Drugs take per cent cost of stem cell transplant – Dr Ibadin

UBTH has another successful stem cell transplant. What exactly is it?Stem cell implies primitive cells that are yet to develop into special tissues; stem or primitive in that it has the capability of developing after transplant. It means you are taking from an individual who has a desirable trait and you transfuse it into another […]

UBTH has another successful stem cell transplant. What exactly is it?
Stem cell implies primitive cells that are yet to develop into special tissues; stem or primitive in that it has the capability of developing after transplant. It means you are taking from an individual who has a desirable trait and you transfuse it into another person who has the traits or character you want to suppress or eliminate.
The success was achieved  through a collaboration with the University of  Basel  Switzerland which provided the technical support and the machine identified as cobe spectra  which drains the blood through one arm and replaces it  through the other arm at the same time.  
As adults we have about six litres of blood in us, which is then divided into two—a part is liquid and the other part is cells. These cells are different parts; some are red while some are white, while some are in other colours. The red blood cells are the ones that make blood red. For sicklers the problem is located in the red blood cells, especially some of them who survive long enough, they may have major challenges and to do with the fact they can have stroke, which affect the brain. Other parts of the body may also suffer but what we have achieved here is total replacement of the entire red blood cells in an individual who is alive and replaces them completely with another type of cell.

How do you determine when a patient needs a cell transplant?
There are indications for stem cell transplant but the commonest one we are familiar with here is sickle cell anaemia. There are other conditions that may warrant stem cell transplant, for instance, an individual with cancer of the bone marrow. Individuals who also had chemotherapy or radiotherapy, that means they are cancer patients, can be subjected to that special machine treatment after which they now have a situation where they are not able to cope with infection. They also benefit from stem cell transplant

How can a patient know if he needs stem transplant?
The patient may not know if he needs a transplant; all he needs is come to hospital to complain about a number of things. It is the responsibility of the doctor to put those pictures of complaints together. Even for sicklers,   it’s not all of them that will require stem cell transplant. There are some sicklers you don’t know they are sicklers until they have major crisis.

Is there any life span for the donor and recipient?
The donor  has no risk at all  apart from the fact that he is donating some cell to an individual who requires it. It is not like  kidney transplant  or any other major organ transplant  that does not have the power to regenerate. In the case of bone marrow transplant the body regrows it. For the recipient there may be problems, but some of them are dependent on the drugs usage and procedure. Others are dependent  on who is attending to the patient, while others are dependent on the environment where the patient is. For instance you use drugs to knock off the  recipients  ability to respond  to a foreign agent. The way God made all of us is  such that if I take a tissue from you now and put it in my system  my body should be able to reject it. Even for ordinary blood transfusion, no matter how close we are my body should be able to reject it, but if you don’t want the body to reject it because  you want to move tissue from one person to the other, then there  are drugs that are available that enable you suppress that ability of the individual to reject it.
Those drugs are expensive and they are toxic to the system. By the time you apply them, then the individual is now unable to respond to events, which means that subsequently even when he is faced with normal daily challenges, he might not be able to respond. That can be a major challenge so they can succumb to common infections. That is why after the transplant they are kept in special environment where they are exposed minimally to foreign agents in the system or body. The environment where they are kept is also important. The environment is where the air is purified. If it’s not purified then they can also have infections.

How affordable can the stem cell transplant be and what do you think the government can do to make it affordable?
Affordability is relative. At UBTH, it may cost about N5m,  if you do the same procedure outside  the country you will be spending equivalent of N20m. But within our Nigerian environment, yes, you will say N5m is difficult to come by  but what is  N5m compared to the life of an individual?  The cost is contributed largely by the drugs the patients take; the drugs are expensive, they are difficult to get and they are not readily available. Drugs take about 60% of that cost, so we cannot compromise on the drugs. Another thing that contribute to the high cost is power; we need to supply uninterrupted  energy to the place. If that is the case then we will not rely on public power supply. So for a period of 120 days, generator will be running continuously. As to what government can do, government is already doing something. The federal government has made some money available to us. We are going to expand the number of rooms now, where we can keep these patients. The nature of the treatment is that you cannot keep more than one patient in a particular room, these rooms are special rooms. They are air tight; there are machines that filter the air. Already we have four rooms. Government has made money available to have more rooms and make sure they are effective. Government can reduce cost of treatment if they help supply the drugs or grant some rebate on drug importation.