Several hospitals in the country were capable of providing kidney transplants to children, however, only a handful of patients were able to be treated because of the high cost of the operation, said Dr Suroj Supavekin, an assistant professor at Siriraj Hospital's Paediatric Nephrology Division.

At Siriraj Hospital, for example, only one or two patients a year received a kidney transplant even though the hospital could perform 10 to 20 operations, the doctor said.

Those transplants were covered by donations made to the hospital. Because of its limited budget, it had around 12 children on the waiting list for a kidney transplant each year, he said.

Unlike adults with chronic kidney-failure, whose treatment is covered by the Social Security Fund, young patients were not covered by any healthcare scheme, Suroj said.

Only those children whose parents are civil servants are currently covered by the civil servant's healthcare welfare scheme.

"We have no choice but to tell them to accept the truth," said Dr Suroj, referring to the parents of children with kidney failure who did have enough money to pay for a transplant.

The cost of a kidney transplant at a state hospital ranges from Bt150,000 to Bt300,000 per case, excluding the cost of medications of between Bt10,000 to Bt30,000 a month. The drugs must be taken for many months after the transplant.

People who have transplants must take drugs to keep the body's immune system from rejecting the new organ. These immuno-suppressive drugs can help maintain the transplanted kidney for many years.

Information from the website of the US National Institutes of Health's National Kidney and Urologic Diseases Information Clearinghouse said that from birth to age four years, birth defects and hereditary diseases are by far the leading causes of kidney failure in children.

The official figures in Thailand are not available, whereas the US statistics showed the annual rate of new cases were only about two cases in every 100,000.

The National Health Security Office, which oversees the management of the Bt30 health scheme, does not even cover the cost of kidney dialysis due to the high cost.

The scheme, which covers the majority of the population, was piloting to see whether it was feasible to include kidney dialysis - a treatment that extends the lives of patients with chronic kidney failure.

A report from the NHISO showed the cost of kidney dialysis would be at least Bt1 billion per year, if the Bt30 scheme covered the cost of this treatment.

Dialysis is a way to remove the waste products and extra water from the blood of patients with kidney failure.

But a child whose kidneys fail completely must receive treatment to replace the work of the kidneys.

Donated kidneys came from either the parents or siblings, he said.

Arthit Khwankhom

The Nation