About Us
Organ transplantation is safe, sustainable and widely accepted definitive treatment for patients with end stage organ diseases.  It has markedly improved the survival and quality-of-life of patients with end-organ dysfunction.  To date, transplantation of various solid organs namely the kidney, liver, heart, pancreas, lungs, and small bowels is performed worldwide.

The Division of Organ Transplantation and Vascular Surgery at the National Kidney and Transplant Institute is grounded in a patient-centered philosophy in providing comprehensive management of patients with end stage renal disease and other end stage organ failures from pre-operative evaluation to transplantation and follow up.  We are also a team dedicated in bridging patients to transplantation through planning and performing various dialysis and vascular access surgeries.

The Division was established in 1983, and has pioneered kidney, liver, kidney-pancreas transplantation in the country. To date, the center of transplantation in the country has performed more than 7000 transplantations from living and deceased donors. 

Apart from leading activities in transplant education in the institute, the division collaborates with the Organ Procurement Organization (OPO) - Human Organ Preservation Effort (HOPE) and the Department of Health - Renal Disease Control Program (REDCOP) to increase the public acceptance of organ transplantation and awareness in organ donation in all parts of the country.
The transplant team is composed of exceptionally competent transplant surgeons, nephrologist and other internists, anesthesiologists, transplant coordinators, nurses, clinical pharmacologists, nutritionists, and social workers.

Services 

1. KIDNEY TRANSPLANTATION

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

Chronic kidney failure has a prevalence rate of 2.5% in the Philippines, affecting at least 13 per million Filipinos. With chronic kidney disease, there is gradual diminution of the kidney’s function in filtering the blood, excreting wastes in the form of urine, production of erythropoietin for red blood cell production resulting to anemia, renin production resulting to uncontrolled blood pressure elevation and dysregulation in electrolyte and extracellular fluid volume. The two treatment options for patients with chronic kidney disease are dialysis and transplantation.

Dialysis may be in the form of hemodialysis or peritoneal dialysis. Dialysis is the process of filtering the blood or abdominal fluid to remove waste and excess fluid. Kidney transplantation is the process of implanting a kidney from a living or deceased donor to a patient with renal failure. It is the best renal replacement therapy because the transplanted kidney is able to execute all the functions of the kidney and offers good quality of life. Its success is highly dependent on a precise surgical technique and balanced anti-rejection protocol.

There have been more than 7000 renal transplantation performed in the country since 1983. In the Philippine registry there are 10,000-12,000 new cases of chronic kidney disease registered annually with only 10% of them undergoing kidney transplantation. This is mainly due to shortage of kidney donors amidst the persistent rise in the number of cases of chronic kidney disease.

TYPES OF ORGAN DONOR

There are three types of probable donors for kidney transplantation:

• Living Related Donor

A living related donor is a person who is related to recipient by blood up to 4^th degree of consanguinity. He may be a parent, sibling, child, first cousin, nephew, nieces, aunt or uncle.

• Living Non-Related Donor

A living non-related donor is a distant relative (beyond 4^th degree of consanguinity) or a non-blood relative who is emotionally related (spouse, in-law) or socially related (employee, neighbor) to the recipient.

• Deceased Organ Donation

Deceased organ donation is donation from a probable donor who is deemed brain dead or at a state of imminent brain death after he has suffered from an irreversible brain injury.

Pre-Transplant Evaluation For Living Donation

The pre-transplant evaluation of the recipient and probable donor is a meticulous process of evaluating the compatibility, suitability of the recipient and donor to undergo surgery and long term sustainability of the renal allograft. The goal of recipient evaluation is to evaluate the recipient’s medical, psychological and ethical suitability to undergo transplantation. The goal of kidney donor evaluation is to protect the living donor from losing a kidney that they might otherwise need, to avoid unnecessary morbidity associated with donation and at the same time to protect the recipient from receiving organs with transmissible disease. This thorough evaluation and planning of the kidney transplantation is handled by a multidisciplinary team composed of the nephrology service, transplant surgeons and urology service. Assessment by other services may be necessary depending on the patient’s needs which includes:  Cardiology, Pulmonology, Psychiatry, Endocrinology, dental and social worker.

Deceased Organ Donation

The Organ Donation Act of 1991 (R.A. 7170) authorize the legacy or donation of all or part of a human body after death for specified purpose. Death is defined as irreversible cessation of circulatory and respiratory functions or the irreversible cessation of all functions of the entire brain, characterized by absence of electrical activity in the brain, blood flow to the brain and brain function.

A deceased donor may be a pediatric or adult patient who is deemed brain dead or in a state of imminent brain death usually from an acute brain damage.

The process of donation begins with referral of a probable deceased donor to the designated Organ Procurement Organization (OPO) after declaration of brain death. The OPO assesses the probable donor’s medical suitability for organ donation, secure consent for organ donation and continue donor management through series of laboratory tests. The organs are allocated based on the geographical location, ABO compatibility and following the Donor Allocation Scoring System (DASS).

1. DIALYSIS ACCESS SURGERY

HEMODIALYSIS

Hemodialysis is the process of intermittently drawing blood from the patient brought to the dialysis machine where it undergoes filtration and removal of excess fluid and returned back to the patient.

Hemodialysis access creation is crucial in the success and efficiency of a patient’s dialysis. It may be in the form of Arteriovenous fistula, Arteriovenous graft or central venous catheter placed in the neck.

Vascular surgeons are highly skilled and adept in putting short-term and long-term  dialysis access to ensure adequate and efficient dialysis. They are also competent in open and endovascular approach for non-maturing fistula, and  other complications of hemodialysis access.

An Arteriovenous fistula is created ideally 6 months prior to initiation of dialysis to allow ample time for creation, maturation and reassessment of the fistula for revision if necessary.

An arteriovenous graft is ideally created 3-6 weeks prior to the initiation of dialysis although some grafts material may be cannulated earlier.

A central venous catheter (usually in the neck)  is a short term dialysis access that is placed when there is immediate need for dialysis among patients without AV fistula or graft.

TRANSPLANT SURGEONS

CONTACT US

Telephone number: 8981-0300 Local 2170

 Email address: This email address is being protected from spambots. You need JavaScript enabled to view it.

TRAINING PROGRAM – BASE ON PSTS MANUAL
Accreditation
Training in Organ Transplant Surgery is fully accredited by the Philippine Society for Transplant Surgeons (PSTS) and Philippine College of Surgeons (PCS).

Program
This is a two (2) year clinical and research fellowship on solid organ transplantation and vascular access for dialysis.
It provides a comprehensive experience in the perioperative medical and surgical management of transplant patients including pre-operative donor and recipient work-up, transplantation, immunosuppression, critical care and management of post-operative complications.
Requirements:

• Letter of application addressed to the Division Chair and Training Officer (Division of Organ Transplantation and Vascular Surgery)
• 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 applicants, submit the above requirements to:

ADOLFO C. PARAYNO, MD
Division Chair – Division of Organ Transplantation and Vascular Surgery

MARC ANTER E. MEJES, MD
Training Officer

National Kidney and Transplant Institute
Division of Organ Transplantation and Vascular Surgery, 2^nd Floor Annex Building
East Avenue , Diliman, Quezon City
Or contact Tel No.: 981-0300, 981-0400 – 19 local 2170 and Telefax 920-7707
Email address: This email address is being protected from spambots. You need JavaScript enabled to view it. and This email address is being protected from spambots. You need JavaScript enabled to view it.

FAQ's 

1. What is the success rate of kidney transplant in the Philippines?
   The 1-year survival rate of patients after kidney transplantation is as high as 95%,    5-year survival is 85% and 10-year survival is as high as 70% for living donors.  The 1-year survival rate post kidney transplantation from deceased organ donor is high as 90%. 
2. Will I be able to go back to work after the transplant?
   Definitely yes, once transplanted kidney function is deemed stable
3. How long will the operation last?
   Usually on the average, three (3) hours.
4. How long will I stay in the hospital?
   On the average, transplant patients stays in the hospital about 6-7 days after operation
5. What are the advantages of transplant over dialysis?
   With transplant, patients enjoy a better quality of life because they can go back to their normal activity and resume work
6. What are the procedures prior to kidney transplant will I undergo?
   Both transplant recipient and donor will undergo thorough clinical evaluation and non-invasive diagnostics tests to check compatibility and suitability to undergo surgery
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 300 KT in a year.
9. When can I be pregnant after KT?
   Pregnancy is advised 2 years after KT.
10. Who can be organ donors?
    The types of organ donors can be living related, living non-related or deceased organ donor.
11. What is the Deceased Organ Donation Program?
    The Deceased 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.
12. What are the criteria for deceased organ donation?
    A deceased donor may be a pediatric or adult patient who is deemed brain dead or in a state of imminent brain death usually from an acute brain damage.
13. When is a person brain dead and why is he an ideal organ donor?
    Brain death is defined as irreversible cessation of all functions of the entire brain, characterized by absence of electrical activity in the brain, blood flow to the brain and brain function. “Brain Dead” patients are ideal organ donors because the body’s circulatory function is intact therefore the function of the transplantable organ is preserved.
14. Why go for deceased donors when there are relatives willing to donate?
    Living donors are the most ideal but there are cases when patients have no suitable living donor that is the time he/she needs a deceased donor. Since we cannot predict when a suitable donor will be available, the patient meanwhile has to be maintained by dialysis for kidney patients. Sometimes, a patient has to wait for a number of years before getting a good match.