Tuesday, November 27, 2012

Solving Thailand's Kidney Shortage

November 27, 2012 (AltThaiNews) - Bangkok Post in their article, "Hospital appeals for more kidney donors: Nation faces shortage as 4,000 await transplants" reported that:
Of the more than 40,000 people who suffer from chronic kidney disease, about 4,000 of them are awaiting a kidney transplant. But there are only about 400 kidneys available for transplant procedures each year, Dr Sophon Jirasiritham, chairman of Ramathibodi Hospital's kidney transplant project, said.
Nations around the world face a similar dilemma and the traditional sought-after solution is to ask for more people to become organ donors. Even with a donated kidney, a patient in need of a transplant will then face a lifetime of taking immunosuppressant drugs to prevent their body from rejecting their new organ. 

There is a solution in the works however, that solves both problems simultaneously. Regenerative medicine.

Regenerative medicine is the culturing from a patient their adult stem cells. These cells are then used to grow, inside a laboratory, a new organ. With gene therapy, it may be possible to also correct genetic defects that may lead to future problems when the organ is finally transplanted into the patient. In effect, regenerative medicine is the leveraging of bioengineering to turn the patient into their own donor.

The Wake Forest Institute for Regenerative Medicine has been working on this for years. Their progress is remarkable, but still much more is needed to be done. The issue of augmenting kidney function is discussed on their website specifically. Their work in regenerating human tissue and organs is discussed in greater detail by WFIRM's director, Dr. Anthony Atala, during a TED Talk in 2010.

Regenerative medicine is not a theory, it is a reality being shaped in research laboratories around the world, including in Thailand. In 2009, Thailand's Princess Maha Chakri Sirindhorn spoke before the 4th World Congress on Regenerative Medicine on the subject, organized by the National Research Council of Thailand at Central World in Bangkok, and initiated the creation of the Thailand Biomedical Engineering (BME) Consortium. Universities in Thailand are now pursuing the development of regenerative medicine.

The problem, around the world, and in Thailand as well, is a lack of funding and a lack of qualified researchers and technicians to accelerate the bridging of research work to clinical therapies that will begin profoundly transforming the lives of patients as well as the face of modern healthcare.

To rectify this problem, better efforts could be made to communicate the potential of regenerative medicine to the public, to raise awareness and support for pushing this field further and begin yielding tangible results for Thai society. Not only will this help in raising financial capital for research and implementation, but it will help raise the "human capital" necessary to advance research and administer therapies.

A concerted effort to overhaul Thai education must be made - and if the government is unwilling to do it, then it must be a matter taken into the hands of communities themselves. Across Bangkok and surrounding provinces, it is not uncommon to find tutoring houses teaching a range of subjects through a variety of methods. These are not to replace government schools - but to augment them. They both keep students constructively busy after school, and in many cases improve their academic performance.

Encouraging tutoring houses to teach a wider range of subjects, including computer skills, electronics, mechanical and technical skills, as well as biology, modeled after DIYbio clubs springing up across America and Europe would be a good step toward raising human capital. Leveraging open courseware (OCW), free educational material put out by top universities from around the world (MIT, Berkeley, UC Irvine to name a few), would also help develop Thailand's human capital. Local universities might also release OCW, either from their own material, or translated from existing OCW lectures.

In Shanghai, China, the city government announced its intentions to help interested parties set up a network of hackerspaces. City governments in Thailand might think about setting up hackerspaces and DIYbio community labs to help improve education, local collaboration, strengthen local business, and augment research and development pursued by Thai universities and institutions.

Placing these near universities would give interested students a place to go after class to apply theory to practical applications, preparing them for entrepreneurial opportunities or enhancing their skill sets ahead of employment. Students around the world have been organizing these spaces themselves with great success, and it may be a trend some Thai students may want to follow.

The overarching effect of encouraging better educated, more technically competent and collaborative communities, is the acceleration of the sort of technological progress necessary to turn the focus and research of institutions like WFIRM and BME, into beneficial, practical solutions for society.

This road-map of building up human capital and in turn building up Thailand's research & healthcare infrastructure, to breakthrough the current barriers holding back the promise of regenerative medicine may not help patients today waiting for new kidneys, and additional donors will have to do - but over time it will exponentially benefit future patients facing all kinds of illnesses and conditions.