22 November 2004	Monday	09 Shawwal 1425

KARACHI, Nov 21: Following a rare initiative involving an international health agency, an airline and the administration of a hospital in Karachi, a kidney was flown in from Europe and transplanted into an 18-year-old Pakistani, Uzma, in the early hours of Sunday.

A patient of end-stage renal disease, Uzma had been on dialysis for the last more than four years at the Sindh Institute of Urology and Transplantation (SIUT), the hospital where she was operated upon. The transplant operation ended at about 2am on Sunday.

According to a statement released by the SIUT, the kidney for the operation came from the body of a 50-year-old woman who died suddenly in a hospital thousands of miles away in Maastricht, The Netherlands. The family of the deceased allowed her kidney to be donated.

Consequently, the Maastricht-based Eurotransplant Foundation - which coordinates cadaver organ donation within six European countries - was informed. No suitable recipient for the kidney, however, could be located in the six European countries.

The Eurotransplant Foundation then informed the SIUT of the development, which welcomed the donation after going through the details about the donor as well as the kidney's condition, said the statement. Thus, began a race against time to fly the organ to Karachi in good condition, within the limited time permissible under such circumstances.

The cadaver kidney started its journey from Maastricht to Amsterdam, preserved in a box of ice. At Amsterdam the foundation handed over the kidney to the pilot of the Pakistan International's flight PK 763, who flew it to Frankfurt.

The kidney was subsequently flown to Islamabad on board PIA flight PK 764, said the SIUT handout. Concerned about possible loss of precious time, a doctor was dispatched to Islamabad to receive the kidney and bring it to Karachi as soon as possible.

At the Islamabad airport, according to the statement, there was a time lag of only 15 minutes for the kidney to be transferred from one flight to the other. This was due to the cooperation extended by the PIA staff and the dozens of people who were waiting to be flown over to Karachi.

Flight PK 309, which subsequently brought the organ to Karachi, was actually supposed to depart a good 45 minutes before the kidney's arrival from Frankfurt. And the next flight to Karachi was many hours away.

The PIA staff decided to delay the departure of the flight to save time. The pilot of the flight informed the passengers of the situation and requested them to wait for the organ which was being flown in.

The passengers showed their approval by clapping. The kidney was flown to Karachi on board this flight and it reached the SIUT by Saturday evening, said the statement.

In the meantime, the SIUT staff had screened six patients, selected on the basis of the blood group and the absence of donors in their families. The next step of tissue-typing narrowed the choice to two potential recipients.

Uzma had the best possible match and was selected for the transplant operation. The donation was very special for Uzma because her two sisters were also in renal failure. One of them is on dialysis at the SIUT.

Her father is a driver by profession and can barely support his family. Had it not been for free treatment at the SIUT, he would not be in a position to seek healthcare for his ailing daughters, according to the statement.

It is due to free treatment of all patients, that the SIUT has been facing an yearly deficit of Rs100 million for the last three years. It has been dipping into its endowment fund to meet the deficit, with the result that the entire amount has almost been wiped out.

"The citizens of Pakistan need to rise to the occasion before the over stretched SIUT may have to start refusing the patients - something which the institute will never wish to do," stated the handout.

"Moreover, it is unfortunate that cadaveric donation is still not possible in Pakistan because there is no legislation to support it. This is particularly saddening because all the Muslim countries in the Middle East and South Asia have appropriate legislation to permit donation of organs after death (heart-beating cadaver)".

The law on organ transplantation was under active consideration of the departments concerned, including the ministry of health, stated the handout. The SIUT hoped that the law was likely to be promulgated soon.

The law would benefit not only the patients of renal failure but also those of end-stage liver, heart, lungs, small intestine, pancreas and cornea diseases. One dead person could save the lives of 10 living persons in need of transplantation. In Pakistan this would mean benefiting about 50,000 patients every year, said the statement.

In the case of Uzma, an exemplary role was played by the Eurotransplant Foundation which has donated 21 kidneys to the SIUT over the past 10 years. The foundation has been helping other Muslim countries, too, for example Turkey, which used the donations to bring about the promulgation of a law on cadaver organ donation, according to the SIUT statement.

Similarly, the PIA played a pivotal role in transporting the kidney to Pakistan. With the active help of its director of flight operations and its flight crew, the airline not only took care of the kidney but demonstrated agility and precision so that the organ could be transported all the way to Karachi in a short period of less than 12 hours of flying time, stated the handout.

Uzma is recovering well from her surgery and is in the SIUT's intensive care unit. Her kidney is likely to recover full function within two weeks after which she will be discharged from the hospital to resume a normal life.