24 January 2004	Saturday	01 Zilhaj 1424

KARACHI, Jan 23: A laparoscopic live donor right nephrectomy procedure, first of its kind in the country, was performed at the Sindh Institute of Urology and Transplantation here on Friday.

The procedure, originally introduced in 1995 in Europe, is considered to be a major development making the renal transplantation from a live donor, a considerably complication-free option.

Renal transplantation, a choice treatment for chronic renal failure, holds particular significance for Pakistan where despite frequent surge in the incidence of renal failure and ever-growing requirement for kidney transplantation, cadaver organ donation is yet to be legalized.

Prior to the live demonstration of the procedure, speakers including Surgeon Magdi Shehata, director of transplantation and consultant laparoscopic and transplant surgeon in Nottingham City Hospital, UK, and Dr. K Alagesan, clinical director and consultant in anaesthesia and intensive care medicine at the same institution explicitly discussed the issue.

It was mentioned that there happens to be no age limit for donors and donations were made by people ranging between the age of 27 and 73 years. Median age was said to be 47. Interestingly at Nottingham City Hospital, there were more women donating their organs compared to men.

Although the procedure aims at minimal dissection and invasive equivalent operation contributory to short hospital stay, short recovery time, early return to normal life and less scars, it was mentioned that the procedure incurs high cost, mainly in terms of theatre time and consumables.

"Living donor nephrectomy is yet a reality with two-third of all donors in the US going for it," Dr. Magdi Shehata said, mentioning that the number of such procedures are gradually increasing in the UK.

The scenario was attributed to above cited benefits, as well as considerably high graft survival rate and satisfactory post-operative health condition of both donor and recipient.

The fact was, however, reiterated that team work on the part of an experienced and well-skilled laparoscopic surgeon, alongwith an adept anaesthetist, as well as camera person was a pre-requisite.

Surgeons were strongly advised to ensure maximum hand assisted practice by Dr. Shehata, who later also performed the procedure relayed right from the SIUT operation theatre and witnessed by local urologists belonging to different medical institutions scattered across the city.

Dr. K. Alagesan, in his presentation, underscored the need for a safe anaesthetic technique that could provide safety and comfort to the patient. He also highlighted the significance of pre-operative assessment of the donor, mentioning that those with ischemic heart disease and holding chances for heart attack were not suitable for laparoscopic surgery.-APP