Kidney patients grapple with transplant queues headache

Amos Araka Nyakundi, lies in his hospital bed in the renal unit ward at Kenyatta National Hospital, undergoing his second dialysis of the week.

This has become his new normal since he was diagnosed with acute kidney failure back in January.

The kidney failure came after the 26-year old kept on being admitted to the hospital, and every time the doctors would find that his blood level was low.

“They said this immensely decreased the ability of my kidneys to function,” says Nyakundi.

He was put on dialysis. Nyakundi has been going through this procedure at the hospital since January.

“My brother uses at least four days a week for this procedure. First, he has to book for the dialysis a day earlier, which means he must be at the hospital on Sunday for the Monday’s dialysis, and Wednesday for Thursday’s procedure. And that’s not just it when worst comes to worst, sometimes he has to spend the night at the booking queue,” explains his sister, Drucilla Nyakundi.

But this predicament is likely to come to an end in January, as Nyakundi is one of 34 lucky kidney patients who recently qualified for Kenyatta National Hospital kidney transplant programme.

He is set to get a kidney from Drucilla, 34, who qualified as a donor. The pair must go through several tests before the scheduled surgery.

Though after the procedure, Nyakundi will be expected to be on medication throughout his life, the surgery is expected to improve his lifestyle immeasurably.

Although getting the right amount of dialysis improves the overall health and enables one to live longer, kidney failure patients still face challenges.

According to Dr Benjamin Wambugu, a member of the Kenya Renal Association, the quality of life among kidney patients under dialysis is immensely interrupted.

“They have to strictly watch out for what they eat, as well as their intake of fluids. This is apart from the hours spent on dialysis as well as queuing to book for the procedure,” says John Gikonyo, a representative of the Renal Patients Society of Kenya (RPSK), and also a kidney transplant beneficiary.

This is apart from huge medical bills that come with weekly dialysis procedures, as well as the great amount of time spent in the whole process.

For instance, at Kenya’s biggest referral hospital, patients with kidney failure have to wait for days between one dialysis session and the other.

This, according to nephrologists, leaves kidney transplant as the best option for people suffering from chronic kidney disease.

Globally, kidneys are the most transplanted organs. A 2018 Global Observatory on Donations and Transplantation report indicated that 100,000 kidney transplants were conducted worldwide.

Even then, Kenya still lags.

At the KNH, 25 kidney transplants are conducted annually, which belies the fact that there are possibly many willing donors.

One of the main contributors to the lower number of kidney transplants locally, experts say, is due to the reliance on blood-related donors.

“This is a major challenge, especially at this age of high prevalence of non-communicable diseases, as well as considering that most of the time, kidney diseases run through the family. This means that even if you get a donor, there’s a probability that during screening, they probably will not qualify to donate this organ,” explains Dr John Ngigi, the head of Renal Unit at Kenyatta National Hospital.

This fact that was reflected during the KNH kidney transplant screening session, where out of 600 patients who turned up with potential donors, only 34 qualified for the programme.

“Some cases were as a result of health issues, where even some who qualified had underlying health conditions that couldn’t allow them to donate to the prospective recipients,” says Dr Ngigi.

Prof Seth Mcligeyo, a nephrologist and a member of the Renal Unit, says there is a need for expansion of the donor pool to include non-relatives, as well as embracing post-mortem organ donation.

“When someone is brain dead, and there’s no hope of recovering, then their organs can be used to help other people, expanding organ donor pool,” says Dr Ngigi.

In 2017, the Health Act was enacted, making it easier for Kenyans to donate their body organs for transplant and research, but unfortunately, this is yet to be implemented.

On the other hand, the issue of non-blood relatives being allowed to donate to combat kidney shortage has been a matter of debate.

Some argue that this could create a loophole for illegal organ trade.

For instance, there have emerged cases of desperate Kenyans trying to sell their organs in the black market, online, with high prices for these organs on this platform luring many into this trap.

A 2012 report by CBS News indicated that in Iran, the only nation that allows organs to be bought and sold for profit in the market, a kidney could be worth more than Sh16 million.

Illegal harvesting

But Dr Ngigi says such isolated cases should not be used to deny many genuine kidney patients access to quality life through kidney transplants. “The government should guard against commercialisation and illegal harvesting. There should be a robust legal framework to guard this sector,” he adds.

The nephrologists and the kidney patients association have also pushed for the need for increased sensitisation of potential donors, to remove the fear that many people have about donating a kidney.

One of the fears that potential donors have is for their health after donating a kidney.

However, the experience of those who have donated an organ has shown that giving out a kidney does not negatively affect the life or health of the donor.

There an argument that due to the increased awareness that they need to take better care of themselves after donation, many donors end up leading healthier lives post-transplant.