Doctors introducing kidney transplant from brain-dead donors in Bangladesh
If successful, this cadaveric kidney transplant will raise new hopes among the patients who need kidneys but cannot find living donors.
The government last year amended the organ donation law allowing collection of organs from the brain-dead. But getting consent from the relatives remains a major challenge.
Dr ASM Tanim Anwar, who is coordinating the Bangladesh-Korea Kidney Transplantation team, told that the South Korean team will be coming to Dhaka next week.
“They will perform first cadaveric organ donor transplantation in Bangladesh if brain-dead donors could be found and consent from the family obtained,” he said.
“This is a major challenge. We have to raise awareness about this issue. There is no religious barrier contrary to what some people perceive.”
A registrar of nephrology at Dhaka Medical College Hospital, Tanim Anwar had a fellowship on organ donor management and transplant from Korea University Anam Hospital.
He said the Korean specialised transplant team from Anam Hopital would be coming to give a select group of Bangladeshi doctors’ hands-on training on cadaveric transplantation.
The surgery can be done in any of the four hospitals – Dhaka Medical College Hospital, Bangabandhu Sheikh Mujib Medical University, Birdem and Combined Military Hospital – based on the availability of the donor.
“Technology is not a problem for us since we are doing kidney transplantation for decades from the living donors. We need to know how to do it from a brain-dead person,” said the doctor.
Patients with kidney failure depend on dialysis for their kidneys to function. Transplantation is a preferred option for them for a longer and better life.
Bangladesh does not have statistics on the number of kidney patients and the demand for transplantation.
Estimates suggest around 20 million people are currently suffering from some form of kidney diseases.
The annual demand for the kidney transplantation is estimated to be 5000, but on average, only around 120 people can manage kidneys from their relatives to undergo a transplant.
President of the International Federation of Eye and Tissue Bank Mahmood Farazdaghi in 2012, during his Bangladesh visit, told there was no religious barrier to donation of organs posthumously.
Citing references of Grand Mufti of Al-Azhar University, the foremost institution in the Islamic world for the study of Sunni theology and Sharia, he had said, “When a person dies, doctors can decide what is useable for another human being and what is not.”
Tens of thousands of heart patients may not need open-heart surgery
The procedure, called transcatheter aortic valve replacement (TAVR), has been reserved mostly for patients so old and sick they might not survive open-heart surgery. Now, two large clinical trials show that TAVR is just as useful in younger, healthier patients.
It might even be better, offering lower risks of disabling strokes and death, compared to open-heart surgery. Cardiologists say it will likely change the standard of care for most patients with failing aortic valves.
In open-heart surgery, a patient’s ribs are cracked apart and the heart is stopped to insert the new aortic valve.
With TAVR, the only incision is a small hole in the groin where the catheter is inserted. Most patients are sedated, but awake through the procedure, and recovery takes just days, not months, as is often the case following the usual surgery.
The results “shift our thinking from asking who should get TAVR to why should anyone get surgery,” said Dr Howard Herrmann, director of interventional cardiology at the University of Pennsylvania.
The studies are to be published in the New England Journal of Medicine and presented Sunday at the American College of Cardiology’s annual meeting.
The Food and Drug Administration is expected to approve the procedure for lower-risk patients. As many as 20,000 patients a year would be eligible for TAVR, in addition to the nearly 60,000 intermediate- and high-risk patients who get the operation now.
“This is a clear win for TAVR,” said Dr Michael J Mack, a heart surgeon at Baylor Scott and White The Heart Hospital-Plano, in Texas. From now on, “we will be very selective” about who gets open-heart surgery, said Mack, a principal investigator in one of the trials.
Some healthier patients will still need the traditional surgery — for example, those born with two flaps to the aortic valve instead of the usual three.
The trials were sponsored by makers of TAVR valves, Edwards Lifesciences of Irvine, California, and Medtronic, headquartered in Dublin.
China says tests of human immunoglobulin are HIV negative
“Shanghai authorities have run virus tests for HIV, hepatitis B and hepatitis C on the reported batch and they all show negative,” the National Medical Products Administration said in a statement on late Wednesday.
China’s National Health Commission had earlier said there was a “very low” risk of HIV infection from the batch after a baby was reported to have tested “weak” HIV positive.
It asked medical institutions to halt the use of the batch and seal remaining supplies for further investigation.
Shanghai’s Medical Products Administration said it had ordered the manufacturer to halt production.
Human immunoglobulin is made with human blood plasma and is used to treat a variety of conditions.
The Shanghai Medical Products Administration said in a statement on Wednesday that the batch, identified by China’s National Health Commission as number 20180610Z, was made by China Meheco Xinxing Pharma Co, a unit of state-controlled ChinaMeheco Group Co Ltd.
The manufacturer could not immediately be reached for comment on Thursday. Chinese offices are largely shut for the week-long Lunar New Year holiday.
The investigation began after a baby in Jiangxi province had initially tested “weak” positive for HIV during a health check, exposure that was traced to the batch under investigation, domestic media the China Economic Observer reported. The baby subsequently tested negative for HIV, the report said.
It is not clear how many people may have been injected with the batch under investigation. The media report said the batch contained 12,226 doses due to expire in 2021.
The Chinese government has repeatedly vowed to tighten safety oversight and to crack down on companies and officials following a string of food and drug scandals in recent years, including one last year involving the maker of a rabies vaccine.