KNH conducts first laparoscopic kidney transplant

A 36-year-old Dickson Njoroge and his donor, Dickson Ndekei became the first pair of patients of the minimally invasive surgery.

In this procedure, a kidney is removed from the donor through an incision in the lower abdomen then it is transplanted into the recipient’s body.

The procedure not only reduces pain and scars but will reduce the length of stay in hospital.

Traditionally, KNH has been performing open kidney surgery, a procedure that requires large incisions with lengthy hospitalization.

The surgery that involves up to 30 centimetre-long cuts just below the ribs in some instances requires the removal of a rib, and later the cut is closed with stitches.

Patients who undergo this procedure are always left with permanent scars but now, there is light at the end of the tunnel after a team of doctors led by Dr. Paul Njogu and Dr Charles Waihenya, successfully conducted the advanced technique in kidney transplant.

“You hear people call a keyhole because a small hole and being able to access the internal organs of choice or target and in so doing we minimize scarring the patient, we are also able to minimize blood loss and therefore also pain...we're using advanced cameras to be able to see inside and therefore we are able to take precautions in a better way,” Dr Njogu said.

Dr Patrick Mbugua, who is the Head of the Renal Unit at KNH, added: “Since 2010 to this year we have transplanted at least 250 patients and our patients have been doing well...we have been following them up and at the moment we are able to do one transplant every week...Yes, we have not reached where we wanted to be, we would like to be transplanting at least two patients every week.”

In laparoscopic surgery, a surgeon makes 3 or 4 small cuts that in most cases cannot go beyond 2.5 centimetres and inserts a tiny tube with a light and a camera known as a laparoscope to access the kidney.

On a TV-like monitor that receives images from the camera, a surgeon is able to see the inside organs, it is towards the end of the procedure that a doctor will make a large cut of up to 10 centimetres to take out the kidney.

Dickson Njoroge is the first patient of the new technology with his donor cousin Dickson Ndekei.

“Nilianza shida ya kidney April last year I came here they diagnosed me with kidney failure and they told me that the only option is kidney transplant or dialysis na wakaniadvise wakaniguide tukaanza dialysis but afterwards wakaniambia bado naweza fanya transplant,” Njoroge explained.

“Ndio ilikuwa siku ya transplant tukaja Monday nikaelezewa kuhusu hizi types nikaambiwa kuna ingine mpya imekuja inaitwa laparoscopic na kuna ile ya kitambo lakini after kunielezea elezea nikasema maybe naweza jaribu nikuwe wa kwanza ile mpya juu naambiwa itakuwa easier na itakuwa simple na naweza rudi kazini haraka kuliko kushinda nimelazwa hapa nimekaa siku mbili nikakuwa okay saa hizi niko sawa,” Ndekei added.

On his part, urologist Dr. Charles Waihenya said: “It is cheaper to do a transplant in the long run than doing dialysis every week...some patients go two-three times so the day of dialysis they don’t do any work the following day they have to rest...you can imagine if they are going three times they have only one day that they are normal in a week.”

According to Dr. Patrick Mbugua, 10% of the country’s population have kidney disease but the majority are unaware, a reason he is calling on the public to ensure frequent check-ups. 

Even with the milestone in treatment, there are still major challenges of cost and access to donors especially where family members cannot donate due to different reasons. In Kenya, the law allows only family to donate any organ to a patient.

“The kidney that Dickson has gotten from his cousin, the body knows that it's not his, so like the body tries to protect itself from all invaders...it will try and reject it so Dickson, the recipient, will have to use rejection medication to cheat the immune system to accept and not reject this new kidney so that it can continue to serve him for the rest of his life,” Nephrologist Dr. Benjamin Wambugu noted.

Stakeholders are eagerly waiting for the new law that is in the pipeline that will allow regulated organ harvesting from donors.