Haiti's kidney transplantation unit

We read Jane Regan's World Report about the kidney disease situation in Haiti with interest,¹ and we congratulate those physicians in the USA for their generosity in helping the Haitian people. Regan described how difficult it would be to set up a transplantation programme in Haiti, but in fact, Haiti has not only the first transplantation surgeon accredited by the American Society of Transplant Surgeons but also its first and functional renal transplantation centre.

One of us, Jacque Maurice Jeudy, is director of this centre. I trained as a urologist in Haiti and France and completed an abdominal transplantation surgical fellowship at the Miami Transplant Institute, University of Miami Miller School of Medicine–Jackson Memorial Hospital, Miami, FL, USA. In 2008, I returned to Haiti, against all expectations, with the big ambition of creating the first renal transplantation centre in Haiti. This dream was thought to be impossible to achieve, given that Haiti is the most impoverished nation in the Americas.

In 2008, we founded the first organ transplantation programme in Haiti and, on Nov 30, 2009, we completed the first living, related donor kidney transplantation at the Centre Hospitalier du Sacre Coeur in a suburb of Port-Au-Prince, Haiti.² The recipient, a man aged 63 years with a long history of type 2 diabetes and hypertension, had developed end-stage renal failure and had been on haemodialysis for 5 years before receiving the transplant. The donor was his niece, a healthy woman aged 32 years. After 11 h of donor and recipient surgeries, the transplantation was a success, and immediate graft function was achieved. Both patients went home after 7 days in hospital. The recipient was treated with immunosuppressants, including tacrolimus and mycophenolate mofetil. Tacrolimus trough concentrations were done weekly by the Immunopathology Laboratory at the University of Miami. The patient had good renal transplant function, with a serum creatinine of 1·2 mg/dL measured at 60 days after transplantation.

All of the medical staff and personnel at this 40-bed hospital were thrilled to be involved in this historical event. The birth of the Haiti Kidney Transplant Program in 2008 was a historical moment for the country.

In 2010, we moved the transplantation unit to the Hospital Canapé Vert, Port-au-Prince, Haiti. In 2018, eight living kidney transplantations were done without economic help from any other institution.³ We provide most of the financial and surgical resources, and over the years, we have not sought any publicity for these actions. We are just two transplantation surgeons doing our jobs, and doing the right thing. The Haiti Kidney Transplant Program is widely available to any Haitian citizen.

To date, the renal allograft survival rate is 98% at 1 year and 92% at 5 years.⁴ By comparison, survival while on dialysis is 30% at 1 year.4, 5