Turkey needs more donors as kidney disease rates rise

However, professors and specialists say Turkey needs to make improvements in order to increase the number of kidney donors because the number of people waiting for kidney transplantation are increasing dramatically each year.

The issue of organ transplantation came into the spotlight after some recent outstanding transplantation cases performed at Akdeniz and Hacettepe universities. The world’s first triple limb transplant and Turkey’s first face transplant were performed by professors at the Akdeniz University School of Medicine Hospital in January. Professors at Ankara’s Hacettepe University School of Medicine Hospital performed the second full-face transplant in February. Such transplants are rare in Turkey and were scrutinized by the media intensely.

However, how much Turkey has accomplished in the area of kidney transplantation has not been brought to the forefront by the media. Thanks to the efforts of doctors, non-governmental organizations and the Ministry of Health’s recent successful policies, Turkey has made great advances in kidney transplantation, in the way of increasing the number of treatment centers, operations and doctors that specialize in this area. The number of patients who underwent kidney transplants was between 500 and 600 a year but increased to 3,000 last year.

The number of transplantation centers specializing in kidney transplantation has also increased in the last five years in Turkey. There are 62 kidney transplantation centers in Turkey, some of which stand among the most outstanding around the globe. In comparison to Turkey, the number of kidney transplantation centers is low in other countries. For example, in England there are only eight kidney transplantation centers in total.

Between April 16 and 17, İstanbul hosted a symposium which brought together specialists and professors working in the field of nephrology, a branch of medicine dealing with the study of the function and diseases of the kidney, from around the world.

The 12th International Transplantation Symposium, which was organized by Pfizer Turkey, was held at the Renaissance Polat İstanbul Hotel in İstanbul’s Yeşilköy neighborhood, to discuss recent developments on the treatment of liver disease and kidney transplantation. Close to 200 physicians attended the symposium, where they got the chance to exchange ideas and share experiences with their colleagues.

Nephrology professors and specialists who attended the symposium say Turkey has made great strides in the area of organ transplantation, but the improvement Turkey has shown in kidney transplantation over the past few years is spectacular, though it needs more improvement because the number of people with chronic kidney disease is increasing dramatically each year in the country. This year alone 70,000 patients need a transplant; however, only 3,000 operations are performed per year.

Speaking to Sunday’s Zaman, Dr. Aydın Türkmen, a professor at İstanbul University’s Faculty of Medicine in the department of pediatric nephrology, said the prevalence of chronic kidney disease cases in the adult population is 17 percent, which means one out of every six people are suffering from chronic kidney disease in Turkey. There are two common diseases that cause chronic kidney disease: diabetes and hypertension. Incidents of both are very high in Turkey. The prevalence rate for hypertension is 33 percent, while this figure stands at 13 percent for diabetes across the country,” Türkmen said.

“By controlling the increase of these two diseases, we can decrease chronic kidney disease cases in Turkey as well. Chronic kidney disease has become an epidemic in Turkey. The number of people with chronic kidney disease is currently 70,000, but this number is expected to increase up to 125,000 in the following five years; meaning 125,000 patients will have to undergo dialysis. This number is very high, and the dialysis treatment is very expensive, so we need more kidney transplantation centers in Turkey.”

Dr. Ülkem Yakupoğlu, an associate professor at İstanbul’s Acıbadem University, told Sunday’s Zaman that there are 70,000 people waiting for a kidney transplant, but the number of people included in official lists for people waiting for a kidney is 19,000 or 20,000. “Many people are not aware of the fact that a kidney transplant is the best treatment for patients suffering from chronic kidney failure at the terminal stage,” said Yakupoğlu. “People who are diagnosed with chronic kidney failure should first ask their physicians whether dialysis is their only chance or whether they have a chance at getting a kidney transplant. Although Turkey has shown great improvement in recent years, 3,000 kidney transplants per year are not sufficient because about 70,000 people are diagnosed with kidney failure every year in Turkey.” Focusing on the burden dialysis treatment brings to the Turkish economy, Dr. Alihan Gürkan, a professor at İstanbul’s Acıbadem University, told Sunday’s Zaman that dialysis treatment is very expensive; Turkey spends TL 3 billion per year on dialysis treatment. This amount is expected to increase up to TL 10 billion per year in five years, which means Turkey will spend half of its total health budget per year within one year. Gürkan also added that a kidney transplant is a much better and cheaper option than dialysis.

Gürkan said the number of kidney donors is low in Turkey compared to other countries, so more needs to be done to raise awareness about kidney donation and the number of people waiting for a kidney transplant. Gürkan added that media outlets should also commit to promoting organ donation in Turkey.

Appreciating the improvements that have taken place in Turkey in recent years, Professor Josep M. Campistol, director of the department of nephrology and urology of the University of Barcelona, told Sunday’s Zaman: “Turkey is a good country, not only economically and not only in carpets, but it’s also very good in transplants. It’s a large country with a large population and, if I am correct, I think they do approximately 3,000 per year, and a number greater than 2,000 transplants per year is in my opinion a good number.” Campistol added: “However, it’s not only an issue of numbers, but an issue of quality. In this country there are very good physicians, very good transplant physicians, very good nephrologists [and] very good surgeons. And they do a very good job.”

About the recent face and limb transplant surgeries at Turkish universities, Campistol says: “I think that’s an important thing. Legs and arms are very nice for the newspapers, but it’s only maybe one or two cases. But the more important thing is that there are about 3,000 patients on dialysis who are saved by a kidney transplant.”

He added that he is not saying arms or legs are not important, but he says it should be considered that the kidney performs a large number of bodily functions. Both for chronic liver patients and patients on dialysis, if a transplant operation is not carried out, they will most likely die much sooner.