The Philippines has surmounted all forms of disaster-natural, political and economic. All these undoubtedly affected our medical care including transplantation. Nevertheless, this country has taken big bold steps in confronting problems that are unique in a developing country.
Since its foundation in 1983, the National Kidney Institute, formerly the National Kidney Foundation of the Philippines has grown to become the center of transplantation in the Philippines. Transplant milestones include the first simultaneous pancreas and kidney transplant in Asia (1988), the first liver transplant in August 1988, the first simultaneous liver and kidney transplant in Asia (1990) and the first bone marrow transplant also in 1990 As of September 1992, a total of 727 kidney transplants have been performed. The majority (76%) were from living related donation (LRD). One year patient and graft survival for LRD is 90%. One year patient and graft survival for cadaver (CAD) is 75% and 62% respectively. At 3 years, patient and graft survival for LRD is 83% and 80% respectively. Three years patient and graft survival for CAD is 71% and 56%, respectively.
Five liver transplants have been performed, one of which was the first simultaneous liver and kidney transplant. The longest survivor now is 14 months posttransplant. Five simultaneous pancreas and kidney transplant were performed for endstage renal disease secondary to diabetes. The longest survivor is now 4 years and 9 months post-transplant with excellent kidney and pancreas function. For these patients who otherwise had been marked for death, transplant undoubtedly had offered them a second lease on life.
The Human Organ Preservation Effort (H.O.P.E.) formerly the Cadaver Organ Retrieval Effort was also organized in 1983 at the National Kidney Institute with the following activities: Information drive to promote acceptance of transplantation and organ donation, maintains a list of patients in the cadaver pool and to coordinate cadaver organ retrieval. The demand for cadaver organ is increasing. With the passage of the Organ Donation Act of 1991, these problems of organ shortage we hope would be alleviated. This law authorizes the "legacy of all or part of a human body after death for specified purpose." A total of 174 cadaveric kidneys, 5 livers and 5 pancreas have been transplanted. The result of our transplant is comparable or even much better than that of other countries. To our patients who accept our offer of transplantation, indeed, this is "LIFE AFTER DEATH": a gift of life to them after a meaningful death of a good samaritan. (Author)