Doctors who have been discussing Prime Minister KP Sharma Oli’s future medical course have said regular dialysis may not be an option, just as Oli underwent a third haemodialysis in a little over two weeks on Saturday.

Multiple doctors, including those who have been attending to Oli, the Post spoke with said the best option will be another kidney transplant.

Read: Oli is firm, will not be stepping down any time soon, his aides say

After both his kidneys stopped functioning, Oli had a renal transplant in 2007, and he has been on one kidney since.

"The prime minister’s health condition is stable now, but immediate intervention is required,” a doctor, who has attended to Oli in the past and has been following his health condition for the past several years, told the Post on condition of anonymity because he was not allowed to speak to the media. "We have been contemplating transplantation and a suitable country for the same."

Oli’s health became a cause for concern first in August-September when he flew to Singapore twice. While information regarding his health was kept under wraps, after his return, Oli declared publicly that he was as right as rain.

But last month, his health saw quick deterioration. He was admitted to Grande International Hospital where he underwent two rounds of dialysis in as many days.

Since then doctors have been saying Oli either has to be on regular dialysis—at least three times a week—or he needs another transplant, but a concrete decision is yet to be made.

Read: The health of the prime minister is a topic that affects everyone in the country

On Saturday, Grande said in a statement that Oli had undergone dialysis.

Since regular dialysis should not be considered a long-term option, doctors say, there is a need for serious deliberations on another kidney transplant and how, when and where it should be done.

Renal transplantation can be carried out in Nepal, but the prime minister’s physicians do not want to take any risk and are exploring countries where he can get state-of-the-art services.

Meanwhile, there are some legal aspects that need to be taken into consideration, say doctors.

As per Nepal's law regarding human organ transplantation, people from family members, close relatives, adopted son/daughter, and close relatives between two or more families can donate their kidneys.

Family members mean husband, wife, son, daughter, father, mother, adopted son, adopted daughter, siblings, grandfather, grandmother, grandson, granddaughter, father-in-law and mother-in-law. Close relatives mean adoptive father, adoptive mother, stepfather, stepmother, uncle, aunt, nephew, niece, brother-in-law, sister-in-law, maternal uncle and maternal aunt, sons-in-law and daughters-in-law.

In case of failure to meet these criteria, there is a provision of paired exchange. The law defines paired exchange as: if someone in a family experiences an organ failure and has a donor ready to donate but the patient is unable to receive it due to incompatible cross-match, the person can receive the organ from another family who is undergoing similar problems and the donor in their family is a match.

The United States of America, Thailand and Singapore are among the countries which are being considered as options for the transplantation for the prime minister, according to the doctor. He, however, said the donor is yet to be explored.

Dr Rishi Kumar Kafley, executive director and consultant nephrologist at the National Kidney Centre, the country’s premier hospital for renal treatment and dialysis, said anyone can donate a kidney in India, and the USA and other developed countries.

"There are hundreds of thousands of party workers in the Nepal Communist Party," said Kafley. "I don't think it will be difficult for the prime minister to find a donor; anyone whose kidney is compatible can donate."

Despite doctors’ advice to rest more and work less, Oli, since his discharge from hospital on October 31, has been on a decision-making spree. He, however, has confined himself to Baluwatar and is holding meetings and taking decisions from there.

His move to cut down on formal programmes like inaugurations and public meetings though is good, physicians attending to him as well as his advisers must zero in on the future medical course for him at the earliest, said another doctor who also requested anonymity.

While regular dialysis can be an option for many, given the role Oli has to play in the capacity of the prime minister, he must go for another transplant, according to the doctor. While Oli could avoid physical exertion by cutting down on meetings and confining himself to Baluwatar, as the prime minister and party chair, his mental stress is understandable, he said.

According to Kafley, the prime minister’s health may seem stable after every dialysis, but that does not mean it is a long-term solution.

"This may mean a stable condition for some weeks or a few months," said Kafley. "The only option is another kidney transplant at the earliest and it would be better if it is carried out at a time when his health condition is stable. "

Kidney transplantation can be carried out in two weeks after a compatible donor is found and one can be discharged from hospital two weeks after the transplant.

“After the discharge, the patient needs four weeks of rest,” said Kafley. “After that, they are fit to resume duties, if all goes as planned.”