Transplant trailblazers

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Dr Mustafa Ahmed, consultant nephrologist Welcare Hospital, Dubai.

We need to establish our own programme and collaborate with our counterparts.

Anyone that is involved in illegal transplant tourism should feel the full arm of the law. Measures could be put in place to prosecute both doctors and patients who are involved in the illegal organ trade.

Mr Abusin: We are performing transplants in the UAE in our free time, something that is not adequate for a transplant programme. We want government commitment and funding. A lot of awareness is also needed about organ donation, both live and cadaver.

We should follow the method used in the US election, by targeting the young generation that is open to communication and receptive to new ideas.

How important is it from a patient point of view that a national donation and transplant scheme is set up?

Mr Abusin: Transplants transform the quality of life for those on dialysis, a treatment that adds 30 to 40 years to your biological age, because it increases your risk of mortality. Transplants bring that age down to normal.

Also 15% of renal patients on dialysis will have a problem with their parathyroid function and will suffer from pathological fractures. About 1% of these will also suffer from psychosis and land up in a cell for no good reason.

Dr Ahmed: With modern immunosuppressants there is a 95% five-year survival rate, and graft survival in 80% of people lasts more than 20 years. It is difficult to put a figure on the mortality of dialysis patients but it is about 10% per year.

If you have about 1,000 dialysis patients in the UAE at one time that's about 100 unnecessary deaths per year.

Just last month I had a local family come to me because three months ago the son developed liver failure and kidney failure and needed an urgent transplant.

I begged the health authority to let me do a transplant. But he died because there was no transplant service.

Is transplant a cost effective way of treating renal failure?

Dr Ahmed: Patients on dialysis cost AED140,000 [US$38,000] each a year to treat, and a transplant costs AED60,000 [$16,000], then AED10,000 [$2,700] a year for the medications.

If we transplant five patients we are saving the government AED700,000 [$190,000] per year. Over five years that's AED3.5million, almost $1 million. That's just five transplant patients a year and we would be saving the UAE government $1 million. It makes economic sense.

How do you think the public would react to such a scheme?

Dr Ahmed: They are willing to donate. The Road Traffic Authority can do three things; they can give people a brochure about donation, counsel them about it, and ask if they want to donate or opt out - then issue a donor card.

Mr Abusin: Once we do the first cadavaric transplant in the country it will be plain sailing. If there was a cadaver scheme here we could save so many people.

We could transplant hearts, lungs, liver, small bowel, cornea, face transplants, bone marrow, ovaries and wombs. All of these are transplants that work.

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