Why kidney patients will no longer have to travel to India

Kidney patients seeking transplants will no longer have to travel to South Africa or India to conduct compatibility tests.

This is after the Kenyatta National Hospital established a human leukocyte antigen (HLA) tissue typing centre that will enable compatibility tests for kidney transplants to be conducted locally.

HLA is a type of molecule found on the surface of most cells in the body, and play an important role in the body’s response to foreign substances.

Human leukocyte antigen tests are done before a donor stem cell or organ transplant, to find out if tissues match between the donor and the person receiving the transplant.

“This was a big issue because all patients projected for kidney transplantation could not access these services locally," Kilivwa Mukaya, a KNH molecular specialist, said. 

"All the compatibility tests were referred either to South Africa or India.

“This process delayed interventional time. It also increased the cost of carrying out this transplantation procedure.”

According to Dr John Ngigi, a nephrologist at Kenyatta Prime Care Clinic, KNH carries out 130 dialysis cases every week.

On average, about 260 patients require kidney transplants each year.

The ultramodern machine will be managed by experienced staff led by Dr Anne Baraza, an immunologist and Dr Kassim Ali, a clinical pathologist.

Other players include Kilivwa Mukaya, Patricia Nabende, Alphonce Kioko, Jeniffer Mutua, and Mishack Kirimi.

With the know-how and the equipment available coupled with the goodwill from collaborating partners, the facility will offer a relief to patients because of 24 hours turn around time.

The low number of transplant operations in the country have been due to the unavailability of HLA tissue typing services locally.

"The number is set to increase upon the start of the transplant immunology tests within KNH,”  Nancy Wang’ombe, a  kidney transplant co-ordinator,  said.

A kidney transplant is a surgical procedure to place a healthy kidney from a living or deceased donor into a person whose kidneys no longer function properly.

The kidneys are two bean-shaped organs located on each side of the spine just below the rib cage. Each is about the size of a fist.

Their main function is to filter and remove waste, minerals and fluid from the blood by producing urine.

When your kidneys lose this filtering ability, harmful levels of fluid and waste accumulate in the body, which can raise blood pressure and result in kidney failure (end-stage kidney disease).

The end-stage renal disease occurs when the kidneys have lost about 90 per cent of their ability to function normally.

The KNH Renal Unit department has a team of specialised kidney doctors who work hand in hand with their peers from the University of Nairobi in the management of patients.

Their effort to achieve maximum success is affected by delays in the preparation process before grafting is done.

The cost of putting up and equipping a Transplant Immunology laboratory is costly.

The concept is new in the country and Africa as a whole, save for South Africa and part of North Africa. Proposals were done for funding through Private Public Partnership without success.

In 2015, the Africa Development Bank, in partnership with the East African governments, embarked on the establishment of centres of excellence in East Africa.

Kenya was picked to host the East Africa Kidney Institute.

As per the plan, the current Renal Unit would be improved to offer specialised services, as well as train on behalf of EAKI.

Part of the funds released for batch one equipment was used to procure LUMINEX machine, critical equipment in HLA tissue typing analysis.

However, the machine required more accompanying equipment and molecular reagents in order to function. This request was honoured in 2019.

Test validation to confirm the reliability of the results has been carried out. The hospital will enrol in the HLA accreditation programme.

(edited by Amol Awuor)