IMAGINE waking up one day to the news that your spouse needs an organ transplant! What would run through your mind?
This is the predicament that Haswell Kalinda found himself when his wife, Saboi Mundia, learnt that she needed a new liver.
Saboi suffered ill-health following liver failure and was facing death.
But Haswell offered part of his own liver to save his wife’s life.
Both Haswell and Saboi travelled to India last month to undergo the operation. The couple is still recovering in India.
According to the American Transplant Foundation, a liver transplant is a surgical procedure done in some patients with liver failure to replace their diseased liver with a healthy one.
When a patient receives a liver transplant, his or her entire liver is removed. It is then replaced by a portion of the donor’s healthy liver.
The donor and the recipient are placed in side-by-side operating rooms during surgery.
A surgeon removes a part of the donor’s liver, typically the right half.
This donated segment of the liver is then immediately placed in the recipient in the next operating room.
According to the foundation, the remaining part of the donor’s liver regenerates itself and is sufficient to maintain normal body functions.
The recipient also receives a large enough segment of the donor liver to maintain body functions.
During approximately the next two months, the remaining and transplanted parts of the donor liver grow to normal size, providing normal long-term liver function for the donor and the recipient, and restoring normal liver functions to both.
And Consultant surgeon at University Teaching Hospital adult hospital dealing with general surgeon and renal transplant Dr Michael Mbambiko says Zambia has never done any liver or kidney transplant although they are working on starting soon.
Dr Mbambiko says if one’s liver fails or a person develops liver disease at any stage, he or she cannot live.
He says when the liver stops working, a person would die unless he or she receives a liver.
Dr Mbambiko says there are many causes of liver failure and among the commonest is liver cirrhosis where it is replaced by scar tissue so the liver cells are damaged.
He says the commonest cause of cirrhosis is Hepatitis C infection.
Dr Mbambiko says the other common cause is alcohol cirrhosis in people who drink a lot of alcohol, “especially hard stuff”.
However, he says this is not common in Zambia but in colder countries where they drink very strong alcoholic beverages.
Dr Mbambiko said there is also damage to the biliary system which is common in children.
He explains that it is called biliary atresia (also known as extrahepatic ductopenia and progressive obliterative cholangiopathy, a childhood disease of the liver in which one or more bile ducts are abnormally narrow, blocked, or absent. It can be congenital or acquired).
“So when children present with liver failure, this is usually the problem,” he says.
Dr Mbambiko says there is also some auto immune disease where the body starts attacking its own liver but the most common causes are Hepatitis C.
Some drugs can also damage a liver, according to him.
He explains that when a person’s liver has failed, that person cannnot live just like with kidneys.
“I am a kidney expert myself, I am not a liver transplant surgeon so when the liver fails, they will need a liver transplant. If you don’t transplant, they will eventually die. So there are two types of liver transplant. You can have a cadaveric liver transplantation which means you get the liver from a dead person. This is the commonest type of liver transplant but because of the increased demand for organs…the number of people who need organs far much surpasses the available organs for transplant, recently advances have been made where a living person, this is the second type, donating part of their liver,” he says.
“The commonest type and which has been practiced for quite some time is when a person dies and you get their liver and give the recipient. In Zambia, we have never done any liver or kidney transplant. We are working on starting kidney transplants. So people needing transplants either they get transplants or they die. Most of them actually pass on. Or what happens is that patients needing treatment abroad, the doctors treating them may recommend that they need a liver transplant and may go out of the country for that.”
He says the live liver transplants are not so common because the are “quite a complex procedure and not all centres can do it”.
“So in this case, part of the liver from a living person is gotten from the living person and put in a person who needs the liver. Now the liver is the only organ in the body that can regenerate so if we get half your liver, your half liver remaining will regenerate, it will regrow to its normal size and function. Even the person we have given half the liver, it will also grow. It takes about four months. They are done by relatives but in developed countries we even have altruistic donors who say they want to donate (Altruistic donation is the term used when people offer their organs for transplant to strangers),” Dr Mbambiko says.
He says chances of one surviving are much, much higher than dying from this procedure because one is in a controlled environment in a hospital.
Dr Mbambiko said for the one who gets the liver, “it takes more or less four months but like any other operation, complications can occur but essentially after someone has received a liver after five years, over 70 per cent of them are still alive”.
He says the usual complications after a transplant were that they have to be put on Immunosuppressive treatment.
“…because when you get an organ from another person, it may be a liver, bone marrow, kidney. Your body recognises that as foreign and your body fights and rejects it so after the transplant we give immune suppressive treatment. They suppress the immune system so that your body does not reject, so one of the commonest things that can happen is rejection but luckily it is treated because we don’t just transplant. We do tests for the transplant so that the donor and the recipient are matching. So if you have done your tests properly, the rate of rejection is reduced,”
Dr Mbambiko says.
He says there are also a lot of myths and misinformation going round on transplants.
Dr Mbambiko says some time last year when there were the so called ritual murders, it was suspected that organs were being sold.
He says transplant medicine is a science and there is no way a person can be killed and an organ is gotten and put in a sack and taken away.
“That organ won’t work, it will die. When you are collecting these organs, it’s in a controlled environment so that the organ you get is alive. There are certain procedures and protocols we follow. There is no way a person can be killed by people who are non-medical and get a heart, liver or kidney and rush it somewhere, it won’t work,” says Dr Mbambiko, who is also the Surgical Society of Zambia president.
And Saboi, now recuperating together with her husband, writes that the experience had given her a greater appreciation of God and life.
“It is amazing how God has revealed to me and my family how He works out things for our good. Sometimes we get so hurt by the way things are happening even when we pray so hard, but God already has it figured out, even if we don’t understand and it is just wonderful when in the end you realise how God was working things out for you. Therefore, I want to say to you ‘Trust in the Lord with all your heart and lean not on your own understanding; in all your ways submit to Him, and He will make your paths straight’ Proverbs 3:5 and 6,” Saboi wrote.
She also expressed gratitude at the support she and Haswell had been receiving during the period of their recovery.
“Both me and Haswell are recovering well, I am still in India and hope to be reunited with my family pretty soon. My family and I have received so much support from so many people, including my mother who has sacrificed so much for me and I don’t know what I would ever do without her. My amazing transplant team at Max Super Speciality Hospital headed by Dr Subash Gupta, family and friends, friends of friends and relatives, my wonderful in-laws, my church family at Chainama SDA church and other churches, my workmates at CEC Liquid Telecoms and various people I have never even met. Thank you for your fasting and prayers, (please continue praying), financial contributions, words of comfort and encouragement and visits. My healing process is ongoing for a while and I continue to ask for your continued prayers. For you all, I am grateful and pray for God to bless each one of you according to your needs.”
Inevitably, she reserves her most heartfelt appreciation and prayers for her husband.
“Haswell Kalinda, I have been trying to find the right words to show how grateful I am for you my dearest husband but I realise no words could ever put into context what your gift means to me. I don’t know what I did to deserve you my love, all I can say is that I’m truly blessed. You have always loved me unconditionally and you are proud to show your love for me to the world. It has been a very bumpy road but you’ve stuck by my side, loving me, praying for me, making me laugh, encouraging me, making me feel beautiful even when I don’t feel that way. You have supported me in every way possible. I would like the world to know that you are a wonderful man and I will always love you with all of me. Thank you for being an example to our kids and everybody else of what true love really is,” writes Saboi.
“It’s amazing to feel how much our love for each other can still continue to grow after all these years and to such a deeper level. I pray for the favour of God to rest upon you, I pray for your good health and prosperity in all you do. I pray for your continued growth in God’s grace, knowledge and wisdom. ‘A generous person will prosper; whoever refreshes others will be refreshed’. Proverbs 11:25. God bless.”