Dr. Kanthimathi , Chief Civil Surgeon, Rajiv Gandhi Government General Hospital, Chennai, who last week took charge as Member Secretary, Transplant Authority of Tamil Nadu (TRANSTAN), says one of her immediate challenges is to bring about transparency in the organ transplantation programme to ensure that all Indian patients deserving an organ get it.
Excerpts from an interview in Chennai:
You have taken charge as Member Secretary of TRANSTAN at a time when there are allegations that foreigners are given organs bypassing Indian patients on the wait-list. What are your challenges?
My immediate challenge is to make this organisation transparent so that no Indian patient is overlooked in allocation of organs. If I can address this problem of transparency in the system then probably other things will just fall in place. All Indian patients deserving organs should get it.
The NOTTO Director had recently put a note in the official organ allocation WhatsApp group expressing serious concern over foreign patients getting organs bypassing Indians. Are you investigating any such case of violation in allocation of organs?
I have taken charge just four days ago. I am trying to analyse and set things right. Nothing like that has happened in the last four or five days. The problem now is I don’t have direct access or control over the Tamil Nadu Organ Sharing Registry. This registry has the list of all patients waiting for organ transplant. This is being maintained by a private NGO. I am trying to bring the server to our office. Another major initiative that is being planned is to create a mobile app instead of WhatsApp for TRANSTAN.
TRANSTAN was initially operating by sending SMS alerts to hospitals on the availability of organs of brain-dead patients. Recently a WhatsApp group was started with all stakeholders as members, which brought about some transparency. Is it true that there is pressure from some quarters to shut down the WhatsApp group?
The WhatsApp group has definitely improved the level of transparency, thanks to Dr P. Balaji who was the Member Secretary till a few days ago. By and large, say about 90% surgeons and consultants are happy with this because they get alerts instantly and come to know of the organ allocations. But there might be some antagonism towards this from some quarters which I don’t want to state. I think we can overcome that problem.
What is the process involved in allocating an organ to a hospital? For instance, if a patient is declared brain-dead in a hospital in Chennai or outside, what happens next?
Once a patient is certified brain-dead, TRANSTAN gets an alert that there is a potential donor. After that, we send out an alert in the WhatsApp group to all hospitals. First we make sure that no Indian patient is overlooked. Hospitals should give us a decline message if they don’t want to take the organ. If a foreigner is being given an organ by overlooking Indians, then the transplant surgeon has to give valid reasons why they are not being considered. Even if there are no Indian patients, we ask other States. After notifying National Organ and Tissue Transplant Organisation, we make another check and allocate the organ to the international patient.
When a hospital claims that Indian patients in its wait list are not fit for the transplant and seek the organ for a foreigner, do you have a mechanism to verify the genuineness of their claim?
They can’t say in one line that they are declining the organ for Indian patients. It has to be turned down case-by-case with a valid reason. I cannot check the veracity of such a claim... yes, there is a possibility that a false claim can be made to give preference to a foreign national. I don’t have the manpower to check all that... I need somebody to go to that hospital and check. TRANSTAN has only seven transplant coordinators working for the whole of Tamil Nadu who are working on a contract basis. This is another challenge for me.
