Pain of Kenyans waiting for organ transplants

The name was difficult to pronounce, but Makena Nkatha was finally relieved to know what had troubled her eyes since she was seven years old.

The keratoconus diagnosis came in 2011, when she was 15 years and had never heard of such a name.

The condition—where the eye’s cornea thins out and bulges outwardly like a cone—worsened and she was enlisted for a cornea transplant in 2019.

Since then, her life involves waiting, rushing … and waiting again.

“I have been waiting for a cornea since 2019. No donors have come through. Really people should donate, because when you’re dead you don’t need it,” she says.

Donation of the cornea is limited to dead people, as this would lead to blindness in a living donor.

Nkatha, now an accountant in Nairobi, cannot see clearly and a cornea transplant would restore vision, reduce pain, and improve the appearance of her eyes.

“I know I have lost many opportunities in life because of poor eyesight,” she says.

Thousands of Kenyans like her must travel abroad or wait endlessly for imported body tissues because Kenya has no law to guide the harvesting of tissues and organs from dead people.

But medics fear even when the law is in place, Kenyans may be reluctant to enlist themselves as donors when they die, due to cultural reasons.

Currently, hospitals have a waiting list of about 1,050, people who are blind or cannot see properly and need donated corneas.

“An estimated 75,000 people need corneal transplants in Kenya with over 1,000 documented patients on the waiting lists in various eye hospitals,” says Dr Maurice Wakwabubi, a general surgeon who heads the Kenya Tissue and Transplant Authority.

In 2021, only about 400 corneal transplant surgeries were successfully conducted in Kenya.

Dr Wakwabubi says the tissue authority is working on regulations to enable Kenyans to donate their body parts when they die.

“We set up a technical working group of medical experts and have developed draft procedures and regulations,” he said on Tuesday during World  Transplant Day celebrations at the Kenyatta National Hospital, which hosts the authority.

“We need to look at them again to do validation. World Health Organization will help us expedite public participation because many people need help,” he added.

The National Assembly will need to approve the regulations before they are finally gazetted.

Dr Rebecah Nandasaba, an ophthalmologist and glaucoma specialist at KNH, says on average, Kenyan patients wait at least one year to get matching corneas.

“You can only donate cornea when you die,” she said. “So we import from the USA, and within 14 days it must be used.”

She said once the regulations are in place, Kenyan doctors will begin harvesting corneas from dead donors, who made such a will when they were alive.

“We’re setting up an eye bank at KNH. We are in the early stages and identified space and are looking to get equipment,” she said.

Kenya has about 20 health facilities doing organ transplants, mostly kidney and cornea.

According to the tissue authority, approximately 12,500 Kenyans have End Stage Kidney Disease and require kidney transplants.

But getting their relatives to donate kidneys is a tall order.

By October 2022, 6,300 of these patients were undergoing dialysis while looking for donors.

“Even though a majority of kidney patients opt for dialysis treatment due to various factors, the number of transplants in the country is still quite low,” Wakwabubi says.

From 2012 to 2022, only 708 kidney transplants were done in Kenya. In 2021, only 160 kidney transplants were done, against 5,700 patients on dialysis.

“This gives a transplant conversion rate of 2.8 per cent against a rate of approximately 10 per cent that has been observed globally,” Wakwabubi adds.

Medics at the KNH began bone marrow transplants last year and are currently preparing to start liver transplantation.

However, they say Kenyans have to be ready to donate parts of their livers to make this successful.

“You can live with half or a quarter of your liver and after transplant in three months it grows into full size,” says Dr Muthenya Muia, a surgeon at KNH.

“We are planning to begin transplants and we have trained three doctors. Patients are there in big numbers.”

-Edited by SKanyara