Nepal | December 07, 2019

EDITORIAL: Transplant milestone

The Himalayan Times

With transplantation using kidneys from brain dead persons more people would get a new lease of life, and this would also help reduce the illegal trade in kidneys

In recent years Nepal has made strides in the expansion of dialysis and kidney transplant facilities, not only in terms of more hospitals providing these services but also from the point of financial assistance provided to kidney-failure patients from the government, for both dialysis and transplantation.

But another milestone was made last week when the kidneys of a jeep accident victim, a 30-year-old resident of Sindhuli, were transplanted into the bodies of two kidney-failure patients, a 15-year-old boy and a 51-year-old man.

A team of twenty doctors led by Dr Pukar Shrestha conducted the operation at the Human Organ Transplant Centre Bhaktapur. This operation was legally made possible by the enactment of a human organ transplant law in 2015 and the making of the related regulations in 2016.

Thursday’s surgery is the first transplantation of kidneys taken from a brain dead person; all earlier operations had been conducted from live donors. But it is difficult to get live donors: first because of the unwillingness of many to part with one of their vital organs and secondly because the kidneys of a willing donor and the would-be recipient may not match for medical purposes, and also to a certain extent because a transplant may not succeed.

With transplantation using kidneys from brain dead persons, this kind of problem does not arise and more people would get a new lease of life. This would also help reduce the illegal trade in kidneys under which brokers trick innocent people into parting with their kidney cheaply, and most of the money thus received is pocketed by them giving the donors a smaller amount.

Thursday’s operation should serve as an example to be followed in the future. To do this, more needs to be done. Persuading the family of a brain dead person is often a difficult exercise; as many people would be unwilling to donate the organs of their brain dead family members for religious, superstitious and other reasons. Such walls need to be broken down.

Effective awareness programmes and counseling in this regard would help. Maybe some kind of other incentives for them in a genuine expression of gratitude by the government might be an added encouragement to agree to donate the kidneys and other organs of a brain dead person.

Thursday’s operation holds important implications for the efforts to save the lives of people who are suffering from end-stage failure of their vital and other organs.

At least, eight organs can be utilized to give a new life to several other persons – two kidneys, two lungs, one heart, one liver, one pancreas, one small intestine, two corneas, and skin.

Now is the time to put in place an effective system of utilizing the organs of brain dead people – from taking prior permission from people, as in the case of cornea donation, and later from the families of such victims, making a roster of them, tracking them, and keeping ready at all times a whole machinery to move into action to take out such organs when accidents happen and people go brain-dead, to matching their organs and finding suitable recipients and grafting the organs into their bodies. For this, the government should make more investment and encourage more centres to undertake such operations.

Electric crematorium

More people have opted to use the electric crematorium at the Pashupati Aryaghat as it is less time consuming and also less expensive.

As a result, the pollution in the Bagmati River Aryaghat stretch has been reduced. Traditional wooden pyres cost more than Rs. 10,000 whereas the electric crematorium are doing it for less than Rs. 4,000.

Meanwhile, it takes the electric crematorium only 45 minutes to cremate a body while it takes four hours to do so in traditional pyres. This helps keep the river pollution free and is economical at the same time as well.

The building had been built at a cost of Rs. 110 million provided by the government. At first, only a few bodies were cremated in the electric crematorium and people hesitated in doing so. However, the electric crematorium is gradually gaining in popularity with more people using it.

As the crematorium is coming in use increasingly people have to queue to cremate the bodies. Therefore, having other electric crematoriums as well would facilitate the cremation of the bodies without having to wait for long.

A version of this article appears in print on May 16, 2017 of The Himalayan Times.

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