Newcastle’s renal and transplant team has been awarded funding by the International Society of Nephrology to establish a Sister Transplant Centre partnership between the Institute of Transplantation at the Freeman Hospital and the Human Organ Transplant Centre in Kathmandu, Nepal.
The prestigious Sister Transplant Centre programme is a global initiative by the International Society of Nephrology (ISN) and The Transplantation Society (TTS) which awards funding to create new kidney transplant centres, and develop existing kidney transplant programmes in emerging countries.
Leading the partnership at the Freeman Hospital are Dr Alison Brown, lead nephrologist and renal lead for kidney–pancreas and antibody renal incompatible transplants, and Professor David Talbot, consultant transplant surgeon. They made the application to the ISN program after working alongside Dr Pukar Shrestha, the clinical lead in Nepal for a number of years.
Dr Shrestha, the Executive Director of the Human Organ Transplant Centre in Nepal, trained as a transplant surgeon at the Freeman Hospital from 2004-2008 before returning to his native Nepal with the ambition of setting up the country’s first transplant centre.
Dr Brown said: “We’re delighted to have been awarded entry to the ISN-TTS Sister Transplant Centres program; over the years we have been able to provide help, support and advice to Dr Shrestha and his team in Nepal.
“This prestigious award will help to further facilitate and formalise the partnership between renal services at the Freeman and the Human Organ Transplant Centre.”
Professor Talbot and consultant urologist Mr David Rix travelled to Nepal in 2008 to assist Dr Shrestha as he set up the transplant centre, which carried out its first successful kidney transplant in early 2009. The centre has now performed over 200 renal transplants and in December 2016 announced that it had successfully performed its first liver transplant.
Professor Talbot said: “There were some significant barriers to transplant when David Rix and I travelled to Nepal for the first time, including the imprisonment of donor surgeons if the living donor died.
“Pukar’s brother is the Attorney General for Nepal and we were able to meet with Nepal’s first Prime Minister, Bhimsen Thapa and thankfully the law was repealed.”
“I returned to Nepal to assist Pukar with his first transplants. However just as important as the successful live donor programme is the recent recognition and legislation for brain dead and cadaveric donation which will hopefully open the way to transplantation of more kidneys and also other vital organs.
The partnership will enter the Sister Transplant Centre program at level C and will receive funding of $1500 a year for the first two years.
With the support of Ann Mobaraki, assistant directorate accountant at the trust, the funding will allow the two centres to exchange knowledge and expertise and to help further expand the renal services the Human Organ Transplant Centre is able to offer.
Dr Brown explains: “This funding will allow a nephrologist from Kathmandu to come and study with us at the transplant unit at the Freeman, and hopefully one of our tissue typing experts from the Department of Histocompatibility and immunogenetics at NHS Blood and Transplant will travel to Nepal to help Dr Shrestha and his team develop their tissue typing service.”
The development of the links between the Institute of Transplantation and the Human Organ Transplant Centre is vital to help to promote Dr Shrestha’s work in Nepal. At present Nepal is unable to provide funding for haemodialysis for more than two years so a patient with end stage renal failure would have to receive a kidney transplant within this time.
Dr Brown said: “The transplant set up and infrastructure in Nepal is completely different to what we are used to in the UK. Several members of our team have seen first-hand the fantastic work that Dr Shrestha and his team do in Nepal with very limited resources, he has excellent outcomes and we are keen to continue to help this develop.”