Inside Museveni’s meeting with scientists after Uganda’s successful Kidney Transplant

President Museveni on Friday met a team of Ugandan and Indian medical experts who successfully last week conducted the country’s first kidney transplant at Mulago Hospital.

Health minister Dr Jane Ruth Aceng said the president wondered –during the meeting- why it took the experts so long to start doing organ transplants in Uganda.

But Aceng emphasized that issues discussed in the meeting at State House Entebbe also included the limited number of specialists in the country and the low absorption of the existing specialists into public service.

“He committed to training more [specialists]. He is waiting for a report from us on how many we can train annually and how many we shall require moving forward. That includes other specialists like Intensive Care Unit (ICU) nurses needed in thousands,” Dr Aceng revealed.

Additionally, Dr Aceng disclosed that the president, who was essential in getting the organ transplant program started in Uganda, “pushed health authorities to ensure that the law comes into force.”

“So, we also discussed the need to lift the ban on recruitment so that we can start employing specialists. If we can’t do this for the whole country, we need to begin with the specialized services that we have now launched and then move to the whole country,” she explained to Monitor on Saturday.

The organ transplant unit of Mulago NRH currently has three transplant surgeons, three nephrologists, three perfusionists, three anesthesiologists, 10 ICU nurses, eight theater nurses, one social worker, biomedical engineers, and one administrator, according to government data.

“Government has provided the startup funds for medicines and supplies and all these medicines are provided free for patient care,” Dr Aceng noted.

Process leading to Uganda’s first kidney transplant

The transplant was led by Mulago NRH transplant surgeon Prof Frank Asiimwe, and seven experienced specialists from India’s Yashoda Hospital. The Indian specialists are credited for guiding the Ugandan team.

On March 15, 2023, the President assented to the Uganda Human Organ Donation and Transplant Bill, filling the legal framework void- and allowing specialists to begin transplants. The Mulago organ transplant unit has modern equipment and specialists who have been trained in India following a 2014 memorandum of understanding with Yashoda Hospitals.

The transplant unit of Mulago has two transplant theaters, two Intensive care units, one high-dependency unit (HDU), plenty of wall oxygen, and other different types of air that may be required. Mulago also has four inpatient rooms at the HDU level with biometric-controlled access.

Mulago NRH embarked on preparations for the maiden transplant about two months ago as four pairs –each with donor and recipient, were selected from dialysis patients for transplant. The selectees were subjected to various tests for compatibility in preparation.

“Two weeks ago, the patients were deemed ready, and our colleagues from Yashoda [Hospitals] flew in. The Ministry of Health top management was paid a visit by Mulago and they indicated that they were ready and we gave them a go-ahead,” Dr Aceng said.

“The patient had pre-transplant counseling and we were taken through the consent process of the recipient, donor, and next of kin. On December 20, 2023 between 8am and 12pm, one patient was transplanted. The donor and patient are recovering very well. This is the most beautiful Christmas gift that we have had from Mulago NRH,” she added.

Kidney disease burden

According to information from the Health Ministry, 13 per cent of Ugandans have some kidney disease with 2 per cent having end-stage disease– meaning they require dialysis and eventually transplant. Many have been going abroad for the transplant which can cost as much as $35,000 (over Shs120million). It is estimated that the cost in Mulago NRH could be around Shs50million.

Currently, there are over 1000 patients with end-stage kidney disease on dialysis, according to the Health Ministry. Mulago National Referral Hospital handles 1082 dialysis sessions annually. Kiruddu Hospital handles almost a similar number. Other people get kidney care in regional referral hospitals and private facilities.