The CKC Transplant Program is 20 years old. The first transplant was performed on 6th August 1995. So far close to 700 transplants have been performed with very good results (curve), i.e. 20 year patient survival is 78 %, graft survival 60%, which matches with the best in the world.
CKC accepts living related donors in accordance with the Egyptian Law. It also accepts unrelated donors only upon a formal approval by the Egyptian Ministry of Health (MOH), which requires assessment by two Ethics Committees, one in the Center and the other in the MOH.
The process starts by evaluation of the recipient for general health and risks involved in the contemplated surgical intervention or intolerance to the subsequent medications to avoid rejection of the transplanted kidney. Any reversible condition discovered during this assessment is treated before he/she is enrolled into the Program. The donor is also assessed physically and by several lab tests and imaging techniques with three objectives:
- Matching with the recipient regarding the blood group and tissue type.
- Freedom from any transmissible disease
- Being healthy with minimal risk involved in surgery or in removing one of his/her kidneys.
All donors have to sit for psychiatric evaluation to make sure of their mental competence and not being subjected to any coercion or pressure. Once the patient and his potential donor are accepted, the formal process of obtaining the MOH clearance is triggered by the Center by submitting medical reports and other forms.
It usually takes about a month for medical evaluation and two weeks for obtaining MOH clearance. Waiting time that follows is usually short, i.e. one to three weeks depending on the order of each patient on the transplant waiting list.
The operation is performed in the specially equipped theatres at the CKC headquarters. These are designed according to the international standards including positive air pressure, single flow air conditioning, bacterial filters in the air circuit, first class operating table, lights, instruments and accessories, etc. The team includes many physicians, nurses, assistants, lab chemists and technicians, imaging and administrators. For each case are assigned 4 surgeon, 2 anesthetists, 3 physicians, 2 resident, 2nursing supervisors, 4 nurses and4 assistant nurses, involved during the operation and in-hospital follow-up.
The operation takes about three hours including removing the kidney from the donor, its perfusion and fixing it to the patient pelvic vessels and urinary bladder. After recovery, the patient isadmitted to an isolated room for 7 to 10 days, or until all drains are removed. The donor’s hospital stay is usually 4-7 days.
During his/her stay at the hospital the patient is fully educated on his/her treatment and instructed about life style and medications. Clinical and laboratory follow-up is done twice-weekly for the first month, with gradual spacing of hospital visits and investigations eventually to an occasional visit once or twice a year later on. The donor is also followed up for one year to ensure complete rehabilitation and recovery of sustained normal overall kidney function with his/her single kidney.
CKC is licensed for kidney transplantation bythe Egyptian Ministry of Health and is recognized as a moderate size transplant center at the national Worldwide Transplant Center Directory,(San Francisco) UNOS (United Network for Organ Sharing) and the Collaborative Transplant Study group (CTS) in Heidelberg, Germany. The latter provides statistics about the Center among other transplant centers around the world, which provides opportunity of comparing outcomes and reacting accordingly.
CKC team meets once a year in a dedicated conference to discuss the results of the past year, reviews recent international recommendations and sets its protocols for the coming year. It has developed its own protocol since 2002 and published its data internationally in two scientific papers in years 2007(https://www.ncbi.nlm.nih.gov/pubmed/18194116) and 2015 (https://www.ncbi.nlm.nih.gov/pubmed/25894123)