First successful kidney transplantation in Manipur done at Shija

Imphal, August 20 : In what can marked as a significant milestone in the medical history of Manipur, Shija Institute of Renal Sciences, a unit of Shija Hospitals, Langol, Imphal has successfully performed the first kidney transplantation surgery in the state.

A press conference in this regard was held today at Shija Hospitals. The press conference was chaired by Dr. Kh. Palin (Chairman cum Managing Director, Shija Hospitals), Dr. Jugindra S (Medical Superintendent, Shija Hospitals), Dr. P. Guliver (Director and Consultant Nephrologist, Shija Institute of Renal Sciences) and Dr. Somorendro Paonam (Consultant Urologist and Renal Transplant Surgeon, Shija Institute of Renal Sciences).

A 29 year old patient from Bishnupur Ward No. 3, youngest of five siblings has been suffering from chronic renal failure and steroid induced diabetes mellitus since 2013. For this patient kidney transplantation was the best treatment option.

Shija Hospitals had earlier applied for recognition as Transplantation centre and  after thorough inspection of the current facilities and staff, certificate of registration under Sections 14 & 15 of the Transplantation of Human Organs (Ammendment, 2011) for Kidney and Cornea Transplantation was granted to Shija Hospitals by the Govt. of Manipur vide Registration No. THO/001/K-C/2010 dated 22^nd April, 2016.

After proper counseling, the recipient patient was admitted for kidney transplantation on 12^th Aug’16. His elder brother was the donor in this case. A team of doctors led by Dr. Somorendro Paonam, Consultant Urologist and Renal Transplant Surgeon, Shija Hospitals along with Dr. Sananda Bag, Senior Consultant Urologist and Renal Transplant Surgeon, Yasoda Hospitals, Hyderabad performed the procedure known as Living Related Renal Allograft Transplantation (LRRAT) or the first successful kidney transplantation surgery in the state on 14^th Aug’16.

The press conference began with a short video clipping showing the transplant surgery and words of appreciation and gratitude by the kidney recipient to Dr. Guliver, Dr. Somorendro and the entire team of Shija Hospitals.

The elder brothers of the recipient including the donor expressed their overwhelming joy on the successful transplantation. Heartfelt gratitude and congratulations were also extended by the family members to the entire team of Shija Hospitals.

During his introductory speech, Dr. Jugindra said that Shija could perform the 1^st successful kidney transplant surgery only because of the trust and confidence bestowed by the entire family of the patient. He also expressed gratitude to the Director, Health Services and the entire team of Medical Directorate for granting certificate of registration to Shija Hospitals for organ transplantation.

Dr. Guliver Potsangbam during his speech highlighted the important functions of the kidneys, most common causes of kidney failure treatment alternatives for end stage renal failure and advantages of kidney transplantation. The kidney could either come from a living donor or a cadaveric donor (brain dead or heart dead donor). For live donation, it is very important that the person who is going to donate his or her kidney does this based on his or her own decision and free will. This is a gift, and it is prohibited by law to pay for the donation. It is also very important that the donor has received and understood the information about what a kidney donation is and what kidney transplantation means. The donor must in essence be healthy. This is ascertained by careful medical investigation. Older age does not need to be a problem; the health status is the most important. The most common situation is that a mother or father, a brother or sister, or a husband or wife will donate a kidney. The decision to donate must be made by the donor, without any pressure from the recipient, other family members or from the hospital. If a kidney is donated from a family member, the operation can be planned ahead of time so that it suits both the donor and the recipient. This is a valuable advantage for the patient with kidney disease. One can also expect the procedure to have very good results, both in the short and the long term. Dr. Guliver further stated that, haemodialysis, the alternative treatment for kidney failure is very cumbersome and expensive procedure. The patient has to come for hemodialysis two to three times a week to the hospital. The procedure takes at least 4 hours per session. This results in massive loss of working hours for the patient and the relatives. It is estimated that the average cost of haemodialysis alone (2 times per week) at a dialysis unit in Imphal amounts to Rs 2,40,000 per year (in 2014) excluding medications. Medications would cost another Rs. 10,000 to 15,000/- per month. The overall cost of living donor kidney transplantation is estimated at Rs. 3,50,000/-. The follow-up after kidney transplantation would amount to approximately Rs 10,000 to 15,000 per month in the first year, including medication and follow-up visits. This would be much less in the subsequent years. Consequently, there would be a considerable monetary savings with a renal transplantation especially if done in one’s hometown. Thus, Kidney transplantation is the ideal treatment for patients with end stage renal failure.

Dr. Somorendro Paonam spoke on what is kidney transplantation, its history, technical details of the surgery which he had performed including present condition of the patient. According to him the living kidney transplantation program in India has evolved in the past 45 years and is currently the second largest program in numbers after the USA. Transplantation from deceased donation where neurological criteria are used for determination of death has been possible since 1995 after the Indian parliament passed the law related to transplantation. It is estimated that globally, chronic kidney disease is associated with approximately 735,000 deaths annually. The prevalence of end-stage renal disease requiring transplantation in India is estimated to be between 151 and 232 per million populations.  If an average of these figures is taken, it is estimated that almost 220,000 people require kidney transplantation in India. Against this, currently, approximately 7500 kidney transplantations are performed at 250 kidney transplant centers in India. Of these, 90% come from living donors and 10% from deceased donors. The data are not as accurate as would be desirable due the absence of a national transplant registry. He also said that Manipur is the second state in NE India to have kidney transplant facility next to Guwahati in Assam. He further stated that the future plan of Shija Institute of Renal Sciences would be to have the transplant programme running with more patients from the state, to have patients from the neighboring states and international patients from neighboring countries particularly Myanmar and to start deceased or cadaveric donor programme.

According to both Dr. Guliver Potsangbam and Dr. Somorendro Paonam, the recently operated patient is now fully recovered and fit to be discharged from the hospital today.

Answering to questions from media, Dr. Palin informed the gathering that Shija would follow the guidelines for transplant strictly and no unethical practices would be encouraged in any form. He also stressed on PPP healthcare model to provide affordable quality healthcare to the larger economically weaker section of the society.