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Staff from SPMC receive training on brain death diagnosis and deceased donors from visiting UB staff

An ISN-TTS Sister Transplant Centers (STC) partnership between the Southern Philippines Medical Center (SPMC) Kidney Transplant Unit in the Philippines and the University of Barcelona (UB) in Spain has graduated from the program after seven years of collaboration. The partnership was extended from the usual six-year duration due to COVID-19-related disruptions.

The primary objective of the collaboration was to improve access to kidney transplant facilities and quality of care at SPMC, the emerging center. More specifically, the teams were looking to increase the number of annual kidney transplants by expanding potential donor sources and developing a deceased donor program. They also wanted to train staff and refine their ethical transplant program.

The SPMC achieved outstanding results through the STC partnership, with a 200% increase in kidney transplants, a 400% increase in patients receiving pre-transplant recipient workups, and a 600% increase in the transplant waiting list thanks to increased trust in the center’s capacity. In addition:

• 1262 healthcare professionals were trained
• 52 face-to-face seminars and webinars were held
• 6 instructional modules for teaching healthcare professionals were developed
• 340 deceased donor referrals were made per year
• 54 kidney transplants from deceased and living donors were carried out

Staff at the UB provided training in deceased donation and kidney transplantation, helping to implement robust protocols and improve surgical techniques. They also provided the expertise to create a permanent kidney disease prevention and detection program and establish a hospital transplant ethics committee at SPMC.

An initial SWOT analysis by Dr. Fritz Diekmann from the UB led to recommendations to create a four-story kidney and transplant center, the Mindanao Kidney and Transplant Institute, equipped with an immunology and HLA laboratory.

ISN-TTS Program participants from UB and SPMC outside the construction of the Mindanao Kidney and Transplant Institute in the Philippines

Maria Theresa Bad-ang, STC liaison officer at SPMC, comments, “There was a vast knowledge exchange between the two centers with monthly virtual meetings to discuss deceased donation clinical transplantation cases.” The transplant team visited the SPMC with one surgical expert, Dr. Jose Buitron, staying onsite for three months. Two surgeons and two transplant coordinators visited the UB to enhance their surgical skills.

Three representatives from SPMC took advanced transplant procurement management (TPM) courses in Spain. Five intermediate TPM training courses were held in the Philippines, producing 200 graduates able to train others in deceased donation. The STC partnership also paved the way for a postgraduate program in organ donation (the ODISSeA project) to be offered in two universities in the Philippines.

Through the STC Program, the SPMC developed organ donation protocols and kidney transplant guidelines, gaining national recognition for its kidney transplant program and establishing protocol agreements with other healthcare centers based on the guidelines. Having demonstrated the feasibility of the organ deceased donation program, other centers can replicate it.

The SPMC was one of the first centers to come up with a protocol for safely resuming deceased donation and transplantation when the COVID-19 pandemic enforced a temporary suspension of all transplant activities in the country. The protocol was developed through several consultative meetings with stakeholders and experts, including the team from UB.

A positive relationship with local and national political institutions was forged, helping to move policy toward universal healthcare for the Filipino population and lowering the cost of post-transplant medication prices for patients. Davao City Council passed an ordinance to streamline deceased organ donation in Davao City. According to Dr. Bad-Ang, this political involvement in the deceased donation and transplantation program will facilitate the project’s sustainability.

Although the pair has graduated, a solid relationship now exists between the centers, allowing professionals from both sides to keep in touch whenever needed.

The SPMC will continue implementing the improved measures and work toward consolidating the deceased organ donation and transplantation programs. Once this goal is achieved, the pair will be ready to expand to form a trio with another local center in the Philippines.

Dr.Bad-ang adds, ” We are extremely thankful for the support provided by the ISN over the last seven years. The funding has been crucial in developing the kidney care initiatives and achieving our objectives.”