Human organ transplants: GPHC receives accreditation to operationalise centre

The Georgetown Public Hospital Corporation (GPHC) was on Wednesday certified and accredited by Guyana’s Health Ministry and Human Organ and Tissue Transplant Agency to operate a Human Organ and Transplant Center.
The centre, which is the first of its kind, is authorised to provide transplants services for kidney, liver, intestine, multi-visceral, pancreas and pancreatic islet, heart and lung exchange to citizens.
Its establishment is provided for under the Human Organ and Tissue Transplant Bill, which provides the necessary legal framework for the retrieval of human organs, tissue, cells, and biofluids for transplantation and blood transfusion.
Health Minister Dr Frank Anthony said the centre was part of Government’s move to modernise the local healthcare sector through improved services.
On this point, Dr Anthony explained that GPHC has been conducting kidney transplant surgeries for the last 10 years; however, the accreditation will allow the hospital to expand transplant care to citizens.
“By this action, you’re setting the bar for other hospitals in our country so that whatever process we would have gone through here today that ,when other institutions would like to be certified, the same high standards would apply to all institutions,” Dr Anthony said.
The Health Minister added that a systematic procedure will be followed to determine the eligibility of individuals as potential donors. Subsequently, an additional evaluation would be conducted to assess their suitability, followed by approaching their families.
He clarified that with the family’s consent, the donation process is initiated, followed by the subsequent transplant, with the ultimate purpose of granting hope and a chance at life to a deserving individual.

Training
In preparation for the commissioning of centre, the Ministry embarked on a series of rigorous transplant training to expand the capability of health practitioners stationed at the centre.
These include transplant nurses, social workers, anaesthesiologists, and organ transplant surgeons.
Dr Anthony said the training was facilitated through various partnerships with medical institutions in Portugal, Spain, and Brazil.
“As we go forward moving from living donors to cadaveric transplants, I think the public can rest assured that we are adhering to all the best international practices, and I want to commend the agency for the work that they would have done so far,” the Health Minister said.
Cadaveric transplants involve the utilisation of organs from a donor who has been pronounced brain dead and has given consent for his/her organs to be donated to those in need.

Inspections and examinations
Speaking to the assessment and accreditation process, Member of the Human Organ and Tissue Transplant Agency, David Samaroo explained that GPHC was engaged in a series of inspections and examinations.
On this point, he disclosed that while GPHC fulfilled the criteria for the establishment of the centre, three crucial areas were flagged and the hospital has expressed its commitment to addressing those issues.
According to Samaroo, these include the expansion of human organ and transplant operating rooms, Intensive Care Units (ICU) and pre- and post-care facilities.
Additionally, the hospital is currently outsourcing tissue typing services to other medical institutions.
“The third short comings that we have found was that should we have a complication and the patient needed a kidney biopsy, should we extract that tissue? We didn’t have the mechanism in place or did we had the personnel in place to read the slides.
“I am happy to say over the past two months while we would have identified these issues and we have brought them to the attention of the CEO at the Georgetown Public Hospital Corporation, a number of actions were actually taken,” Samaroo explained.

Registry
The Human Organ and Tissue Transplant Agency is actively working to establish Guyana’s first National Human Organ and Transplant Registry.
The platform, which will be managed by the agency, is part of efforts to fast-track the process by which ill citizens access functioning organs.
Currently, the agency goes through a rigorous process before organs are donated, this includes consulting with multiple stakeholders from various agencies after a donor is identified and their family consents for the procedure to be executed.
With the registry in place, national donors and recipient lists will be added to the Health Ministry’s database to allow citizens to become donors following their passing and patients to receive organs once available.
The registration will include the consent, amendment, and revocation of consent from adults regarding the donation of their organs, tissue, cells, or biofluids, among other things.
The establishment of a National Donor and Transplant Registry is provided for in Part Three, Section 13 of the Human Organ and Tissue Transplant Bill 2021. As a result, a prioritisation process will be implemented to ensure that recipients of organs are catered for effectively.
Moreover, individuals who are in need of organ, tissue, cell, and biofluid transplantation, as well as those who have received such treatments, will be included in the registration process.
To fulfil this requirement, the Human Organ and Tissue Transplant Agency, through legislation, will assume the responsibility of managing, operating, and preserving the donor registry.
The act specifies that “The Agency shall keep proper records of all its dealings in relation to its functions under this act which shall include annotations and inventories of organs, tissues, cells, cell explants, cell lines and biofluids and other substances available and those used and how used.”

Transplant Bill
In January 2022, the transplant bill that had been introduced in the National Assembly the previous year was approved.
The bill incorporated measures to establish an agency responsible for overseeing the removal, donation, and transfer of human organs to patients requiring them.
The agency is expected to collaborate with authorised hospitals to coordinate surgeries and develop operating protocols. Additionally, the agency will be responsible for conducting public awareness campaigns regarding consent for organ donation and utilisation.
The bill also notes that transplantations are to be used in regenerative medicine including cell therapy, gene therapy, stem cell therapy, and other therapeutic purposes; for medical education and scientific research purposes, including stem cell research, cell explant research, and cell line research; and for connected matters. (G1)