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Dr Jacob Olugbenga Awobusuyi

Hello, am Dr Jacob Awobusuyi, a Consultant Nephrologist at Lagos State University Teaching Hospital. I led the team that recently performed the first renal transplant at LASUTH.

For my full profile, visit HERE

You are welcome to ask me any question by posting it in the comment section below. I will do my best to answer your questions on Thursday, 14th January 2016 at 2pm.

Dear Dr Awobusuyi, let me first thank you for taking time out to be on Meet The Guru. I have three (3) questions:

 

1. Which people typically make up a renal transplant team and what are their roles?

 

2. Can you compare the cost of having the procedure done in LASUTH and somewhere like India?

 

3. What steps have been put in place or are being taken to ensure sustainability of the renal transplant programme in LASUTH? 

A renal transplant team is a multidisciplinary team consisting of:
1. Nephrologists
2. Transplant surgeons
3. Nurses
4. Anaesthetists
5. Pharmacists
6. Clinical Psychologists
7. Dieticians
8. Other members depending on the unit

Nephrologists and transplant Surgeons perform the Donor and Recipient’s pre kidney transplantation work-up, the surgeons perform the operation, and the post-transplant patient’s management is done by nephrologists.
Nurses provide the pre and post- op nursing care for the patient. Roles of the other members of the Team are self- explanatory.
The transplant team takes joint decisions on eligibility of both donor and recipient for the transplant operation and also determine the appropriate timing of the operation, the best approach to donor nephrectomy, the immunosuppression agents to be used depending on the risk assessment of the recipient and all other aspects of treatment related to the transplant surgery.

Aim of LASUTH transplant program is to make kidney transplantation affordable to patients. Compared with having it done outside the country, it is far less expensive.
Secondly, the inconvenience of travelling out of the country for a procedure that could be done within the country is eliminated and regular follow up by the team is easier with a transplant unit that is within the country compared with a team outside the country.

Our transplant program is one of the few transplant programs that commenced with all members being staff of the hospital were the surgery is done. The surgery and patient’s care were to a large extent done by the LASUTH team. We are however grateful for the support given by Dr. Ayo Shonibare and Dr. Ebun Bamgboye. They were really wonderful.

To ensure sustainability, we currently have the multi-disciplinary renal team meetings on a regular basis. At these meetings, clinical details potential donor and recipient pairs that are accepted into the program are discussed and topics on the various aspects of renal transplantation are presented by Consultants and Senior Registrars.
We also have the patients’ forum meeting twice monthly. Patients with Chronic Kidney Disease and their relatives are encouraged to participate in the meeting. We conduct patients’ education, and address issues raised by the participants. This has enabled us to sustain the interest of our patients, as they have the opportunity to interact with the team and also with other patients who are at various stages of completing their pre-transplantation work-up at this meeting.

1. How long did the operation last?

2. What did he experience as the challenges of doing such operation:
a. At LASUTH?
b. In Nigeria?

3. If to be marketed outside Nigeria, what would he fix as the cost of such operation?

4. If offered the right terms, can he assemble a team or teams (of experts in the field) that
may gain the confidence of investors to establish a 200 to 400 bedded nephrology centre
in Lagos or Abuja?

During our preparation for the operation, <strong>a lot of attention was paid to training, and retraining of staff</strong>, and also to <strong>procurement of all the instruments and consumables&nbsp;</strong>that were needed. <strong>We also enjoyed the full support of the Hospital’s management</strong>. We therefore had a very smooth conduct with no significant challenge.N4,000,000.00 – N5,000,00.00 (Four to five million Naira) is a reasonable cost for the procedure.There shouldn’t be any problem in assembling a Nephrology team that would work in such a centre in the country. The manpower necessary for operating the centre is readily available within the country.

Well done for the feat Dr Awobusuyi. More power to your elbow. How easy is it to get a non-family member donor and what is the estimated cost of a renal transplant in Lasuth?

We sincerely don’t accept commercial donors and we have recently rejected two donors brought in by a patient because we have reasons to believe that they were commercial donors. We encourage our patients to have an open and honest discussion with members of their families. Hopefully, a family member would be compassionate enough to accept being a donor.

Emotionally related donors may be considered in a situation in which none of the family members is suitable as donor. But a thorough screening would be performed to rule out commercialisation.

All our patients and donors are requested to swear an affidavit in court, ascertaining their relationship and also a psychological evaluation is done by our clinical psychologist.

 

The clinical psychologist generates a psychological profile of the potential donor that facilitates an informed and rational decision with respect to the suitability and psychological readiness of the donor for the organ donation and the surgical procedure. The psychological evaluation procedure involves an interactive interview combined with selected psychological tests to profile the personality and mental state of the donor.

Our current estimated cost is N4,500,000.00 (Four million, five hundred Naira). This covers Pre- transplantation Donor/recipient evaluation, the transplant operation, immunosupression drugs including induction with simulect (cost of 2 vials of simulect is about N850,000.00 (Eight hundred and fifty thousand Naira only), and three - four months maintemance anti-rejection drugs. 

Gbenga
Welcome on board as a fellow leader in kidney Transplant.
Congratulations.
Are you Tie phobic?

Thanks HOD Medicine, UITH. I am not "tiephobic". I just feel more comfortable without ties. Regards

I am Dr Douglas Nkemdilim, The Chief Medical Officer in charge of State General Hospital, Ekwulobia in Anambra State. I was closely associated with Gbenga Awobusuyi when we were undergraduae medical students in  University Of Ilorin. A quiet and unassuming young boy at the time, Gbenga was more studious than any other members of our peer group, including Segun Adelaragbe. .
CONGRATS GBENGA. I wish you more successes in Renal medicine.
Dougidor

Thanks Douglas my good friend,
 
It's been quite a while! Trust all is well.
 
I'll keep in touch, now that I have your number.
 
Stay blessed
 
My regards,
 
Gbenga