Health
Nigerian hospitals explore deceased-donor kidney transplant
…As cases rise amid low living donation
With kidney failure on the rise in Nigeria, hospitals are exploring the deceased-donor transplant option as organ donation, which is often transactional, from living donors remains low.
They are pushing for a highly regulated cadaveric system to take root as the primary source of kidney transplantation, a process where people can offer their organs for the use of others after they have been certified dead.
Health facilities with the capacity for renal care are recording increases in late presentation of cases which may lead to permanent placement on dialysis treatment or transplantation.
BusinessDay’s findings show that a new dialysis unit, which opened only a few months ago at the Lagos State University Teaching Hospital (LASUTH), is currently oversubscribed due to a plethora of kidney problems.
At the Federal Medical Centre, Ebute-Meta, cases seeking dialysis daily are on the rise, especially among young people and those challenged by long-standing cases of hypertension, diabetes, or inflammation of the kidney.
Almost two in every 10 Nigerian adults suffer either chronic or acute kidney failure, according to the Nigerian Association of Nephrology (NAN).
Dialysis has remained the most common and accessible form of treatment in the country, even though many do not make it through either as a result of financial constraints or deterioration of their condition. Only a few well-heeled patients are able to get kidney donation in a process that some experts worry could have been induced by financial rewards.
Experts say there is a wave of cadaveric organ donation being explored across the world, and Nigeria can benefit from it.
Adetokunbo Fabamwo, LASUTH’s chief medical director, said in an interview that while the laws that guide the process are currently being pushed at the Lagos State House of Assembly for ratification, the hospital is also building structures to begin trials.
“We have already designed how we are going to do it. We are going to keep a register of people that need kidneys and another register of those that want to donate. We will set up a unit that is going to manage it. We can do it,” the director said.
“The challenge about transplant is the donor. A lot of relations do not like to donate to their relatives. So they are looking for commercial donors. We don’t encourage that. If you are going to have a transplant in LASUTH, you must bring a relative who will consent to donate. Nigeria should have very strict regulations about donation.”
He explained that through the system, people before they die, if suffering from some other fatal illnesses that do not affect their kidney, could sign up for donation. Immediately after they die, the kidney can be removed for someone who has been waiting for a kidney, he said.
Olugbenga Awobusuyi, president-elect of NAN and the Transplant Society of Nigeria, similarly explained that the primary donor source in advanced countries has shifted to organs from deceased individuals.
According to him, the organs used are those from people who die in the hospital, mostly those in the intensive care unit and are being maintained on life support.
“Their brains can die but because they are on life support, we are able to assist the breathing and beating of the heart of the dead person. We can sustain the function of other organs, even though the brain is dead,” the nephrology expert said.
“We believe that if we can have such a programme in the country, it is going to benefit society a lot, in that people don’t have to buy organs. Organs from dead people are highly regulated strictly by established criteria.”
For instance, in the United States, hospitals are required to have written agreements with organisations that coordinate organ and tissue donation and recovery. There are 58 organ procurement organisations, according to the US Centre for Diseases Control and Prevention.
For screening and testing, organ and tissue recovery organisations are required to obtain a medical and social history of deceased donors by asking their next-of-kin, and sometimes other persons who knew the potential donor, questions about behaviours that may have exposed the potential donor to certain diseases. This questionnaire serves as one of several resources to assess the donor’s risk for having a disease.
Hospitals are required to evaluate living potential kidney donors for the presence of behaviours or medical history that may increase the risk of infection in the donor.
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Hospitals that perform organ recovery from kidney donors are also required to perform certain tests to see if the potential donor may have infections such as human immunodeficiency virus (HIV), hepatitis B or hepatitis C virus, syphilis, and cytomegalovirus. These test results are provided to the healthcare facility where transplantation of the organ or tissue will occur.
Awobusuyi said NAN had been pushing the adoption across the country, with Lagos State leading the charge.
Drivers of kidney failure
Fabamwo lamented that many are drinking different sorts of toxic concoctions that are being sold by traditional vendors, without minding the toll it takes on their health.
He listed the abuse of some medications, hypertension, and diabetes as some of the commonest causes of kidney failure, saying people are not checking their blood pressure and sugar levels until the kidneys are affected.
Olamide Olowoyo, consultant nephrologist and head of Nephrology Unit, Department of Internal Medicine, Federal Medical Centre Ebute-Metta, said the prevalence of chronic kidney disease now ranges between 11 and about 15 percent.
According to him, unlike what happens in other countries where it is mainly elderly people who suffer chronic kidney failure, “in Nigeria, we tend to have a younger population who are the economically productive population. Ours is a bit worse”.
She said the inflammation of the kidney, HIV, hereditary kidney diseases, toxic concoction and obstruction of the urinary tract are also drivers.
Olowoyo said one of her patients, a security officer, who should get routine dialysis every week only appears twice due to lack of funds.
The West African Society of Parenteral & Enteral Nutrition (WASPEN) has called on President Bola Ahmed Tinubu to make clinical malnutrition a national healthcare priority, warning that the crisis is growing but remains largely overlooked in Nigeria’s healthcare system.
WASPEN’s Founder and President, Dr. Teresa Pounds, made this appeal on Monday during a press conference ahead of the 2025 WASPEN Clinical Nutrition Conference, scheduled for June 17–19 in collaboration with the National Hospital Abuja.
Themed “Bridging the Gap: Integrating Hospital and Community Malnutrition Care in Developing Countries,” the event aims to foster solutions for hospital and community malnutrition.
Describing malnutrition as “the skeleton in the hospital’s closet,” Dr. Pounds emphasised the need for urgent awareness, policy reform, and collaboration among healthcare stakeholders to ensure effective hospital nutrition programs.
“Many patients in Nigerian hospitals suffer from inadequate nutritional support, leading to prolonged hospital stays, increased complications, and higher mortality rates. This issue must be addressed at the highest level,” she stated.
The press conference was attended by the management of Genrith Pharmaceuticals Limited, a major partner, led by its CEO, Chief Emmanuel Umenwa.
Call for National Clinical Nutrition Policy
Dr. Pounds, a U.S.-based specialist in critical care nutrition and a board-certified nutrition support pharmacist, urged the government to implement a national policy framework to support specialised clinical nutrition interventions. She stressed the importance of integrating mandatory nutrition screening and intervention into all healthcare facilities.
She also called on the Federal and State Ministries of Health to expand and enforce standardised clinical nutrition policies, ensure hospitals conduct structured nutrition screening for all patients, makes medical nutrition therapy accessible and affordable, and support research and local production of specialised nutritional products.
She further encouraged NAFDAC, NIPRD, pharmaceutical companies, and NGOs to collaborate on research, funding, and product development to improve hospital and community-based nutritional care.
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“We need a national framework that ensures no patient suffers due to a lack of proper nutrition,” the expert stressed.
Conference to Attract Top Medical and Policy Experts
Speaking on the upcoming conference, Dr. Pounds noted that it will bring together leading medical experts, policymakers, and healthcare stakeholders to develop strategies for addressing malnutrition.
Prominent figures expected at the event include Prof. Ali Pate, Coordinating Minister of Health (Special Guest of Honour), Nyesom Wike, Minister of the FCT (Chief Host), Prof. Muhammad Raji Mahmud, Chief Medical Director, National Hospital Abuja (Host), Prof. Audu Bala, President, Nigerian Medical Association (Keynote Speaker), Pharm. Ibrahim Tanko Ayuba, President, Pharmaceutical Society of Nigeria (Guest of Honour), and Prof. Salisu Maiwada Abubaka, President, Nutrition Society of Nigeria (Guest of Honour) admiration.
Pre-Conference Activities
Prof. Raji Mahmud, Chief Medical Director of the National Hospital Abuja, represented by the Chairperson of the Local Organising Committee (LOC), Pharm. Adesola Clara assured that the hospital has the necessary facilities and expertise to host a successful conference. He emphasised that the hospital is fully prepared for the programme.
Also, the WASPEN Central Planning Committee, led by Mrs. Ghinsel Blessing, revealed that pre-conference activities will include a hands-on training workshop on nutritional kits in hospitals, scheduled for June 16, a health walk to raise awareness about hospital malnutrition, expected to be led by First Lady Sen. Oluremi Tinubu.
With malnutrition posing a silent but deadly threat to healthcare outcomes, WASPEN hopes that the Tinubu administration will take decisive action to integrate nutrition-focused interventions into Nigeria’s health policies.
The 2025 WASPEN Clinical Nutrition Conference is expected to be a game-changer in shaping the future of clinical nutrition in Nigeria and West Africa.
Two US biotech companies say the Food and Drug Administration has cleared them to conduct clinical trials of their gene-edited pig kidneys for human transplants.
United Therapeutics along with another company, eGenesis, have been working since 2021 on experiments implanting pig kidneys into humans: initially brain-dead patients and more recently living recipients.
Advocates hope the approach will help address the severe organ shortage. More than 100,000 people in the United States are awaiting transplants, including over 90,000 in need of kidneys.
United Therapeutics’s approval, announced Monday, allows the company to advance its technology toward a licensed product if the trial succeeds.
The study authorization was hailed as a “significant step forward in our relentless mission to expand the availability of transplantable organs,” by Leigh Peterson, the company’s executive vice president.
The trial will initially enroll six patients with the end-stage renal disease before expanding to as many as 50, United Therapeutics said in a statement. The first transplant is expected in mid-2025.
Meanwhile, rival eGenesis said it had received FDA approval in December for a separate three-patient kidney study.
“The study will evaluate patients with kidney failure who are listed for a transplant but who face a low probability of receiving a deceased donor offer within a five-year timeframe,” the company said.
Xenotransplantation — transplanting organs from one species to another — has been a tantalizing yet elusive goal for science.
Early experiments in primates faltered, but advances in gene editing and immune system management have brought the field closer to reality.
Pigs have emerged as ideal donors: they grow quickly, produce large litters, and are already part of the human food supply.
United Therapeutics said trial patients would be monitored for life, assessing survival rates, kidney function, and the risk of zoonotic infections — diseases that jump from animals to humans.
Currently, there is only one living human recipient of a pig organ: Towana Looney, a 53-year-old from Alabama who received a United Therapeutics kidney on November 25, 2024.
She is also the longest-surviving recipient, having lived with a pig kidney for 71 days as of Tuesday. David Bennett of Maryland received a pig heart in 2022 and survived 60 days.
The Swiss government said Thursday it aimed to overhaul its law on medically-assisted reproduction to legalise egg donations and give broader access to sperm donations.
Currently egg donations are not allowed and only married couples can access sperm donations.
The Swiss parliament has long said it wants to change that, and has asked the government with coming up with a proposal to provide broader access.
A government statement said it had “decided to completely revise the law on medically assisted reproduction in order to adapt it to the current context” and had asked the interior ministry to draft a proposed law by the end of next year.
The government said it wants to legalise egg donations in cases where a woman in a couple is infertile, as a parallel to the already legal use of sperm donations in cases of male sterility.
Bern said its priority was “the protection of donors and the welfare of the child”, stressing that “this protection cannot be guaranteed if parents resort to egg donation abroad”.
The government also said it wanted to expand access to both egg and sperm donation to unmarried couples.
After Switzerland legalised same-sex marriage in 2022, married lesbian couples have also had access to sperm donations.
But the government said the current law barring unmarried couples from access to such medically assisted reproduction was “outdated and no longer corresponds to social reality”.
