An Indian hospital is to intervene in wrestling cancer in Nigeria in a special project geared towards cancer prevention.
Senior consultant in Surgical Oncology, Apollo Hospital, New Delhi, India, Dr Vikram Singh told journalists in Abuja that the hospital's intention was to reduce the number of Nigerians visiting India for cancer-related ailments.
He said: "We have quite a lot of patients from your country, particularly for transplantation or other kidney problems, particularly renal transplantation. When the kidney is not working because of many reasons, like diabetes, long use of painkillers, or has failed completely, there are two options: transplantation and dialysis.
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"In dialysis you continue it for life, but in transplant, you get one kidney. I have seen a patient from lagos, 68 years old, his wife and daughter had transplants five years back and they are doing nicely. Even at 65, 70, they get very well after a transplant and they do normal jobs and get back to routine life. That is required way to deal with kidney failure. Suppose there is no donor for transplant, then you go for dialysis—cleaning of the blood by a machine for four hours—and it is required two or three times a week for lifelong.
How easy is it to get a donor?
Most of the transplants we have done in India and in your country are been donated by families.
According to Singh, "we get cadavers also—brain dead but heart is working. Last week we have done one, with a brain haemorrhage, the family donated the kidney. We put one kidney into an 18 year old girl and the other into a 25 year old woman. Both are doing well. But we are not using them much, because families don’t give consent for cadaver transplants. Main programme is life related, from family members."
He explained that the situation with donation of organs is very cumbersome, stating that, "if they don’t give consent, we cannot take the kidney. Consent is necessary even in life related transplants.
Whats the life expectancy for people who have had kidney transplants?
We have heard of rejection in kidney transplants.
"In most cases it is caused by noncompliance—medicine is not available, or sometimes they think they don’t need medicines because they are alive and reduce the dose or stop it. But the body is different and the kidney is different, so rejection can happen. In that case we do a second transplant or go for dialysis.
"We usually test for tissue matching, and secondly give drugs known as immnuosuppressants they have to take regularly. It starts with a high dose, but later on comes down.
Have there been cases where the body keeps rejecting a kidney?
That happens in two types of noncompatibility—when the blood group is not matched, and when the body rejects the kidney. Again you want to transplant.
Singh contended that "when the blood group does not match, and there is rejection, the antibodies increase and that increases the chances of a second rejection. When the donor match is positive, we still cannot do a transplant otherwise the body will reject the kidney. What we do is plasma exchange, to take out the antibodies, and when the crossmatch matches, then we do the transplant.
"There are three, four things causing kidneys to damage nowadays. One is diabetes—every third or fourth person is diabetic, because of lifestyle: they don’t go out, or do morning walks, their eating is bad—just sitting watching TV and eating fatty foods. Even in india. Fifteen years ago, we were seeing 10 to 20% diabetes cases, now they are up to 40%. Half of the cases we transplant are diabetics. The second thing is hypertension. And stop smoking. Smoking was thought to affect only heart and lungs, but now we know it is injurious to kidneys too.
"Third important factor is drugs: people go into pharmacies after a hard day’s work and get tablets for pain relief for self medication. Painkillers over a long time cause kidney damage. Pain killers should be taken only when required. If we take care of these things, we can cut down the numbers of patients with kidney failure."