Nigerian donates cornea for transplant

… As experts call for local harvest of cornea in the country

The first successful cornea transplant operation on two patients by a local donor recently has received commendation by members of the medical community, friends and family of the donors and recipients of the cornea in Lagos.

The two patients- names withheld, had a successful cornea transplant in August 2010 following the death of Kola Shodipo, a 47 year old man who prior to his death on the 18th of the same month, pledged to donate the cornea in his eyes which were removed some hours after his death. The corneas were later used to restore sight to two individuals who had cornea blindness in one eye each.

Speaking to journalists at a recent press conference at Lagos State University Teaching Hospital (LASUTH),Ikeja, Lagos, Mosun Faderin, Medical Director of Eye Bank for Restoring Sight, Nigeria, said that cornea blindness encompasses a range of eye conditions that ultimately affect the transparency of the cornea, leading to blindness.

Faderin stated that though cornea blindness is reversible giving the fact that it is only the front part of the eye that is damaged, the aftereffects of bacterial, fungal, or viral infections, eye trauma, traditional medicine or home remedies, which often harm the eye rather than relieve pain or improve eyesight have been implicated in the cause of blindness.

In her words “Attacking the root causes of corneal blindness is the best path to blindness prevention. When that part is damaged, the person cannot see but with a successful surgery which involves the replacement of the damaged cornea with another got from another human, sight can be restored. For the cornea to be useful for a transplant, it must be removed within 12 hours after death with the consent of either the deceased, given before death, or the family members.”

Olaseinde Akinsete, Chairman of the Board of Eye Bank, recalled that although corneal transplant is lawful in Nigeria under Decree No.23, titled Cornea Grafting Decree 1973, not many corneal grafting operations have been carried out in the country.

“Under the decree, any person can either by writing or orally in the presence of two or more witnesses authorizes the excision of his or her eyes after death. The law stipulates that the person lawfully in custody of the body after death may unless he has reason to believe that the request was subsequently withdrawn, authorize removal of eyes. Notwithstanding the promulgation of the above mentioned decree, not many corneal grafting operations were carried out in Nigeria.”

While giving an insight to the number of people with cornea blindness in Nigeria, Akinsete added: “Nigeria has about 1,170,000 blind people, based on a blindness rate of 0.78 percent. Cornea blindness is about 7.9percent that is 92,430. It is the latter that may benefit from corneal grafting.”

Taking a cursory look at cornea transplant in Nigeria, late Shodipo is the first Nigerian to donate his eyes for a cornea transplant. Until now, all cornea transplants in Nigeria have been done with corneas got from other countries, mostly from India.

However, since the Eye bank became a reality when the Nigeria Society for the Blind and the Ophthalmological Society of Nigeria (OSN) got together to give birth to the Eye Bank from the money donated for cornea grafting in 2004, not a single cornea has been harvested locally until very recently. Sadly, the biggest challenge the country is faced with is that the public first of all don’t believe they should donate any part of their body after death. This is as pertinent as it is not possible to restore sight to a ‘blind’ person. In order to convince the public that someone who has cornea blindness (and this group accounts for about 33 percent of those with reversible or curable blindness worldwide), that the Board of the Eye Bank decided to source for corneas from abroad.

There is no gain saying that late Shodipo made his intention of donating his eyes in 2008 because of his love for people and applauded his humanitarian work. The first locally harvested corneas from a Nigerian donor who had pledged/donated his eyes after he saw and heard the experiences of two cornea graft recipients prior to his passing on have to be commended.

For Femi Olugbile, Chief Medical Director of LASUTH, the transplant is a landmark achievement even as he commended the family for ensuring that they obeyed Shodipo’s wish. Olugbile however called for the creation of proper legislation that would make it possible for unclaimed dead bodies and bodies of destitute be used for the extraction of useful body parts that can help sustain lives of those who have serious medical condition which would need transplant.

“The challenge of harvesting corneas and other body tissues for use on live patients in our country is a major one. Unfortunately, these bodies cannot be touched for cornea transplant and that is a major waste. There has to be a way in which that can be tidied up. A practical law creation exercise needs to be embarked upon to get access to these corneas,” Olugbile stated.

It is noteworthy to state that in 1994, the Government of India passed the Transplantation of Human Organs Act that legalised the concept of brain death and, for the first time, facilitated organ procurement from heart beating, brain dead donors this was borne out the fact that thousands of lives were lost in India annually from heart and liver failure since transplantation of unpaired organs like heart, liver and pancreas were either difficult or impossible from living donors.

Hence, organ and tissue donation is a way to help others- by allowing organs or tissues to be taken from a death individual and transplanted in someone else’s body. It may save another person’s life. Organ and tissue donation is a way of “giving something back” to society. It costs nothing, it does not change your own life, and it can mean a huge improvement to others’ lives.

Organ failure can strike anybody at any time as a result of illness or infection. For most people who experience organ failure, a transplant is their only realistic treatment option. If one dies, the organs could help several people through organ transplants and many others through tissue grafts. For instance a person who is attached to a dialysis machine could return to full-time work after receiving one kidney. Every effort is made to save one’s life before donation is considered as donation doesn’t disfigure the body.