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Updated: January 4, 2013 08:25 IST

Amendment facilitated parallel approval panels in hospitals

Afshan Yasmeen
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Rules permit such panels if a hospital performs more than 25 transplants a year

The surge in number of kidney transplants in the State could be linked to the amended rules in the Transplantation of Human Organs Act 1994. The 2008 amendment has succeeding in loosened the regulatory regime by allowing the constitution of hospital-based authorisation committees.

New rules

While there is a State Authorisation Committee appointed by the government, the new rules permit setting up of hospital-based authorisation committees if a centre (hospital) exceeds 25 transplants a year. Three private hospitals in Bangalore — Manipal Hospitals, Columbia Asia and Narayana Hrudayalaya — have their own committees.

While the heads of these institutions claimed that the committees are similar to the State Authorisation committee (headed by legal experts) and are appointed by the State government, they are also permitted to have in-house doctors and two government nominees.

Another loophole

Sources said this was an easy way to liberalising the process of approving organ transplants. Another big loophole is the much abused Section 9 (3) of the Act, which permits unrelated transplants if it can be proved that the donor did this out of “affection and attachment” and not for monetary considerations.

Asserting that this grey area needs to be addressed appropriately, a senior doctor from M.S. Ramaiah Hospital said: “The big question is when the patient’s blood relatives don’t have the compassion, why is somebody else having it? The answer is obvious and everyone knows that money has changed hands. The government should either completely ban unrelated transplants or should openly allow them.”

Another nephrologist, who questioned the credibility of the process followed by these hospital-based committees, said all approvals by them should be vetted by the State Authorisation Committee.

The numbers

While the State Authorisation Committee had approved 759 transplants from June 2010 till date, a total of 374 transplants took place at the three authorised private hospitals in the same period.

State Authorisation Committee chairperson G.K. Venkatesh said the committee totally depended on the verification provided by the revenue and police officials.

“At least two applications from Ramanagaram for transplants were rejected because of police objections. We follow a rigorous procedure of verifying the details provided by the applicants after they have been certified by the revenue and police officials. We interrogate the donor and recipient separately to ensure there is no foul play,” Dr. Venkatesh explained.

New guidelines

The State committee had evolved several new guidelines such as enclosing a marriage certificate and getting the Tahsildar certify the family tree. “A few applicants have questioned these measures through Right to Information (RTI) Act and have asked us if we have any Government Order on this,” Dr. Venkatesh said.

Hospitals’ claim

Meanwhile, the three private hospitals also claim to follow a fair process of approving transplants.

Sudarshan Ballal, Medical Director of Manipal Hospitals, said the hospital’s committee headed by the former Chief Justice of Tamil Nadu followed an elaborate verification process.

Nandakumar Jairam, chairperson and medical director of Columbia Asia, said his hospital’s committee is also a quasi judicial body following all rules and regulations.

It is headed by former Karnataka High Court judge Shivshankar Bhat.

Expert

Ishitaque Ahamed, consultant nephrologist from Narayana Hrudayalaya, said the hospital had two channels of screening the applications. “Applications cleared by an internal committee headed by one of the chief operating officers, M.S. Rao, again go through a rigorous verification process by an external committee. This committee is headed by medical superintendent Asha Naik, who is a non-practising gynaecologist,” he added.

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