Surgical Hub: Lusaka, Zambia

Advancing Kidney Transplantation at UTH 

The kidney transplant initiative at University Teaching Hospital (UTH) in Lusaka continues to demonstrate encouraging progress, with three successful living donor kidney transplants completed during the January 2025 visit—bringing the total to four since the program’s inception. This milestone marks a major step forward in building a long-term, sustainable transplant program in Zambia.

One of the most promising developments for this initiative was the hospital’s first multidisciplinary organ transplant selection meeting, bringing together nephrology, surgery, radiology, infectious disease, and anesthesia teams. This collaborative effort signals a critical move toward integrated transplant care. UTH leadership, including the chief of clinical care, also reiterated strong support for establishing UTH as a national transplant center.

Throughout the visit, substantial effort was dedicated to training and mentoring local teams. Dr. Bassem Wadie continues to grow in surgical skill and confidence, particularly in vascular anastomosis and operative planning. Daily simulation sessions, intraoperative teaching, and post-op debriefs have been instrumental in capacity building.

However, several challenges remain. There is a pressing need for consistently available transplant-specific equipment, better organization of OR sets, dedicated transplant OR teams, and more robust anesthesia and ICU support. The lack of latex-free supplies during one case highlighted the need for improved coordination and understanding across departments. Efforts are now underway to create a core set of surgical tools to be managed directly by the surgical team.

Looking ahead, the team is working to establish standardized peri- and postoperative protocols, develop a national transplant registry using REDCap, and improve quality assurance measures such as ABO verification. Leaders at UTH has expressed interest in joining the WHO International Registry in Organ Donation and Transplantation, and discussions are ongoing about promoting living donation through public education and policy-level advocacy. Recent transplants have even been featured on Zambian national television to raise awareness.

The ACS H.O.P.E. team remains committed to this collaborative effort through continued training, equipment donations, and long-term planning to build a resilient, locally led transplant program in Zambia. Special thanks to Thomas Pham, MD, FACS from Stanford and Hans Gritsch, MD, FACS from UCLA for volunteering their time in Lusaka this quarter to support this initiative.