Guatemalan doctor studying fistula surgery at Greenwood hospital

Gerard Edic, Staff Writer, Greenwood Commonwealth

A Guatemalan doctor is currently in Greenwood training under a Greenwood Leflore Hospital doctor who specializes in dialysis access surgery.

Dr. Javier Alvizures, a pediatric surgeon at Theodore Roosevelt Hospital in Guatemala City, has been learning how to conduct an arteriovenous (AV) fistula surgery by watching Dr. John Lucas III do the procedure. Lucas has been nationally lauded for his success rate with that type of surgery.

Alvizures, who’s been in town since Monday, had witnessed 22 surgeries as of Friday. He’ll observe more on Monday, his last day in town. He’ll then continue his train­ing for another week at Harvard Medical School in Boston.

“It’s very significant because Dr. Lucas has great experience. I can see the doctor do these types of surgery with resources, technicians,” Alvizures said.

AV fistula surgery is used for dial­ysis, the process of using a machine to clean a person’s blood of toxins when a kidney, the organ that nat­urally performs that function, is impaired as a result of chronic dis­ease or other kidney-related fail­ures.

With surgery, a fistula, which is a tubelike connection between an artery and vein, is planted in a person, usually in the wrist but it can be added in other parts of the body.

A needle is then inserted into the fistula, which trans­ports a person’s blood to the dialysis machine to be cleaned before going back in the body. The fistula stays permanently in the body.

There are other methods for dialysis point-of-access, such as a catheter that’s usually inserted in the neck. However, fistulas are believed to be a safer point-of-access than catheters since catheters need to be replaced, said Sara Hen­dren, senior program director for Bridge of Life.

She was present with Alvizures for his training on Friday.

Bridge of Life, a Denver-based nonprofit, has been in existence since 2007 to pre­vent chronic diseases in coun­tries around the globe, such as Guatemala.

“This is an extension of the training we’re doing in Guatemala City,” Hendren said.

It was Bridge of Life that brought Lucas to Roosevelt Hospital in Guatemala, most recently in 2018, to train its surgeons on the AV fistula surgery.

In fact, Alvizures helped Lucas with the procedure dur­ing one of the Greenwood sur­geon’s stays in Guatemala. Lucas will head back to the country later this year in November to train additional doctors.

“Our hope is to get Dr. Javier trained to do fistulas independently and have him then train doctors in Guatemala, which allows for expanded outreach,” Hendren said.

Alvizures said Roosevelt Hospital is the only center in Guatemala that specializes in the care of pediatric patients with chronic kidney failure.

A 2015 Global Burden of Disease study found that chronic kidney disease was the fifth-leading cause of death in Guatemala, partly due to the lack of dialysis clinics, particu­larly in rural areas.