The New Nation - Internet Edition

The National Institute of Kidney Diseases and Urology (NIKDU) began transplantation of kidney this year raising a hope among patients, said Professor Shamim Ahmed, Director of the NIKDU at Sher-e-Bangla Nagar while talking to this correspondent on Monday.

Lack of coordination among different departments, internal politics and unethical profiteering mood among doctors, high cost of transplantation, etc delayed the transplantation process at the institute, said doctors and staff of the institute, sources said.

However, Professor Dr Shamim Ahmed claimed that the institute first transplanted kidney in April and till today doctors of NIKDU successfully transplanted kidneys among three patients who are now leading almost normal life.

Dr Shamim, also a reputed physician (nephrology) of the country, said the NIKDU is now well prepared to transplant kidney regularly (subject to availability of patients, kidney and necessary money) and claimed that the institute has a pool of trained surgeons to perform the major surgery. Kidney transplant is highly expensive. Not only that relatives of the patients need to collect kidney of a healthy person whose kidney must match with that of the patient, said a doctor of the institute. Under 1999 Human Organ Act, only donation by family members is currently legal in Bangladesh. The number of kidney transplantation is very negligible in Bangladesh compared with that of India and Pakistan. In a conservative and religious society, doubts have been expressed about the influence of religion on transplant. No religion would either endorse or prohibit organ transplantation, because the idea of transplanting human organs did not exist when any of the major religions was preached, a professor said. In this country political, social, cultural and religious leaders and physicians should launch a movement in favour of donating kidney, opined a surgeon. Social movement and consciousness, motivation among educated people, as kidneys have to be preserved within an hour of expiry of a patient, said a Bangabandhu Sheikh Mujib Medical University (BSMMU) professor.

In 1988 Islamic jurists of Saudi Arabia, the birthplace of Islam, and other Arab counties accepted the concept of brain death, and gave nod to cadaver or deceased organ transplant.

Under Amman declaration in 1984, kidney donation by other than relatives is allowed and even the Majlis-e-Sura in Saudi Arabia has permitted organ donation.

Dr Kamrul, an urologist of the NIKDU, said non-availability of kidney, social taboo, lack of mass awareness and religious superstition are some of the barriers to transplant kidneys in Bangladesh. Dr Manash Saha of NIKDU, said a national commission with representative of various professionals can be reconstituted that should be empowered for collecting kidneys beyond blood relatives. In Bangladesh, donation of kidney beyond relatives is prohibited that is one of major barriers to availability of the vital organs in the country. Dr Saha said availability of kidneys can be increased if organs of cadaver patients (also called 'brain death patients or patients kept alive with life support device) are collected with cooperation and consent of patients relatives'). He said a massive social campaign should be launched both in print and electronic media in donating kidneys of cadaver patients that in turn will increase availability of the organs.

India, through massive social campaign, has motivated several thousand people to donate their vital organs during 'brain deaths' that in turn also helped raise the kidney transplantation.

Professor Jahangir Kabir of the BSMMU, who was earlier director of the NIKDU, said only 5.00 per cent of nearly 20,000 kidney patients can do dialysis or some of them can transplant their kidney with rest die from renal failure every year.

He opined that at least one per cent of the national budget is required to treat some 20,000 kidney patients who need dialysis or transplantation, said a surgeon of the institute, said The government at present cannot even spend even 0.05 per cent of the total budget required in the treatment of kidney patients and in the third world countries including Bangladesh, kidney transplantation is more cost effective than dialysis as the latter is expensive even in the mid- or long-term, said the doctor.

Meanwhile, Kidney Foundation, a non-profit organisation organization at Dhanmondi, since its inception in September 2006, in one year period transplanted 48 kidneys with every transplant cost nearly Taka 200,000. The number of kidney transplant was only 11 at BSMMU. A professor of the BSMMU complained that some senior doctors are discouraging patients to transplant kidneys in the university because of their unethical profiteering mindset.