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Transplantation is not a quick fix or cure for renal failure

The world's first successful kidney transplant took place at Boston's Brigham and Women's Hospital, in 1954. It would be more than 20 years before a Bermudian was able to benefit from the medical advances that earned Joseph Murray a Nobel Prize.The Bermuda Hospitals Board is today joining countries around the world as they observe World Kidney Day.It was in 1972 that the first Bermudian received a kidney transplant — 104 residents have since. Kidneys play a vital role in maintaining optimal health. Persons with chronic kidney disease are at risk for heart disease, the number one cause of death worldwide.It's for that reason the Bermuda Hospitals Board is working to educate the community on kidney disease and how prevention can lower rates of cardiovascular disease here. Said Norma Smith, clinical director of Outpatient Services at BHB: “We are encouraging members of the public to engage in preventive behaviours that will hopefully lower the overall incidence of kidney disease in our community.“Our lobby display and information booth will improve awareness of renal disease risk factors, provide information about its early detection and explain how close monitoring can slow its progression. We urge all medical professionals in Bermuda to take an active role in detecting and reducing the risk of chronic kidney disease, particularly in high risk populations.”Like the recipient of the first kidney transplant at Brigham and Women's Hospital, the first Bermudian to benefit was a twin. The hospital is rated as one of the best in the US for kidney transplantation. Bermuda has been affiliated with it since the early 1980s. Transplantation for Bermuda clients comes under the New England Organ Bank. There is a reciprocal agreement whereby Bermuda donates organs to them and in return, they provide organs for local clients.The kidney involved in the first Bermudian transplant worked well for 29 years. Another person who received a kidney from a deceased donor in 1973 still has good function from that kidney today. At that time, there was no haemodialysis in Bermuda and treatment options were very limited. A few people were maintained by another form of dialysis in the Intensive Care Unit while others went overseas for transplants or lived abroad and had dialysis there. The Beresford Swan Dialysis Unit opened here in 1978. Of the 104 residents who have received kidney transplants since 1972, 26 of the organs were donated by a living friend or relative. The rest were donated by the families of deceased persons.There are currently 36 people with working transplanted kidneys in Bermuda; 13 of the organs came from living donors. The youngest recipient was 11 years old and the oldest 73. There are approximately 30 residents waiting for kidneys, some of whom have potential living donors who are being evaluated.According to BHB, transplantation is the best option for those who meet the criteria as it generally gives a better quality of life. Many people also lead full and active lives while receiving dialysis and some choose to have dialysis rather than a transplant as they enjoy coming to the unit for the social interaction. Transplantation is not a quick fix or cure for renal failure. It is a treatment, but is not an ideal treatment for everyone.The recipient must be fit enough to undergo major surgery with a long anaesthetic.Certain medical conditions eliminate a person from being a transplant candidate, such as active cancers, advanced vascular disease, illicit drug abuse, smoking, obesity, severe cardiovascular disease, active infections and infectious diseases.In addition, transplant candidates must:l Be committed to taking anti-rejection medications for the rest of their life — compliance with treatment is essential;l Take very good care of their general health;l Express a commitment to working with their nephrologist, keeping doctors' appointments and taking prescribed blood tests to ensure that the transplanted kidney is functioning well.Transplantation is expensive and even with major medical insurance, the recipient would have to fund living overseas for approximately six weeks.n Information for this article was submitted by Marianne Herbert, renal transplant co-ordinator for the Beresford Swan Dialysis Unit.n For further information on cadaver donation contact Muriel Williams, president of the Bermuda Organ and Tissue Donor Association, on 239-1528.