Barbados is gearing up to become the centre for organ transplants in the Eastern Caribbean.
The revelation has come from Chief Executive Officer (CEO) at the Queen Elizabeth Hospital (QEH) Juliette Bynoe-Sutherland and consultant transplant nephrologist Dr Nerissa Jurawan.
In an exclusive interview with Barbados TODAY, Bynoe-Sutherland and Dr Jurawan disclosed that a new Organ Transplant Bill is almost ready for introduction to Parliament. The legislation would pave the way for the state-owned QEH to significantly expand its current transplant unit, eliminate the need for tissue typing samples to be sent to the United States, and greatly boost the number of surgeries and their scope through the harvesting of organs from deceased donors.
“In our view, both have to go hand in hand – legislation and the infrastructure. We just cannot keep putting people on dialysis. When you have a kidney transplant, you have a completely different quality of life. This would put us in a position to help other Caribbean countries. We would also be able to put in our donor bank, persons from the Caribbean,” Bynoe-Sutherland said.
“So, I would say it is not just the development that is important for Barbados, but for the Eastern Caribbean as well. There are some countries where access to dialysis treatment is very, very difficult.”
Tissue typing is required to make sure there is a match between the donor and the recipient.
“So, we think that with the legislative reform, plus the ability to do tissue typing locally, it would advance our programme,” the hospital boss said.
Dr Jurawan said the move towards increasing transplants and being legally able to harvest organs from the deceased had started several years ago but little progress had been made.
“I hope the Bill will become a reality and be tabled in Parliament for approval. We have been doing kidney transplant, we have been doing corneal transplant, and certainly we can widen the scope and make the Queen Elizabeth Hospital one of the biggest transplant centres in the Eastern Caribbean, not only for kidney transplant. This Bill would hopefully cover liver transplant and bone marrow transplant as well,” the consultant transplant nephrologist told Barbados TODAY.
She also said the hospital wanted to do two kidney transplants per month, but given its current limitations, four to five per year was more realistic.
“The major limitations are the infrastructure in place at the Queen Elizabeth Hospital in terms of the staffing. We also need a special lab to get results a little quicker from the tissue typing. Also, one of the major limiting factors is that we are solely dependent on a live donor programme. So, if a donor does not step forward then we have no organ available,” the specialist doctor said.
“However, if there is legislation, then that can change, then we will become fully reliant on a deceased donor programme… and that can change the scale of things dramatically. So, if that is in place, we are looking at, idealistically, four per month or 48 per year which is a very good start.”
Dr Jurawan also said the demand for dialysis treatment has grown “tremendously” over the last five years and authorities expect that will continue to grow with the burden of chronic disease.
“It is inevitable. So, transplantation is the most sustainable way of dealing with this problem, not only for the patient but for the entire country, because it is the most cost effective. So far, since 2015, we had ten transplants and they are all doing well. We have had one death and that was unfortunate. It was a complication of the transplant, a long-term complication, which I don’t think we could have avoided,” the senior specialist told Barbados TODAY.
She noted that once everything “goes perfectly” after the surgery, recipients of organs are usually discharged seven days after the operation, or two weeks if there are complications.
“With a better quality of life, they can return to a near normal state of living because they are essentially healthy. They can return to work, they can return to school, their time is their own. Their quality of life is better, but not only that, their survival rate is better. They are going to last longer than the patients that we have on dialysis,” Dr Jurawan stated.
She explained that two to three new patients come to the ward every week, and among them were young people.
“The current ones we have in our low clearance clinic, we have a waiting list to get onto dialysis between 40 to 50 patients that we see in the clinic and we are working them up to starting dialysis,” Dr Jurawan added.
Meanwhile, transplant nurse Ruth Shorey emphasised why having a tissue typing laboratory in Barbados is critical.
“If we have the lab here, we can do a lot more…. We can actually create our list. We would know our potential recipients, we would know what their tissue type is…so it means when a potential donor comes along, we do their tissue type, we will be able to match them almost immediately,” she said.
“When you have to send stuff overseas . . . you can lose all of your samples in an air disaster and it is not cheap . . . . If you are going to have legislation, it means you will be putting things in place to have things done on island, including the lab,” she told Barbados TODAY. (emmanueljoseph@barbadostoday.bb)
