Alladi Jayasri

There are over 80 patients waiting for organs, mostly kidneys

The cadaver transplant programme was launched in 1998

Experts call for a rethink on policy on organ donation

BANGALORE: As live unrelated renal transplants continue to be difficult to wish away, the cadaver organ programme in Karnataka appears to be making very little progress for several reasons. The cadaver transplant programme in Bangalore began very well in 1998, with the Foundation for Organ Retrieval and Transplant Education (FORTE), a non-profit organisation, facilitating harvesting of 40 kidneys, two livers and one heart until April 2005.

FORTE’s initiative paved the way for the formation of the Zonal Coordination Committee of Karnataka for Transplantation (ZCCK) set up by the Government under the Health Department to promote cadaver organ transplants. Though it now has over 80 patients waiting for organs, mostly kidneys, it has coordinated just one solitary case — as recently as in June this year. The kidneys of a brain-dead accident victim were recovered and transplanted at BGS Apollo Hospitals, Mysore.

However, the ZCCK, headed by D. Nagaraja, Director, National Institute of Mental Health and Neurosciences, has recently started to build a network of hospitals and extract a commitment from them on cadaver organ transplants.

Gastroenterologist Sadiq S. Sikora, and multi-organ transplant surgeon Ramcharan Thiagarajan at Manipal Institute of Liver and Digestive Diseases, who anchored a week-long programme at the hospital to create awareness about organ donation just before last Sunday’s kidney scam made headlines, say it is time for a rethink on public policy on organ donation, sensitising hospital personnel exploring effective systems within the hospital, so that the moment a donor becomes available, the people involved in the processes begin to function seamlessly — from brain death certification, counselling the family, completing legal formalities and harvesting organs, and sometimes, transporting it in time to reach the recipient.

Liver transplant

Dr. Sikora has 10 patients awaiting liver transplants. The liver transplant activity is in its infancy in India. Till May 2007, the number of transplants was just 342 in the whole country (from The National Medical Journal of India). Of these, 95 were from deceased donors. Bangalore has seen seven transplants, and one of them is from a deceased donor. Dr. Thiagarajan emphasised the urgency in updating the THO Act 1994 to facilitate organ harvesting by all hospitals, as this does not call for the expertise required in transplanting.

Such a change could mean a scenario like this: Bangalore saw 915 road accident deaths in 2006. If five per cent of the victims were certified brain dead, nearly 50 per cent of the wait-listed patients could be looking at a new lease of life without having to look to a live donor. If NIMHANS, which receives the highest number of road accident victims, were to become a harvesting centre, at least 10 persons awaiting transplants could be saved, Dr. Phadke says.