About SIUTTransplantation

World Transplant Scenario

Longest Survivors

• Kidney: 45 years
• Liver: 38 years
• Heart: 29 years

History of Transplantation

Kidney failure is best treated by kidney transplantation, whereby a healthy kidney is transferred from one person to another for the purpose of replacing the recipients damaged or failing kidney. With the help of regular checkups and medication, a transplanted patient can go on to live a normal and active life.

The first living related kidney transplant at SIUT was performed on 20th November 1985. Abdur Rasheed, right throwing a javelin at the transplant games. He was a resident of Azad Kashmir and received a kidney from his brother.

Renal Transplantation in Pakistan

Peritoneal Dialysis was first started in Pakistan in 1970 and hemodialysis in 1972.

Hemodialysis started in Pakistan in 1972.

The ever-increasing number of patients on maintenance dialysis therapy necessitated the starting of a renal transplant program in Pakistan. The first renal transplant in Pakistan was performed in Rawalpindi in 1979.

Living related transplants were the norm until the introduction of commercial buying and selling of organs in 2000 that catapulted Pakistan into the infamous kidney trade. As India worked to reduce the illegal trade within its borders more and more transplant tourist turned to Pakistan and by 2005Pakistan had become the world destination for transplant tourism where almost 1500 foreigners were coming annually to purchase kidneys and receive transplants in private hospitals.

While commercialism was thriving in other parts of Pakistan there were many institutions such as SIUT that from the very start was developing a humanitarian model for bringing all the benefits of transplantation to a disenfranchised population.

Transplantation at SIUT

SIUT developed its transplant program in the 1980’s in response to the dire need of patients that could not afford this life saving treatment. In a country where 70% of the population lives below the poverty line, even basic health care becomes a luxury and specialized care certainly a far away dream. SIUT has made this desperate dream a reality by developing an integrated dialysis and transplant program where all services are provided free and include recipient and donor follow-up and post-transplant immunosuppressive drugs.

For transplantation to be successful in developing countries it has to be made available to the common people and the disenfranchised that constitute 90% of the population

In Pakistan it is estimated that are 18,000 people a year go into end stage renal failure of which only 10% receive dialysis and only 2.3% have the good fortune to be transplanted.

SIUT has created a formidable model for developing transplantation in poor nations, from its funding structure which includes both government and public contributions, to its integrated services that are continually being upgraded with new equipment and manpower training; its cost saving strategies without compromising quality, its work on awareness for the public and research for the medical community.

Every year SIUT has seen a significant increase in the number of patients for dialysis and subsequently transplantation.

In 2005 SIUT conducted 200 dialysis per day - in 2010 almost 650 patients are being dialyzed daily.

One-year graft survival of 95% and five-year survival of 85%

Since its inception SIUT has conducted over 3200 living related transplants and continues to monitor every recipient and donor in the outpatient department. SIUT conducts 10-12 transplants every week and follows up an average of 70-100 patients daily in the OPD.

OUT PATIENT DEPARTMENT FOR TRANSPLANT PATIENTS: Till death do us part

All patients are given lifelong follow up care, medication and social rehabilitation.

Integrated services all under one roof

Transplanted patients are provided all follow up facilities that include:

• Check up by doctors. The Follow up team comprises of Urologists, Nephrologists, Gastroenterologists, Heart specialist, Pulmonologist, Diabetologist, Infectious Disease Specialist, Pharmacist, Dentist, Psychologist and Physiotherapist.
• Lab reports
• Ultra sound and CT
• Medication
• Consultation with Nutritionist and Social Worker (MSO)

Increasing Transplant Activity at SIUT

Donor Follow-up Clinic

Post transplant donors are especially cared for at SIUT and given regular checkups with blood tests and ultra sound every six months. This care is provided for life, along with nutritional and if required psychological consultations. If any donors falls sick they are referred to the relevant specialist at SIUT.

• Total on follow-up (2000-2009) - 2500+
• Weekly clinic - 30 to 40 patients

The donor follow-up clinic with hundreds of healthy rehabilitated donors has become testimony to the success and acceptance of transplantation as a mode of therapy and has stimulated others to donate

Pediatric Renal Transplant Activity at SIUT

Transplant Awareness in Society

SIUT has always made an effort to promote public understanding of transplantation and to celebrate and encourage the altruism of donors.

1800 Donors on the Occasion of "Honouring the Organ Donors" at the Governor’s House, Karachi 2006

Deceased Donor Transplantation

International recognition of the Institute as a premier center of transplantation in the region led Eurotransplant to offer deceased donor kidneys. 26 such donated kidneys have been transplanted at SIUT to date.

But the current transplant scenario in Pakistan is limited to living kidney donations and there is certainly a much larger requirement to be full filled not just for kidney transplantation but for those in end stage failure of other organs.

Needed Organs in Pakistan

• 50,000 people die each year due to end stage organ failure
• 15,000 due to kidney failure
• 10,000 due to liver failure
• 6,500 due to heart failure

The way forward

• Deceased donation - can overcome deficit if fully utilized and save thousands of lives every year
• It will also help in putting a stop to the illegal organ trade and associated exploitation of the impoverished and vulnerable
• It will create a chance for other organ transplantation such as liver, heart, lungs etc.

The availability and acceptance of transplantation as a successful mode of treatment has also paved the way for a viable deceased donor program in Pakistan. The first post-law local deceased donor transplants were performed at SIUT in April 2008.

By making transplant relevant to the disenfranchised SIUT has in essence created the building blocks for our society to move towards deceased organ donations but there is still much work to be done, to spread awareness, debunk myths and set up state of the art facilities able to performs multiple organ transplants that can be made available to the public at large.

Goto: Deceased Donor Program