KARACHI, Dec 1: Experts on the second day of the ninth Congress of the Asian Society of Transplantation (CAST) here on Thursday discussed the modern trends in organ transplantation and their impacts on the healthcare system. The three-day international moot is being organized by the Sindh Institute of Urology and Transplant (SIUT), Karachi.

Dr S Hariharan from USA said that long-term kidney transplant survival could be improved by transplanting a younger recipient with the kidney from a healthy young donor and decreasing the waiting time for surgery.

Dr A Daar from Toronto delivered a very interesting talk on regenerative medicine in the developing world. This involves genetic engineering modulation of tissues and organs. It would eventually provide a tissue bank, from where any recipient needing an organ would benefit.

Dr Paolo Muiesan from Kings Hospital, UK spoke on liver transplantation as a good treatment option for liver cancer, which is one of the most common malignancies worldwide.

Liver failure due to hepatitis C virus is a leading indication for liver transplantation in the USA and Europe, said Dr David Van Theil from USA.

He said that more than 20,000 patients had received a liver graft after liver failure due to hepatitis C virus infection.

Dr J Geogeghan of St. Vincent’s University Hospital Dublin spoke on improving outcomes in liver transplantation through a good match with the recipient, improvement in intensive care, advancement in techniques and good immunosuppression.

Dr Rizvi Sheriff from Colombo spoke on post-transplant diabetes, which is an important complication of transplantation and can lead to higher death ratio and organ rejection.

“The candidates more likely to develop diabetes are those over 40 years of age, on higher doses of steroids, having sedentary life style, obesity, an Afro-American ethnic background and a positive family history. Prevention lies in adopting a healthy lifestyle, low dose steroid regimen and avoiding obesity. Regular monitoring of fasting blood glucose is highly recommended.”

Prof Haroonur Rashid from BSM University, Dhaka stated that infections were one of the important causes of morbidity and mortality in transplant patients in the developing countries; with tuberculosis having a prevalence of 5 to 15 per cent in South Asia alone. These infections could be prevented by improving environmental factors, specific diagnostic approach and special treatment protocols, he added.

While speaking on malignancy after renal transplantation, Dr P Swamy Royal Free Hospital London said that viral related cancers were the third common cause of mortality.

He stressed on viral screening prior to transplantation and regular monitoring later, which would prevent late presentation of the patients developing malignancy. New cancer drugs have improved the prognosis, he added.

Dr H Karakayali from Baskent University Ankara said that liver transplantation was the only curative option for the patients with liver cirrhosis and liver cancer. The prognosis is good after acquiring a healthy liver raft, he said.

Among others who spoke during the day included Prof G Opelz from Germany, Z Varghese of UK, Zaki Murad from Kualalumpur, W Land from Germany, J.P Van Hoof from Maastricht.—PPI