Advanced renal medicine from Singapore

Wednesday, 18 September 2013 00:00 -     - {{hitsCtrl.values.hits}}

Specialised therapy to eliminate chances of kidney rejection By Shabiya Ali Ahlam A leading nephrologist from Singapore opined that although Sri Lanka has talented doctors in the field of renal medicine, the country is unable to handle highly complicated cases due to the absence of advanced technology. Having identified the limitation, Mount Elizabeth Hospital Renal Medicine Specialist Dr. Pary Sivaraman expressed this can be filled by specialists from Singapore. Referring to the recent assessment of the National Kidney Foundation, USA, which noted that the lifetime risk of developing a kidney problem is 60%, Dr. Sivaraman said:  “Kidney related issues are highly common in any part of the world. Due to this high occurrence, it is important for people to know the types of kidney problems and the treatments available for it. Sri Lanka certainly has highly talented doctors in this field but it should be understood that some advances are not available here. This is where we (specialists from Singapore) come in to provide help.” Focusing on a common renal disease, Dr. Sivaraman spoke on the instance of kidney failure. While the best solution for the issue is a kidney transplant, many consider the option of dialysis. However, according to the nephrologist, when looking at the two options in terms of life span, dialysis is not the ideal option and the best solution is always a transplant. Although the recommendation sounds rather simple, Dr. Srivaraman said kidney transplants can be ‘complicated’. Falling under this ‘complicated’ list according to him are patients who have undergone multiple transfusion, a previous transplant, and women with multiple pregnancies. Dr. Sivaraman professed that the mentioned group of patients fall under the high risk category since there is an increasing chance of rejection due to the formation of Human Leukocyte Antigen (HLA) antibodies. “Unfortunately for such cases the standard medication used for kidney transplants don’t work. Specialised therapy to bring down and control the antibody levels is required. This specialised therapy is the lacking factor in Sri Lanka.” Pointing out another high risk group, he stated that Singapore can also offer blood group incompatible transplants. Elaborating on the procedure he said: “Typically for a transplant it is necessary for the donor and the recipient to have the same blood group. A transplant against the blood group will result in rejection and failure of the kidney within 24 hours. However, recent improvements in technology has allowed incompatible blood group transplant to become possible.” Practiced in Singapore for the past five years, the procedure was initiated in Japan 25 years ago. Having followed a complicated regime back then, the procedure was not taken up by other countries.  As new medications came on board and with advanced technology becoming available, incompatible blood group transplant is now common in advanced economies. “We have many patients coming from Sri Lanka who have undergone kidney transplant and have run into problems such as infections and rejections. By coming to Singapore for medical help, these patients were able to get this under control. We are able to confidently handle such cases since we have been involved with many complicated cases for nearly five years and are well equipped with not only the knowledge and experience, but technology as well,” he noted.