition took a turn for the worse last year, preventing him from attending classes at the Apex Academy in Guyana, where he was preparing to sit the Caribbean Secondary Schools Examination, but never had the chance to do so. Munesh was diagnosed with End Stage Renal Failure last October while a patient at Guyana Public Hospital Corporation's clinic and it was then that the mother decided to undergo preliminary tests to determine her chances as a possible donor to her son. After numerous tests, she was confirmed a positive match and the overseas doctors agreed to do the surgery here. This was of much relief since this surgery would have cost between US$20,000 and US$40,000 in Guyana or about US$100,000 in the United States.
In March this year, Dr. Jindal was introduced to the local health sector and arrangements were put in place. Kidney transplant is a surgical procedure involving heterotopic placement of the donor kidney into the iliac fossa of the recipient. It has emerged as the preferred means of renal replacement therapy for patients with End-Stage Renal Disease of any etiology. The leader of the medical team stated that the surgery created confidence in the local institution and has also created expectations and hope for other renal failure patients. On this note he announced that Government will be sustaining the effort to ensure that other patients benefit from similar options.
George Subraj, one of the sponsors of the initiative committed to procuring sponsorship for another five transplant surgeries and the health minister noted that the idea is to ultimately have local capacity to perform kidney transplants.
Dr. Ramsammy said at present there are about 200 Guyanese who should be on dialysis for renal failure and a portion of them would require transplants.
Meanwhile, the Chief Executive Officer of GPHC, Mr. Michael Khan expressed his appreciation of the overseas team for performing the surgery free of cost and is looking forward to future collaboration with the group. He said the exercise will benefit the local doctors tremendously and it is hoped that very soon they will be able to perform such surgeries with little or no outside assistance.
End Stage Renal Failure is when the kidney stops doing the work it is supposed to do. The patient then needs to have dialysis, which is essentially an artificial kidney. This process cleans the blood from impurities in its production of urine. Urine contains impurities which are filtered out of the body through the kidney and when the kidney fails, it backs up into the circulation. This affects the body and has terrible side effects. It can even affect the functions of the heart and lead to death.
Symptoms of the disease. Initially the patient feels unwell and may develop fever with headache along with sleeping problems, which is followed by the loss of appetite and this gets worse with diarrhea and vomiting and sometimes the patient may go into shock. In the long run the patient may also develop heart complications, which can lead to stroke or be fatal. The disease
shortens the lifespan and decreases the quality of life.
In the end, we have succeeded in another milestone in our country, with a great bit of dignity and integrity of the process in place, and with two people having the chance at better lives and a promise in our country of a better health sector." Assisting Dr. Jindal from the overseas medical team were Dr Edward M. Falta (Transplant Surgeon of the Walter Reed Army Medical Centre (WRAMC), Washington), Dr Melenie Guerero, (Pulmonary Care Physician), Laura Owens (Transplant Coordinator) and Dr Arthur L. Womble, attached tothe Athens-Limestone Hospital, Athens, Alabama. They arrived in Guyana last Thursday. The local team includes Dr. Ravi Purohit (Surgeon), Dr. Ramsundar Doobay (Consultant, Internal Medicine), Dr. Anita Florendo (Registrar, Internal Medicine), Dr. Vivienne Amata (Anaesthesiologist), Dr. Pheona Mohamed-Rambaran (Laboratory Director), Mr. Delon France (Medical Technologist) and Dr. Wilson (Radiologist).
In the end, we have succeeded in another milestone in our country, with a great bit of dignity and integrity of the process in place, and with two people having the chance at better lives and a promise in our country of a better health sector." But the task was made easier, according to Dr Jindal, since the operating atmosphere was one of excellence. He said it was impressive to see that the place was neat, clean, and everything that was needed was provided as requested.
The doctor said that he and his team did everything possible to make the operation a success, a reality which was realised soon after the 14-hour conclusion of the process. According to him, the process was completed in less than the time expected a feat which was probably due to the excellent collaboration of the team. "Everything so far was done very well. Both the mother and the kid (boy) are awake, and he is making urine; so we don t expect any problems in the immediate future, but there are always challenges later on in terms of rejection of the kidney." However, he noted that measures will be put in place by the local health sector to provide anti-rejection medication for the boy for the rest of his life, which was regarded as a great burden on a poor country.
According to Dr Jindal, it is expected that the patients will remain hospitalised for another few days, during which time they will be monitored closely.
He said that the mother would stay in the Intensive Care Unit (ICU) for another day, then be transferred to the general ward for another three to four days. The recipient, he said, would remain in the ICU for a couple of days; and once he was stable, he would be admitted to the general ward. However, major precautions would be taken to protect him from infections from other patients, he added. The initiative to have the operation done in Guyana was spearheaded by New York-based Guyanese Mr George Subraj. Mr Subraj, who is President and founder of Zara Luxury Apartments and Homes, took great interest in Munesh s case after he saw a flyer which was being circulated for financial assistance. After some investigation, Mr Subraj said, he solicited the assistance of Dr Jindal, who in turn organised the medical team of renowned experts.
With no financial assistance from anyone, Mr Subraj sought the assistance of Caribbean Airlines, which sponsored the tickets for the team; the owner of Buddy s International Hotel, who accommodated the team at a reduced rate; and a few others who have helped in the area of providing meals for the team while in Guyana. And, according to Mr Subraj, undertaking could be regarded as the beginning of an ongoing programme of assistance, even as he estimated that he would probably be able to bring the team back a few more times to conduct about five more operations.
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