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Tuesday, March 27, 2012
Are we a hotspot for organ trafficking?
Aneesa Alphonsus Free Malaysia Today 27/3/2012
KUALA LUMPUR: That Malaysia is one of the hotspots for the harvesting of human organs may be difficult to digest for some but the fact remains that we are a country on the radar of Bangladeshi police.
In September 2010, a news report said Malaysia was among ‘several countries’ involved in a syndicate linked to illegal kidney trade.
The report, while shocking some, however came as no surprise to Aegile Fernandez, programme director with Tenaganita, simply because she remembers with clarity the first time she heard about human organ trafficking in Malaysia.
“It was in 2009, when word reached me that organs were being trafficked in Johor and linked to Indonesia and Singapore – the triangle of one of the hotspots where this activity was taking place.
Department of Advanced Transplant and Regenerative Medicine, Hirosaki University Graduate School of Medicine, 5 Zaifu-chou, Hirosaki 036-8562, Japan 2Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Japan 3Department of Urology, Oyokyo Kidney Research Institute, Hirosaki 036-8243, Japan
International Journal of Nephrology
Volume 2012 (2012), Article ID 376128, 8 pages
doi:10.1155/2012/376128
Abstract
The oral adsorbent AST-120 has the potential to delay dialysis initiation and improve survival of patients on dialysis. We evaluated the effect of AST-120 on dialysis initiation and its potential to improve survival in patients with chronic kidney disease.
The present retrospective pair-matched study included 560 patients, grouped according to whether or not they received AST-120 before dialysis (AST-120 and non-AST-120 groups). The cumulative dialysis initiation free rate and survival rate were compared by the Kaplan-Meier method.
Multivariate analysis was used to determine the impact of AST-120 on dialysis initiation. Our results showed significant differences in the 12- and 24-month dialysis initiation free rate (), although no significant difference was observed in the survival rate between the two groups.
In conclusion, AST-120 delays dialysis initiation in chronic kidney disease (CKD) patients but has no effect on survival. AST-120 is an effective therapy for delaying the progression of CKD.
"When a body organ 'agent' offered to buy his kidney, destitute and desperate Bangladeshi Mohsin Abdul's only thought was: “I could live with one kidney and having two of these will not help me ease my debts".
Its a scenario that has taken many forms. It could be something we would have first heard many years ago from a friend who’d heard it from another friend, whose mother swore it happened to a distant cousin.
In that version, the victim — we’ll call him Bill — was on a business trip alone somewhere in Europe, and went out to a bar one night to have a cocktail. He wakes up the next morning in an unfamiliar hotel room with severe pain in his lower back.
He is taken to the emergency room, where doctors determined that Bill, unknowingly had undergone major surgery the night before. One of his kidneys had been removed, cleanly and professionally.
This is a chilling tale. With minor variations, the same story has been retold thousands of times by different people in many varied locales. And it’s always based on third-, fourth-, or fifth-hand information.
But while the ‘tale’ may be an urban legend for the rest of us, for 33-year-old Mohsin Abdul, it’s his story.
Mohsin had his kidney harvested almost 10 years ago when he was a 24-year-old farmhand in an obscure Dhaka village called Joypurhat in Bangladesh.
Joypurhat was featured in a report on illegal organ trafficking published by Bernama Online in September last year.
The report named Malaysia as one of the countries implicated in an investigation by Bangladeshi police into an international syndicate allegedly involved in the illegal kidney trade across several countries in Asia.
The news article also said that investigators were focusing on a reputable international hospital with a presence in countries such as Malaysia, Indonesia and India.
Initial investigations had revealed that donors from remote villages in Bangladesh had been flown to the various destinations to have their kidneys harvested.
Guillermo Gracia Gracia 1, Paul Harden 2, Jeremy Chapman 31 Nephrology Service, Hospital Civil de Guadalajara, University of Guardalajara Health Sciences (CUCS) Hospital 278, Guadalajara, Jal 44280 Mexico
2. Oxford Kidney Unit and Oxford Transplant Centre, Churchill Hospita,l Oxford, UK
3. Centre for Transplant and Renal Research, Westmead Millennium Institute, Sydney University, Westmead Hospital, Sydney, NSW 2145 Australia
Saudi Journal of Kidney Diseases and Transplantation: Year:2012 Vol:23 Issue:2 Pages:215-22
Abstract
World Kidney Day on March 8 th 2012 provides a chance to reflect on the success of kidney transplantation as a
therapy for end stage kidney disease that surpasses dialysis treatments both for the quality and quantity of life
that it provides and for its cost effectiveness. Anything that is both cheaper and better, but is not actually the
dominant therapy, must have other drawbacks that prevent replacement of all dialysis treatment by transplantation.
The barriers to universal transplantation as the therapy for end stage kidney disease include the economic
limitations which, in some countries place transplantation, appropriately, at a lower priority than public health
fundamentals such as clean water, sanitation and vaccination. Even in high income countries the technical
challenges of surgery and the consequences of immunosuppression restrict the number of suitable recipients,
but the major finite restrictions onkidney transplantation rates are the shortage of donated organs and the limited
medical, surgical and nursing workforces
with the required expertise.
These problems have solutions which involve the full range of societal, professional, governmental and political
environments. World Kidney Day is a call to deliver transplantation therapy to the one million people a year who
Blood pressure stability in hemodialysis patients confers a survival advantage: results from a large retrospective cohort study
Jochen G Raimann1,2,4, Len A Usvyat1,4, Stephan Thijssen1,2, Peter Kotanko1,2, John Rogus3, Eduardo Lacson Jr3 and Nathan W Levin1,2
1Renal Research Institute, New York, New York, USA
2Beth Israel Medical Center, New York, New York, USA
3Fresenius Medical Care NA, Waltham, Massachusetts, USA
Abstract
The association between changes in systolic and diastolic blood pressure, and the use of cardioprotective drugs on survival of incident hemodialysis patients, was examined in this retrospective cohort study. Pre-hemodialysis systolic and diastolic blood pressures were averaged over the first month of hemodialysis.
Slopes, reflecting temporal changes, were computed by linear regression of systolic blood pressures and Cox regression was used for survival analyses. Patients were initially stratified into four cohorts (below 120, 120 to 150, 151 to 180, and above 180mmHg) and further subdivided into groups with stable (no more than a 1-mmHg change per month), increasing (over 1-mmHg per month), and decreasing (less than 1-mmHg per month) slopes during the first year.
Analyses were repeated for patients who were treated with cardioprotective drugs for 1 month or more in the second year. In 10,245 patients (59% prescribed cardioprotective drugs), both increases and decreases in all ranges of blood pressure were associated with worse outcomes, whereas stable blood pressure had a survival advantage at all levels of systolic and diastolic pressures.
Use of cardioprotective drugs attenuated changes and improved survival. Validation and sensitivity analyses confirmed the primary findings. Therefore, previous temporal trends need to be considered in patient care, and the use of cardioprotective agents is associated with enhanced survival at all blood pressure levels.
KUALA LUMPUR: A factory operator lost both his kidneys after seeking treatment from a so-called sinseh, who used at least 60 needles to poke his head and abdomen “to flush toxins out of his body”.
Besides getting an infection after just two sessions, Wong Kim Min, 47, said his abdomen was also bloated for some time.
Wong, who has been suffering from kidney problems for the past 10 years, said he consulted the sinseh, known as Dr Lau, on July 5 last year.
The sinseh, in his late 20s, was introduced to him by a friend.
Botched treatment: Wong (right) showing photographs of his condition after the sinseh treatment at a press conference organised by Chong at Wisma MCA in Kuala Lumpur yesterday.
“He claimed that he could treat me as my problem was just a minor medical condition,” Wong said, adding that he was asked to pay RM30,000. As part of the treatment, the sinseh used needles to poke Wong's head and abdomen without giving any anaesthetic.
“After the first session, I suffered severe pain and started developing high fever. My abdomen was also swollen,” he said.
“I called Dr Lau but he advised me not to seek treatment at any hospital as I would be given antibiotics which would worsen my condition,” he told a press conference organised by MCA Public Services and Complaints Depart-ment head Datuk Seri Michael Chong here yesterday.
Wong said three days later, he went back for a second treatment session whereby syringes were used on him again.
“My situation worsened after that. I could no longer urinate, so I decided to seek treatment four days later at Ampang Hospital where I was told that blood clots had blocked my urinary tract.”
Wong said he was transferred to Kuala Lumpur Hospital the next day but his condition was so bad that the doctors had to remove both kidneys to save his life.
He was discharged 38 days later. Wong said he now has to undergo dialysis every two days.
“I cannot urinate because I do not have a kidney and I am only allowed to drink 300ml of water a day,” he said, adding that he also suffers from sleeplessness and dizziness.
Wong's lawyer Tan Kim Soon said a police report had been lodged against the practitioner on Jan 31.
“He was then arrested and remanded. However, in a letter dated Feb 10, my client was told by the police that no further action could be taken against the sinseh due to lack of evidence,” he said.
He said he would write a letter on behalf of Wong to ask the police to review the case.
