By Kumudini Hettiarachchi The kidney transplant programme of the semi-government Sri Jayewardenepura General Hospital (SJGH) has descended into turmoil, causing major hardship to severely-ill patients, the Sunday Times learns. The SJGH’s one-and-only Post-Graduate Institute of Medicine (PGIM) certified Kidney Transplant Surgeon has been interdicted (weda thahanam kara atha) by a letter dated August 3 (last [...]

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Patients suffer as SJGH kidney transplant programme in crisis

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By Kumudini Hettiarachchi

The kidney transplant programme of the semi-government Sri Jayewardenepura General Hospital (SJGH) has descended into turmoil, causing major hardship to severely-ill patients, the Sunday Times learns.

The SJGH’s one-and-only Post-Graduate Institute of Medicine (PGIM) certified Kidney Transplant Surgeon has been interdicted (weda thahanam kara atha) by a letter dated August 3 (last Saturday), which also states that the action follows a decision taken by the hospital’s Board of Directors (Management Team) at its meeting on July 30.

While there were claims that no charge sheet had been issued or a preliminary inquiry held before the interdiction, the SJGH Chairman Dr. Saranga Alahapperuma when contacted, said that due processes were followed.

“The kidney transplant programme is continuing with one general surgeon in attendance. We have two surgeons, but one stopped performing kidney transplants five months ago,” he said, explaining that following this and several other issues allegedly raised against the surgeon in question, the Management Team suspended him on August 3.

The Chairman added that the Management Team has instructed this transplant surgeon to complete his existing work as patients have been admitted under him to the hospital. But this surgeon has put into effect a leave application which he had submitted earlier.

Many health sector sources expressed regret over the collapse of the SJGH’s kidney transplant programme which had started back in 2000 (24 years ago), initially with a General Surgeon and one Nephrologist.

“There seem to be several failures on the part of the administration,” one said, while others pointed out that it was in 2013 that the Board-certified Urologist & Transplant Surgeon and a second Nephrologist were appointed to the programme.

By 2021, SJGH secured the No. 1 place among all the state sector centres performing kidney transplants, with 52 surgeries to its credit.

However, in June 2022, SJGH’s kidney transplant programme had run into trouble with the Senior Nephrologist retiring but the post not being advertised a few months before such retirement, as is procedurally required, it is understood. Another hit had followed in October 2022 when the second Nephrologist resigned, with kidney transplants grinding to a halt for two-three months, leaving patients in dire straits.

The Sunday Times learns that when a Nephrologist was appointed to cover-up for this loss, weak life had been infused into the kidney transplant programme, with low-scale numbers being performed.

However, sources pointed out that the programme was not out of the woods – a permanent Nephrologist had been selected in July 2023 and another, as this is a two-person renal unit, in October 2023. The first had not reported to duty and the post had once again been advertised in December 2023. The selectee for the latter vacancy is on no-pay leave overseas but no ‘cover-up’ Nephrologist has still been appointed. Another major challenge had been the non-appointment of a doctor as the Transplant Coordinator for the Deceased Donor Programme, a requirement set by the Health Ministry.

In 2024 (this year), the Sunday Times learns that the kidney transplant programme had limped on with five transplants being done in January-February by the now interdicted Transplant Surgeon. Since the retirement of the General Surgeon in October 2023, no transplants had taken place till April 2024, but a new General Surgeon recalled from retirement has now performed six transplants from April up to now.

In Sri Lanka, in the Colombo district kidney transplants are performed at the National Hospital of Sri Lanka (NHSL), Colombo; the National Institute for Nephrology Dialysis & Transplantation, Maligawatte; the Colombo North Teaching Hospital, Ragama; and the Sri Jayewardenepura General Hospital, Kotte.

Some of the other centres which carry out these transplants include the Kandy and Karapitiya National Hospitals; Kurunegala, Peradeniya and Badulla Teaching Hospitals; and to a smaller extent Anuradhapura and Jaffna Teaching Hospital and Polonnaruwa District General Hospital.

Annually, Sri Lanka has around 2,500 patients awaiting kidney transplants of which the state hospitals are usually able to conduct about 500 per year – around 400 live donor transplants and around 100 deceased donor transplants. These meet only about 10% of the requirement.

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