Father gives a kidney and new lease of life to little daughter

13-year-old Christine Wambui and her father, George Kamau before the twin kidney surgeries at the Kenyatta National Hospital on August 27. PHOTO/JENNIFER MUIRURI 

In Summary

• At 8.45 am on Wednesday morning, Mr Kamau was wheeled into Theatre Six, where one of the surgeons described to him the procedure by which the team would make an incision, remove his kidney and then transplant it in his daughter waiting in an adjacent theatre across the hallway.  
• The donor’s kidney was harvested at 10.37am and was cleaned for the next two minutes, all caution taken to ensure that the organ was ready for transplant.
• Her original kidneys were left in place — a common practice.

She watches visitors from a distance, throws a glance every two minutes, and speaks in a small voice before retreating to the safety of her mother’s side. It’s probably her way of dealing with anxiety.

It’s Tuesday evening and 13-year-old Christine Wambui Kamau is scheduled for a kidney transplant at the Kenyatta National Hospital the following morning.

Her father, 43-year-old George Kamau, is the donor and is also admitted at the renal unit. He has volunteered for the critical operation to remove one of his kidneys that would literally hand his daughter a lifeline. It’s a story of kinship that goes beyond the bond of flesh and blood, or genetics.

The hospital and family invited the Sunday Nation to witness this rare occasion.

The KNH renal unit is abuzz with activity with patients queuing for routine dialysis while others have been admitted for kidney transplants scheduled for the week, as doctors and paramedics work hard if only to save one more life.

It’s a tall order for the medics. Failing kidneys kill 8,000 Kenyans every year due to a combination of poverty, the sheer complexity of transplants, and strict laws meant to guard against illegal harvesting and trading in human organs.

On this Tuesday evening around 6 pm, father and daughter have been visited by family and friends at the renal wing for moral support. Christine is rather quiet, understandably.

TALKATIVE

Mr Kamau was the most talkative in the group of six which comprised his wife Lucy Njeri, Christine and three family friends.

On the adjacent bed is 12-year-old Yvonne Wangari (below, right) who is also scheduled for a kidney transplant the following morning with Humphrey Erastus, her uncle, as the donor. In all, five families benefitted from transplants carried out last week sponsored by the Kenya Commercial Bank Foundation.

But it still cost each family Sh250,000 to conduct pre-transplant tests, some of which were carried out in South Africa.

Christine’s family was one of the lucky ones and that is how she ended up in hospital with her father. Not that she’s worried about hospitals; she actually would like to be a doctor in future.

“I want to be a doctor so that I can treat children with kidney problems,” says the shy girl.

Mr Kamau says that Christine started falling ill a couple of years ago but it’s only last year that she was diagnosed with kidney disease.

“In May last year, her feet started swelling and, following many tests, the problem was found to be caused by her kidneys.”

So severe was the damage to her kidneys that she had to undergo dialysis at least thrice a week at a cost of 9,000 a session at a private hospital in Nairobi.

“When we heard about the kidney transplant we enrolled and, after tests were done and I emerged as the matching donor, we were excited that our daughter would have a chance to play once again,” said Mr Kamau.

At 8.45 am on Wednesday morning, Mr Kamau was wheeled into Theatre Six, where one of the surgeons described to him the procedure by which the team would make an incision, remove his kidney and then transplant it in his daughter waiting in an adjacent theatre across the hallway.  

Anaesthesiologists led by Dr Thomas Chokwe and Dr Charles Kabetu next explained to him about anaesthesia. While the doctors scrubbed — the technical term for preparing for theatre — the nurses arranged the operating equipment as they checked them against a list drawn specifically for the transplant.

SPANISH DOCTOR

Also in theatre was a team of doctors from Spain led by Antonio Alcaraz, a professor of urology at the University of Barcelona who has been conducting annual visits to Kenya through the Interlife project which is aimed at improving Kenya’s capacity to conduct such transplants.

After ensuring that he understood what the operation entailed, Prof Peter Mungai, KNH chief transplant surgeon and professor of urology at UoN School of Medicine, left to scrub for the surgery.

In less than a minute, Mr Kamau was unconscious from the anaesthesia. He was then draped in clean scrubs and the operation site covered with sterile drapes.

First, Prof Mungai thoroughly cleaned the left side of Mr Kamau’s abdomen using an antiseptic solution to reduce chances of infection. He then used a scalpel to make a nine-centimetre long cut below the rib cage, marking the beginning of the three-hour surgery.

Methodically, the surgeon then moved into the patient’s abdomen as the assisting surgeons looked on while scrub nurses waited in queue with the next equipment for use.

Meanwhile, on the outside, nurses and family members distracted Christine in Theatre Six with conversation to ease her anxiety. A different set of medics was preparing her for her own operation that would shortly follow.

After the usual pleasantries to assure Christine that she was in good hands, she was put to sleep and a second team led by Dr James Munene made an incision as they prepared to receive the kidney from her father.

Meanwhile, Prof Mungai’s team went ahead to harvest the kidney and place it in an ice-filled tray where perfusion — the process of preserving an organ outside the body by pumping cold nutrient fluid onto it — was performed and the kidney cooled to 4 degrees centigrade.

The donor’s kidney was harvested at 10.37am and was cleaned for the next two minutes, all caution taken to ensure that the organ was ready for transplant.

At 10.39 am, it was carried to the adjacent theatre where Christine lay unconscious and transplanted into her right lower pelvis. The blood vessels of her new kidney were connected to the vessels leading to the right leg while the ureter was joined to the bladder.

BLOOD VESSELS

Once the clamps on the blood vessels had been removed, blood circulated through her new kidney and it turned pink as it began to function. The time was 10.44 am and Christine now had a new lease of life.

Her original kidneys were left in place — a common practice.

At 11.18 am, the donor’s incision was stitched and Dr Chokwe and his team started the process of reversing the anaesthesia.

Mr Kamau regained consciousness 10 minutes later and confirmed that he was able to breathe independently, understand basic commands and make simple conversation. He was wheeled to the renal unit for recovery.

Finally, it was Dr Kabetu and the anaesthetic team’s turn to ensure that Christine was conscious and in control of her faculties before preparing for other surgeries.

Christine and her father are currently recuperating at KNH. Mr Kamau is scheduled to be discharged today while her daughter will be discharged at the end of next week. The girl will have to take anti-rejection drugs — medicine used to prevent the body from rejecting a transplanted organ — for the rest of her life. Inconvenient, maybe, for the hale and hearty, but a priceless gift to Christine and her family.