As the Cayman Islands awaits a draft of a law that would make it legal to donate and transplant organs, 45 people are on dialysis in local hospitals and eight are on a waiting list in the United States for a new kidney.
Getting a kidney from deceased donors in the US is no easy task, kidney specialist Dr. Frits Hendricks explained at a presentation on World Kidney Day last week at the Cayman Islands Hospital in George Town, as only 5 per cent of donated kidneys in America go to non-US citizens.
“There are eight people from Cayman registered in the US awaiting kidney transplants in the US. There are 90,876 on the waiting list in the US,” he said. “This is the most important reason to start a programme of donation and transplantation on the Islands. You can’t let these people wait and wait and wait and be on dialysis, which is such a lousy life.”
He added: “There are many reasons to get people off dialysis. Their quality of life is so much better after transplantation and it’s also much more cost effective as well.”
Of the 45 people on dialysis in Cayman, 43 attend the Cayman Islands Hospital in Grand Cayman and two are treated in Cayman Brac.
Patients on dialysis spend up to four hours a day, three times a week, hooked up to a dialysis machine.
Dr. Hendricks was a member of a committee tasked with drawing up a framework in which new legislation would legalise the donation and transplantation of human tissue and organs in the Cayman Islands.
During a meeting at the Cayman Islands Hospital on Thursday, 8 March, World Kidney Day, medical professionals mingled with kidney donors and former dialysis patients whose lives have changed enormously since they have become recipients of new kidneys.
Most kidney transplant recipients in the Cayman Islands have received their organs from family members or friends who have been a match.
There is no organ donation programme in the Cayman Islands, meaning if a person dies here, he or she cannot donate organs for transplantation.
“I think, in 2012, the Cayman Islands should contribute to organ donations as other countries do,” Dr. Hendricks said.
Dr. Nelson Iheonunekwu, internist/nephrologist at the Cayman Islands Health Services Authority, said there were more than 17 people who were living with transplanted kidneys in the Cayman Islands, the vast majority of whom had received the organ from a living donor.
Keisha Syms, who donated a kidney to her brother Nicholas Powery, described the experience as “the most wonderful gift you can give anybody next to being a parent, a mother giving birth to a child”.
Ms Syms gave up one of her kidneys to her brother in 2006 when he was 18 years old. He was just days away from going on dialysis when he underwent the kidney transplant. Mr. Powery says he is fit and healthy and is now a father.
“When I was in university, I was a registered organ donor, so whether it was for my brother or anyone else, I would do it. I have already made it clear to my family that when I die, I want all my organs donated and if they don’t, I will come back and haunt them,” Ms Syms said.
However, in Cayman, even if a person wants to donate their organs after death, as the law stand now, post-morten organ donation cannot be done locally.
William Watson was diagnosed with kidney failure at the age of 19 and was on dialysis for three years. At the age of 23, in 1987, he underwent his first transplant operation.
“That lasted for 23 years. The difference between being on dialysis and having a transplant is like night and day. You can go back to having a normal life,” he said.
“In 2009, I went back on dialysis. About a year later, I had my second transplant … During the time, from being a young man until where I am now, I’ve been fortunate enough to get married, I have two kids. Without that transplant, it would never have been possible. I’m very thankful,” Mr. Watson said.
Both kidneys were donated by Mr. Watson’s family members.
From the age of 14, Oscar Watler was on dialysis for 11 years. He got a transplant at the age of 23. His sister Sonia Munn also suffered kidney failure and underwent a kidney transplant, donated by her husband, in 2009.
“When I was on dialysis, it felt more like I was between life and death because my body was always so intoxicated and I was feeling so sick all the time, but since the transplant, I just feel like I wake back up and I feel so much better now,” Ms Munn said.
The Cayman Islands is considering the introduction of a human tissue and organ donation and transplantation law, in part, because it is one of the stipulations laid down by cardiologist Dr. Devi Shetty, who plans to open a medical tourism hospital in Grand Cayman.
Dr. Hendricks said that in the Cayman Islands, there are about 16 potential post-mortem organ donors a year that pass through the intensive care unit or emergency room. About half of those cases are airlifted to Miami while the other half become coroner’s cases. Both situations make organ donations locally difficult.
Organ donations have been the subject considered by two different committees in the Cayman Islands over the years. George Town MLA Elio Solomon was the chairman of a committee set up in 2010 to help draw up draft legislation. An earlier committee was chaired by Dr. Steve Tomlinson.
The Organ and Tissue Transplant Review Committee included representatives from the medical community, legal community, a transplant recipient and legal and policy advisers from the government.
The legislation will mean that, once the necessary facilities and surgeons are in place, people who are suitable donor matches may donate kidneys to patients locally and will no longer have to travel to the US to undergo surgery for kidney transplant operations.
Requests for comments to Mr. Solomon and to the health minister Mark Scotland on the status of the proposed legislation and when it is likely to go before the Legislative Assembly were not responded to by press time.
Dr. Hendricks acknowledged that there may be objections to post-mortem organ donations for religious, ethical or cultural reasons.
“On an island like Cayman, religion plays a very important role,” he said. “If you go in literature, there are 26 religious groups who have spoken about organ transplants. Only two of them are against it. Those are the gypsies and a Shinto group in Japan – for religious reasons they don’t want to have organ transplantation.”
He pointed out that, after a person is classified as brain dead, that individual can help 75 people through tissue donation and eight people through organ donation.
In Cayman, there are five dialysis patients under the age of 38, 10 between the ages of 39 and 50, 12 aged between 51 and 60, two aged between 61 and 70, and 14 who are over the age of 70.