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About Us

Organ transplantation is an accepted life saving therapy for patient with end stage organ diseases. To date, in many countries, almost all vital organs can be successfully transplanted: kidney, liver, heart, pancreas, lungs, and small bowels.

The Department of Organ Transplantation of the National Kidney and Transplant Institute is dedicated and grounded in a patient-centered philosophy in helping patients with end stage renal diseases and other end stage organ failures through transplantation.

The department was first established in 1983, and has pioneered kidney, liver, kidney-pancreas transplantation in the country. Over 6000 transplants (living related, non-living related and deceased donors) to date were performed and still counting; undoubtedly the center for transplantation in the country.

Aside from the foregoing activities in transplantation, the department actively participates in various advocacy programs of the Institute, in promoting organ donation. Hand in hand with Human Organ Preservation Effort (HOPE) and Renal Disease Control Program (REDCOP), the department assists to increase the public awareness in organ donation and the acceptance of organ transplantation as a therapeutic modality in all key cities and provinces in the country.

Our transplant team is multidisciplinary composed of surgeons, physicians, transplant coordinators, psychologists, neurologists, social workers, chaplains and others.


Services 

  • Kidney Transplantation
    • Living Related Kidney Transplantation
    • Living Non-Related Kidney Transplantation
    • Deceased Donor Kidney Transplantation

For patients with end-stage renal disease (ESRD), there are two treatment options: transplantation and dialysis. Although some patients respond well to dialysis, many do not. Children maintained with chronic dialysis do not grow. Adults frequently must give up their jobs and lose their roles as providers and heads of their families. Physical and financial dependency often leads to emotional dependency and depression. The majority of individuals with ESRD also suffer from a myriad of medical complications, including chronic anemia, muscle wasting, extensive bone deterioration, and peripheral nerve damage. Typically, dialysis treatment is 2-3 times a week; 2.5 – 5 hours per session worldwide. For those patients who adapt poorly to dialysis, the only hope for a normal life is a new kidney - a real kidney.

More than 6000 renal transplants have been performed since 1983. Most common disease indications include: glomerular diseases, Diabetes Nephropathy, Hypertensive Nephrosclerosis, etc. However, in Metro Manila alone, there are more than 200 patients waiting for a phone call that tells them that a suitable kidney has been found for them. Nationally there are over 7,000 ESRD patients on renal transplant waiting lists and the lists continue to grow.

TYPES OF KIDNEY

There are three types of renal transplants that are performed at the National Kidney and Transplant Institute:  

    • Living Related Kidney Transplantation

Following legal definition this includes first degree consanguinity-parents and children. Under Administrative Order from the Department of Health it extends the definition of living related donors to include siblings, cousins, nephews, nieces and other blood relatives.

    • Living Non-Related Kidney Transplantation

A living non-related transplant is a kidney transplant from a donor that is not related to the recipient. These maybe a spouse, in-law, friend or altruist donor.

    • Deceased Donor Transplantation

A deceased donor is a kidney that is donated by someone who has just died Deceased organ donors are previously healthy patients who have suffered irreversible catastrophic brain injury of known etiology. The brain dead donor should have effective cardio-circulatory function.

Recipient – Pre-Kidney Transplant Evaluation

As much as possible, the pre-transplant evaluation and work-up of both the recipient and the donor should be done on an outpatient basis. This will free hospital beds for more urgent cases. It is the responsibility of the rotating pre-transplant nephrology fellow to complete the pre-transplant evaluation forms for both the recipient and the donor in coordination with the transplant (recipient surgeon) and urology (donor surgeon) fellow. The rotating pre-transplant nephrology fellow presents the prospective patients for kidney transplantation to the CAT ( Committee on Transplant Acceptance)

Pre- transplant evaluation consists of:

  • Donor work-up checklist
  • Recipient Work-up checklist
  • Social Service Report

Recipient Pre-Transplant Work Up 

Verify Diagnosis of ESRD:

    • History with emphasis on –
      Complete PE to include rectal examinations
      • Primary renal disease – renal biopsy if available
      • Coexisting disease – DM, coronary artery disease, CHF, collagen disease, liver disease, pulmonary disease
      • Previous infections – PTB, hepatitis, childhood diseases especially chicken pox
      • BP control and fluid status
      • Overall functional capacity
      • Medications taken
      • Drug and food allergies
      • Type of dialysis, access, duration of dialysis
      • OB-Gyne history
      • GI history
      • Exposure to noxious agents
      • For children, rule out congenital urologic problems. If (+), refer for urologic clearance
    • Laboratory work-ups – CBC, blood type, BUN, creatinine, FBS, urinalysis, urine CS, 24
      • UC for TP and ECC (if available), US of KUB, stool and occult blood examination

 You will also receive appointments to meet our:

  • Social Worker
  • Dietitian
  • Cardiologist
  • Pulmonologist
  • Psychiatrist
  • Transplant Surgeon
  • Transplant Coordinator

IMPORTANT!!

Recipient Education:

  • Risk/benefit of KT
  • Work-up requirements
  • For cadaver recipient: the need for monthly blood extraction to obtain serum for cross matching & 2 weeks after a blood transfusion, and notification of any major illness or surgery. Inform patients on waiting list that ATN do occur on cadaver kidney and dialysis support may be needed after KT while waiting for the graft to fully recover from ATN.
  • The need for compliance on medications & regular OPD check up after KT
  • Avoidance of blood transfusion, thus the preference for erythropoietin. But if BT is needed, the use of leukocyte filtered/washed PRBC is recommended.
  • Avoidance of pregnancy until at least 2 years after KT.
  • Discontinue smoking because of the increase risk of operative complication & serious pulmonary infection & cancer after KT.
  • High possibility for the need of insulin post-KT among diabetics
  • Hepatitis vaccination of patients who are HBs Ag and anti-HBs (-).

Living Donor Pre-Transplant Wake Up

Inclusion Criteria:

  • 18 – 60 y/o
  • No history of hypertension, DM, GN, Renal stones, collagen disea

 Elusion Criteria:

  • Age < 18 & > 60 y/o. Donors < 18 y/o should be presented to CDTA & Ethics Committee for approval.
  • Hypertension with BP > 140/90 or need for anti-hypertensive medications
  • Diabetes Mellitus
  • History of Nephrolithiasis
  • Hematuria (macroscopic/microscopic)
  • Proteinuria > 250 mg/day
  • GFR < 80 cc/min.
  • Urologic abnormalities such as solitary kidney, horseshoe kidney.
  • Morbid obesity (>30% IBW)
  • Significant medical conditions such as coronary artery disease, neoplastic disease other than localized skin cancer, hepatitis B & C infection, HIV

Selection of Deceased Donor Evaluation

Criteria for Action

  • Age above 18 months and below 60 years old
  • Normal renal function as defined by serum creatinine and creatinine clearance if feasible and by history
  • Contraindications:

Absolute

a. Obvious sepsis
b. Malignancy (except brain tumor)
c. Primary renal disease
d. Known fungal or virus disease


Our Expert Team

Chairman:          

Dr. SERVANDO SERGIO DC. SIMANGAN JR.

Active Consultants:      

Dr. ENRIQUE T. ONA

 

Dr. ANGEL JOAQUIN M. AMANTE

 

Dr. ROSEMARIE R. LIQUETE

 

Dr. BENITO VC. PURUGGANAN JR.

 

Dr. LEO CARLO V. BALOLOY

 

 Dr. RONALD ANTHONY S. FALLER

 

Dr. DENNIS P. SERRANO

 

Dr. ARWIN RONAN P.RONSAYRO

 

 Dr. ADOLFO C. PARAYNO

 

Dr. MARCO JOSE FULVIO C. ABAD

                                  

Dr. MARC ANTER E. MEJES

 

Dr. AMORNETTA JORDAN-CASUPANG

 

Dr. HILDA SAGAYAGA

 

Dr. CHARLTON SIBAL

 

Dr. EDUARDO ARO


Contact Us 

Mailing Address:                 

Department of Organ Transplantation

 

National Kidney and Transplant Institute

 

East Avenue, Quezon City 1100

 

Philippines

Email Address:         

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Contact Numbers:           

(63)(2) 981-0300, 981-0400 local 3125

 

Telefax 920-7707

Business Days & Hours:

Mondays-Fridays 8pm-5pm                


Training Program 

Objectives:

Train Fellows in Transplant Surgery, program focusing on multi-organ transplant and vascular surgery

Accreditation

Training in Transplant Surgery is fully accredited by the Philippine College of Surgeons (PCS).

Program:

Three– year clinical and research fellowship
Emphasis on kidney, liver and pancreas transplantation and vascular access for dialysis
Provides a comprehensive experience in the pre-, intra and post-op care of transplant patients including immunosuppression, critical care and management of post-operative complications
Broad exposure to the medical and surgical management mainly on renal and hepatic transplants

Advance vascular procedure and endovascular surgery

Requirements:

  • Letter of application address to the Chairman (Dept. of Organ Transplantation)
  • Curriculum Vitae
  • Board Certified (Philippine Board of Surgery)
  • Transcript of Records
  • Supporting documents
  • Recommendations from two (2) physicians who have knowledge of his/her moral backgrounds and work ethics
  • Interview by the Admission Committee

For interested applicants, submit the above requirements to:
SERVANDO SERGIO DC. SIMANGAN JR. MD
Chairman – Department of Organ Transplantation
Training Officer: ADOLFO C PARAYNO ,MD
3rd Floor, NKTI
East Avenue , Diliman, Quezon City
Or contact Tel No.: 981-0300, 981-0400 – 19 local 2170 and Telefax 920-7707
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Vascular Surgery Section
Chairman: DR. SERVANDO SERGIO DC. SIMANGAN JR.
Chief of Service:  DR. LEO CARLO BALOLOY


FAQ's 

1. What is the success rate of kidney transplant in the Philippines?

It is very comparable abroad. 95% kidney survival in one year and more than 70% 5year survival rate.

2. Will I be able to go back to work after the transplant?

Definitely yes! Usually after three months if the kidney function is stable.

3. How long will the operation last?

Usually on the average three (3) hours.

4. How long will I stay in the hospital?

About 6 days in uncomplicated cases.

5. What are the advantages of transplant over dialysis?

The advantages are: good quality of life, cost effective, better survival, and can go back to his/her usual activity and improve productive life

6. What are the procedures prior to kidney transplant will I undergo?

The usual which consists of non-invasive laboratory exams and thorough clinical evaluation (dental, cardiac, pulmonary, etc.) to assess a potential recipient’s suitability for transplant.

7. When can I go back to my usual sexual activity?

When you are feeling better and comfortable.

8. How many KT procedures do you perform in a year?

On the average, we perform 250 KT in a year.

9. When can I be pregnant after KT?

Pregnancy is usually advised 2 year after KT.

10. What is the Organ Donation Program?

The Organ Donation Program of the National Kidney and Transplant Institute makes it possible for patients who are in need of an organ or tissue, to have a new lease on life. This is done by encouraging people to enlist in the organ donation program wherein they pledge to donate their organ/s upon death to patients in need of them. Relatives of possible deceased donors are also asked to allow organs of their loved ones to be transplanted to waiting patients in need of vital and viable organs so that they may live normal lives. 

11. What are the criteria for organ donation?

Only a small percentage of patients who die in hospitals meet the criteria for organ donation. Potential donors are patients who have developed “brain death”.

-are comatose, not breathing spontaneously and maintained on a ventilator/respirator

-have sustained irreversible neurological damage

-fixed pupils and no reflexes

-are free of sepsis and transmittable disease

-have no malignancy other than primary brain tumor

-have no history of malignant hypertension or renal disease.

12. Who can be organ donors?

Although living related or unrelated donors can sometimes give kidneys or blood, there are also other sources of organs.

These are people/patients who have been declared “brain dead” due to cerebral trauma; intracranial bleeding; primary brain tumor; anoxia secondary to drug overdose; cardiac arrest; drowning; or smoke inhalation

13. When is a person brain dead and why is he an ideal organ donor?

A person deemed “brain dead” is usually a victim of stroke, head injuries, or accidents, and is comatose, artificially breathing through a respirator, unresponsive to pain or stimuli, and has a total absence of brain function. The patient’s condition is irreversible and brain damage is permanent. In short, he is already DEAD.
“Brain Dead” patients are ideal organ donors since the function of transplantable organs can be maintained to keep them viable TEMPORARILY for a limited time. Deceased kidneys after retrieval can be preserved for 36 to 50 hours. The earlier the organ is transplanted, the better the organ functions and the less difficulties a patient will experience.

14. Why not organ donation from relatives of patients?

Close relatives (brothers, sisters) who become organ donors are the most ideal. The odds of getting a good match or compatibility are higher when the donor is blood related. But there are cases when patients have no suitable living related that is the time he needs a deceased donor.

Since we cannot predict when a suitable donor will be available, the patient meanwhile has to be maintained by expensive dialysis for kidney patients, for example. Sometimes, a patient has to wait for a number of years before getting a good match.