Nigeria’s Quest for Liver Transplantation, by Salisu Na’inna Dambatta
Laboratory tests on patients in many of the country’s teaching hospitals have shown widespread prevalence of hepatitis B virus, the leading cause of liver disease.
In an article co-authored by Nigerian healthcare professionals in the Journal of Biological Sciences and Medicine, Volume 9, Issue 7, 2021, the liver is described as a “major internal organ.” “It has more functions than any other organ, and even if only 10 to 20 percent of the liver’s tissue is functioning, it can sustain life.”
The authors add, “The important roles of the liver include purification, synthesis of proteins and cholesterol; hormone inactivation and regulation of testosterone levels in the blood; and storage of sugars, fats and vitamins.”
Sadly, the liver can become inflamed, they say, from many causes, “such as toxins, biochemical, pharmacological, bacterial or immune-mediated attacks.”
Other reports state that more than 1.5 billion people worldwide suffer from various types of chronic liver disease, with 2 million dying each year.
According to a report, “In Nigeria, 2-20% of the population, or 35 million people, are infected with hepatitis B and hepatitis C viruses, with prevalence rates ranging from 4.3%-23.3% and 0.5-% in different parts of the country, respectively. 15%”.
The report specifically stated that “the prevalence among pregnant women was 4.3% in Port Harcourt, 5.7% in Ilorin, 11.6% in Maiduguri, 8.3% in Zaria and 6.78% in Addo-Ekiti ; Of the HIV patients attending all clinics in Kano, 13.50% were from Lagos and 11.50% from Abuja city, with a seroprevalence rate of 23.3%.”
Experts link the widespread prevalence to low vaccination rates and ineffective national policies for the treatment and prevention of chronic liver disease.
The World Health Organization (WHO) stated in 2018 that the number of deaths caused by liver disease in Nigeria reached 60,044, accounting for 3.10% of the total deaths.
The government-owned Aminu Kano Teaching Hospital is preparing to start liver transplants in an effort to address the widespread liver disease epidemic in Nigeria.
The hospital’s Chief Medical Director (CMD), Professor Abdurrahman Abba Sheshe, announced at the 2020 First Liver Surgery Symposium on Advancing Liver Surgery in Nigeria at the AKTH Department of Surgery that the hospital is preparing to launch liver transplantation.
The CMD lamented the high incidence of liver diseases in Nigeria. “Aggressive action should be taken to reduce the mortality rate, which is 100 per cent,” he said.
The hospital took proactive steps to train consulting surgeons and other specialists on the liver surgery team and procure much of the technical equipment required for the surgery.
In the long term, however, more specialized equipment will be needed. Governments and philanthropists should provide additional equipment to hospitals.
Happily, Chairman Isyaka Rabi’u and Sons (IRS) Rabiu Isyaka Rabiu has yet to commit. He pledged to mobilize family and other donations to establish the National Center for Digestive Diseases and Liver Transplantation at the hospital to treat liver and other gastrointestinal diseases.
It is fitting that a SOGHIN study published in the 2018 Nigerian Journal of Gastroenterology and Hepatology, Volume 10, Issue 1, quoted a hepatologist stating, “Establishment of a West African Regional Liver Transplantation Center for Capacity building is desirable”.
It is not too late for Nigeria and West Africa to have such a center or to start liver transplantation. This is because the first human liver transplant was performed in 1963 by Thomas Earl Starzl, an American doctor, researcher, and organ transplant expert.
Dr. Garzali Ibrahim Umar, a consulting surgeon who was trained abroad in liver transplantation, said liver transplantation may be necessary for patients with liver cancer, cirrhosis and acute liver failure.
Of course, liver transplantation in hospitals can bring good news to patients with chronic liver disease and reduce their high mortality rate.
Given the urgent need to address liver disease across Nigeria, AKTH deserves all the support it can receive to achieve its ambition of bringing super-specialty liver transplantation to the doorsteps of Nigerians.
