KIDNEY transplants done on island may soon become a possibility, according to a group of medical professionals who say Guam does have the expertise to bring the procedure to the island.

“The statistic is that if you get all the expenses of patients on dialysis for two years, and you get all the expenses of a patient undergoing kidney transplantation, both expenses for two years would be equal. But after two years, the transplant would be so much cheaper. The kidney transplant is going to be expensive during the time the patient is being worked up and during the surgery. But after that it is so much less expensive,” stated Dr. Virgilio Petero, a urologist with Pacific Urology Center.

Dr. Petero is also a kidney surgeon who recently moved to Guam from Houston, Texas, where he performed kidney transplant surgery within the University of Texas medical system. He and a Guam colleague, Dr. Hyo Ji, an anesthesiologist with the Guam Surgical Center, are in the early talking stages of developing a team to possibly perform kidney transplants on Guam.

Despite the great potential of the procedure to help the island of Guam, Dr. Ji and Dr. Petero are still in the conceptualization stage. Dr. Petero will be presenting his research at the Marianas Medical Symposium this coming Saturday.

Dr. Ji stated the procedure may not be widely available on Guam within one year, or even two years, but it may eventually be done here.

That being said, there are several local organizations and physicians advocating a healthy lifestyle overall and reaching out to the youth to live healthy lifestyles in order to prevent major health complications such as diabetes and renal failure in their future.

Main cause

The main cause of kidney failure, or end stage kidney disease, on Guam is diabetes and hypertension, stated Dr. Petero. Currently, kidney failure is treated with dialysis. In other cases, patients travel off-island to do the procedure.

Local health experts say that as much as 56 percent of Guam’s population has diabetes. Patients undergo dialysis as much as three times a week. One of five patients under dialysis will die within the year. On average, the life expectancy is about two years.

However, with kidney transplantation, after the first six months to a year, the patient’s life expectancy increases. If an organ is transplanted from a cadaveric donor (harvested from a non-living donor) the average life expectancy is almost 15 years. The procedure takes about two hours, plus pre-operation preparation.

If a kidney comes from a living donor, such as a first degree relative or other match, the average life expectancy is about 26 years. With a living donor, the procedure takes only about an hour.

“It can be done. Eventually we will be able to do it here. We see a lot of people having problems. With transplantation we have longer life, better quality of life, and in the long run it is cheaper than being on dialysis,” Dr. Petero stated.

No guarantee

Organ transplantation does not come with guarantees, however. The donors must be in a healthy condition to be sustained with only one kidney. If not, they may end up on a kidney transplant list themselves in 10 or 15 years.

In addition, the organ recipient must be screened as well. Several other health conditions are associated with kidney failure, such as congestive heart failure. If a renal failure patient has other health complications, he or she may not be eligible for the procedure because he or she may not live to the full potential life expectancy of the new organ.

There are also some risks associated with the procedure. There is a long recuperation process after the procedure. The patient will be on anti-rejection medication for the rest of his or her life. Anti-rejection medication weakens the white blood cells and the body is more susceptible to infections.

However, with new operative techniques, antibiotics, and expertise, the risks of kidney transplant have decreased.

To conduct the procedure, there would have to be a transplant team to include surgeons, anesthesiologist, nursing staff, the post operation team, and enhanced laboratory capabilities. The team would need at least two operating rooms that could be provided by existing establishments, such as the Guam Memorial Hospital.

In addition, there would have to be an ethics committee to handle allocation of organs and the criteria for choosing beneficiaries.