A review of policies and programmes for human organ and tissue donations and transplantations, WHO African Region

Loua, André; Feroleto, Margot; Sougou, Aissatou; Kasilo, Ossy Muganga Julius; Nikiema, Jean‐Baptiste; Fuller, Walter; Kniazkov, Stanislav; Tumusiime, Prosper

doi:10.2471/blt.19.236992

Cited by 17 publications

(23 citation statements)

References 16 publications

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“…In SSA, the national programs for donation and transplantation of organs and tissues are slow and poorly developed and they are fraught with inadequacies in infrastructures, institutional support, and technical expertise [3]. These are attributed to the huge costs and complexity of transplantation, low GDP, lack of subsidy and dearth of facilities.…”

Section: Central Africamentioning

confidence: 99%

“…Loua et al in 2018, documented that 62 transplant centres across seven countries in Africa had transplant activities involving kidney, heart, cornea, liver and bone marrow [3].…”

Section: Central Africamentioning

confidence: 99%

“…Organ donation and transplantation in SSA is fraught with numerous challenges including costs of treatment, inadequate infrastructure and equipment, dearth of highly skilled health professionals, and lack of well-articulated ethico-legal framework and policies [3].…”

Section: Challenges Of Transplantationmentioning

confidence: 99%

“…Adequate histological evaluation of Table 6. Aspects of transplantation programmes in SSA modified from Loua et al [3].…”

Section: Lack Of Infrastructure and Equipmentmentioning

confidence: 99%

“…are also transplanted. However, in SSA, apart from South Africa which also does liver and heart transplantation, the common organ transplanted is the kidney [3]. Though outcomes for transplantation have improved over the years due to better surgical techniques including minimal access surgeries, newer and better immunosuppressive medications, innovations in organ donation; improvement in transplant services is not apparent in SSA.…”

Section: Introductionmentioning

confidence: 99%

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Organ Donation and Transplantation in Sub-Saharan Africa: Opportunities and Challenges

Ulasi¹,

Ijoma²,

Ifebunandu³

et al. 2021

Organ Donation and Transplantation

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Sub-Saharan Africa (SSA), occupying about 80% of the African continent is a heterogeneous region with estimated population of 1.1 billion people in 47 countries. Most belong to the low resource countries (LRCs). The high prevalence of end-organ diseases of kidney, liver, lung and heart makes provision of organ donation and transplantation necessary. Although kidney and heart transplantations were performed in South Africa in the 1960s, transplant activity in SSA lags behind the developed world. Peculiar challenges militating against successful development of transplant programmes include high cost of treatment, low GDP of most countries, inadequate infrastructural and institutional support, absence of subsidy, poor knowledge of the disease condition, poor accessibility to health-care facilities, religious and trado-cultural practices. Many people in the region patronize alternative healthcare as first choice. Opportunities that if harnessed may alter the unfavorable landscape are: implementation of the 2007 WHO Regional Consultation recommendations for establishment of national legal framework and self-sufficient organ donation/transplantation in each country and adoption of their 2020 proposed actions for organ/transplantation for member states, national registries with sharing of data with GODT, prevention of transplant commercialization and tourism. Additionally, adapting some aspects of proven successful models in LRCs will improve transplantation programmes in SSA.

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Section: Central Africamentioning

confidence: 99%

“…Loua et al in 2018, documented that 62 transplant centres across seven countries in Africa had transplant activities involving kidney, heart, cornea, liver and bone marrow [3].…”

Section: Central Africamentioning

confidence: 99%

Section: Challenges Of Transplantationmentioning

confidence: 99%

“…Adequate histological evaluation of Table 6. Aspects of transplantation programmes in SSA modified from Loua et al [3].…”

Section: Lack Of Infrastructure and Equipmentmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Organ Donation and Transplantation in Sub-Saharan Africa: Opportunities and Challenges

Ulasi¹,

Ijoma²,

Ifebunandu³

et al. 2021

Organ Donation and Transplantation

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Biliary atresia in Uganda: Current ethical challenges and advancement of public policy

Kakembo,

Loy,

Fitzgerald

et al. 2024

World j. surg.

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Biliary atresia is a progressive cholangiopathy in neonates, which often results in liver failure. In high‐income countries, initial treatment requires prompt diagnosis followed by Kasai portoenterostomy. For those with a late diagnosis, or those in whom Kasai portoenterostomy fails, liver transplantation is the only lifesaving treatment. Unfortunately, in low‐ and middle‐income countries, timely diagnosis is a challenge and liver transplantation is rarely accessible. Here, we discuss the ethical dilemmas surrounding treatment of babies with biliary atresia in Uganda. Issues that require careful consideration include: risk of catastrophic health expenditure to families, ethical dilemmas of transplant tourism, medical risks of maintaining the transplant in a low‐resourced health system, and difficult decisions encountered by the surgeon caring for these patients. Four distinct models of the patient‐physician relationship are applied to biliary atresia in Uganda. These models describe differences in patient and physician roles, and patient values and autonomy. Solid organ transplantation is a rapidly evolving segment of healthcare in Uganda and ongoing policy advancements may shift ethical considerations in the future.

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Paediatric Nephrology in Africa

et al. 2021

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Purpose of Review We highlight the unique facets of paediatric nephrology in Africa in terms of the spectrum of kidney diseases, available diagnostic and treatment modalities, kidney healthcare financing options, paediatric nephrology manpower and the contribution of geography and demographics. Recent Findings Paediatric acute kidney injury in Africa is now commonly due to sepsis rather than gastroenteritis. Steroid-sensitive form of nephrotic syndrome is far more common than was two decades ago. Summary The hot arid climate in North Africa and the tropical climate in most of sub-Saharan Africa, and the high rate of consanguinity, sickle cell disease and HIV drive the spectrum of paediatric kidney diseases in the continent. Kidney diseases are often precipitated by infectious triggers associated with poor living conditions and little access to medical care thus resulting in late presentation and often end-stage kidney disease. Although accessibility to kidney care has improved in the continent due to training opportunities provided by international professional organisations, most children still face significant barriers to kidney care because they live in rural areas, governments spend the least on healthcare and the continent has the least density of healthcare practitioners and nephrology trainees.

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A review of policies and programmes for human organ and tissue donations and transplantations, WHO African Region

Cited by 17 publications

References 16 publications

Organ Donation and Transplantation in Sub-Saharan Africa: Opportunities and Challenges

Organ Donation and Transplantation in Sub-Saharan Africa: Opportunities and Challenges

Biliary atresia in Uganda: Current ethical challenges and advancement of public policy

Paediatric Nephrology in Africa

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