ON SITE PORCINE KIDNEY TRANSPLANT SIMULATION TO PREPARE A NOVICE TRANSPLANT CENTER FOR HUMAN LIVING KIDNEY TRANSPLANT

Introduction: The Ethiopian kidney transplantation program was recently established. Except for the transplant surgeon most professionals involved had little experience on kidney transplantation. Objectives: To evaluate if simulation with a porcine helped develop the ability of the new kidney transplant center for human living donor nephrectomy and recipient kidney transplantation. Methods: A review of the reports of the transplant surgeon, nursing and anesthesia team and in-depth interviews of all involved in the swine simulation was performed at St. Paul’s Hospital Millennium Medical College in Addis Ababa. Additionally, a self-administered questionnaire was used to collect data on individuals’ perception of the simulation Results: Four simulations sessions were performed on five pigs in three months. There was a month gap between each session. In the first three sessions one swine was utilized for each encounter, while in the last session, two swine were used. With each session, new issues or problems were identified, but the skill and understanding of the team improved steadily. Successful nephrectomy, back table perfusion, and successful allotransplant was achieved by the fourth session. At the end of the fourth simulation, many gaps and areas were identified for focus prior to initiation of human transplant. Everyone involved perceived simulation as important and recommended such an approach in similar settings. Conclusions. The experience, the knowledge and skills gained from porcine living donor and recipient transplant simulations were significant. We recommend using such simulation to test a new service in a new center. Simulation sessions need to be performed until the team gets comfortable and all gaps are identified.