All live organ donations in the State will now be monitored and organised through the Kerala Network for Organ Sharing, the nodal agency of the Government, which had been initially set up to coordinate deceased donor organ donations in Kerala.
The Government last week issued orders to this effect, finalising the guidelines for altruistic and exchange or “swap” donations in the State, which were proposed by KNOS and approved by the Cadaver Transplant Advisory Committee (CTAC), in order to prevent organ trade and overcome the shortage of viable organs for transplant patients.
But even as the Government has been pro-actively initiating measures to make a larger pool of organs available to transplant patients through swap donations, the transplant community in the State is not impressed. They have not responded to the new Government guidelines and have been largely adopting the “wait and watch/react” approach
“Under the new guidelines, a transplant patient has four options to secure an organ -- donation from a near relative, unrelated organ donation from an altruistic donor, swap donation or brain death donation. Separate registry for swap donation will be set up, for those transplant patients who may have a willing donor in the family but whose blood type/lymphocyte matching may not be compatible with that of the patient. Another such “incompatible patient-donor pair” can be found by linking with other transplant centres and an exchange donation can be arranged.
The idea is to link with multiple transplant centres so that once the swap/exchange donation gets going, we can put an end to un-related live donations with surreptitious cash incentives taking place in many hospitals in the State now,” Noble Gracious, the nodal officer of KNOS, said.
Swap donation programme is being successfully carried out in Mumbai by Apex Swap Transplant Registry and Institute of Kidney Diseases and Research Centre, Ahmedabad, a model KNOS can emulate
However, the transplant community says that it cannot see any of these programmes taking off smoothly in the State, given the fate of “Mrithasanjeevani”, the once-robust Government-run deceased organ donation programme.
“Mrithasanjeevani has all but come to a halt and not a single deceased organ donation has taken place in 2018 so far. It just remains to be seen how many truly altruistic persons will come forward to donate organs. These new guidelines may limit live organ donations too because a person wishing to donate a kidney or part of his liver to his close friend might decide not become a donor at all if he cannot give it to his friend. We anticipate a lot of practical difficulties as far as swap donations are concerned,” B. Venugopal, Consultant Liver Transplant Surgeon at KIMS Hospital, said.
Meanwhile, growing desperation of the innumerable end-stage chronic diseases patients awaiting organ transplants in the State is forcing doctors to register these patients under Tamil Nadu and Maharashtra’s deceased organ donation programme.
“Now that Mrithasanjeevani is not moving forward and live donations too are limited by new rules, we are now registering our transplant patients at Trichy, Madurai , Vellore or Coimbatore under TN Organ Sharing Registry. TN follows the priority in waiting list, so the earlier one gets into the list, the better his chances of getting an organ,” Dr. Venugopal said.