KARACHI, Dec 4: No religion restricts organ donations and Islam acknowledges that saving life of one person amounts to saving the whole mankind. This was stated by Dr George Abouna, Professor of Surgery at Drexek University, Philadelphia, while addressing the concluding day of fifth international symposium on urology, nephrology and transplantation, organized by the Sindh Institute of Urology and Transplantation on Sunday.
He spoke at length on current ethical religious, social and legal implications of organ donations. He said that the number of patients waiting for organs was steadily rising and as such organ deficit was on the rise. The only option left was cadaver organs for transplantation and this was supported by all religions, he added.
In support of his views, he referred to Christianity, which calls it (organ donation) as an act of love. “Judaism says it is a good deed a person can do after death,” he said and related Islamic fatwa which read out as an act to save one life amounts to saving whole mankind.
The Buddhist, he said, call cadaver organ donation as final act of generosity.
He said law for cadaver organ law was prevalent throughout the world but its absence in Pakistan had paved way for commercialism and organ sale, which was condemned by the World Health Organization, all governments, societies and religions.
He expressed serious concern over the reports of kidney sale in the country.
Speaking on sepsis and acute renal failure, Prof Robert Schrier said that 48 per cent of all acute cases were secondary to infection. It was important to diagnose condition promptly and treat immediately along with ventilation support, he added.
Dr N. Rao from Manchester gave a talk on medical management of kidney stone and stressed on fluid intake sufficient to produce two litres of urine daily, avoid excess animal proteins, refined carbohydrates and low calcium diet.
On Fournier’s Gangrene, Dr Haq Nawaz said that early recognition, repeated and aggressive debridemen, intensive care treatment and antibiotics were mandatory to prevent irreversible endotoxic shock so mortality rates continued to improve in true urological emergencies.
Prof A. Watson, a British professor of paediatric nephrology, described causes and treatment of acute kidney failure in children. He said the main causes were infections, burns, crush injuries and obstruction due to stones. Early intervention and therapy was mandatory, he remarked.
SIUT Director Prof Adibul Hasan Rizvi, Dr Philip Ransley and others also spoke at the last session presided over by Mrs Zubeida Mustafa.
The two-day symposium, held at Dewan Farooq Medical Complex, was attended by more than 400 delegates.
On the first day of the international moot, Prof Robert Schricr spoke on implications for cardiac failure, liver cirrhosis and pregnancy.
The second talk for the Pakistan Association of Urological Surgeons was delivered by Dr Philip Ransely, paediatric surgeon of urology, from the Hospital for Sick Children, Great Ormond Street, London. Recipient of the prestigious St Peter’s Medal by the British Association of Urological Surgeons in 1998, Mr Ransley spoke on the role of surgery in inter-sex disorders.
Dr Muhammad Umer from Islamabad labelled liver cancer as the fifth common malignancy in Pakistan, associated with cirrhosis in 80 per cent to 90 per cent of the cases, for which liver transplantation was the best treatment option.
Dr Rizwan Khan discussed the role of surgical resection and liver transplantation in liver cancer. He said that as the liver cancer was associated with cirrhosis in 80-90 per cent of cases secondary to Hepatitis-C, the best option was transplantation, especially for a small size liver malignancy.
Talking about HCV in paediatric patients undergoing haemodialysis, Dr Rashid Mirza said that they could develop significant liver disease with portal hypertension. Children respond to interferon therapy much better than adults, he said.
For treating hypertension in diabetes, angiotensin converting enzyme inhibitors were drug of choice, stated Dr Robert Sehrier, Professor of Medicine from the USA. Keeping blood pressure in the recommended normal range was very essential and beneficial for both macro and micro-vascular complications, he said, adding that blood glucose control alone could prevent micro-vascular complications.
Blood pressure control slowed the progression of retinopathy and reduced the incidence of stroke and kidney complications, he added.
This was supported by Dr M. Yaqoob from the UK who said that high glucose level could induce injury to kidney tubules by damaging the cells.
Dr Parabhakar of Singapore talked on primary and secondary prevention programme against chronic kidney diseases. He said 62 per cent of diabetes did not know about the disorder. Hypertension was prevalent in 20.7 per cent of population with 70 per cent having poor control.
Dr C. Ozer from Ankara talked on removal of urinary tract stones. He suggested minimal invasive surgery when ultrasound guided lithotripsy was increasingly used to eliminate radiation exposure. Stones could be prevented by high fluid intake and citrates, he added. —APP