Organ transplantation is one major casualty during COVID-19. At present, all transplant procedures across the nation have been halted as the disease poses ‘severe consequences’ to organ recipients and health-care teams in hospitals.
In Kerala, however, deceased donor organ transplantation is suddenly hogging the limelight, raising hopes of a new revival for the State’s scheme Mrithasanjeevani. The State has done seven transplants this year, five of them in April-May in the thick of COVID-19.
With the National Organ and Tissue Transplant Organisation issuing a directive that all operations of transplant be suspended during the pandemic, all major hospitals doing organ transplants had shut shop.
Discussion on risks
The sudden revival of public interest in deceased donor organ donation has had health-care professionals and transplant surgeons brainstorm on the risks of performing transplants during the pandemic.
“The answer to whether one should risk performing a transplant surgery during COVID-19 entirely depends on the disease epidemiology in Kerala. The emergency COVID-19 task force meeting convened last month concluded that transplant surgeries did not carry an additional risk as disease transmission here is under control. So far, our ‘at risk’ group (chronic diabetes patients, those undergoing dialysis, etc.) has been safe from COVID-19,” says Noble Gracious, nodal officer, Kerala Network for Organ Sharing (KNOS). The risks to dialysis patients and transplant recipients are very real because they are immuno-compromised.
Across the world, there have been several reports of post-transplant infections and long-term transplant recipients suddenly dying due to COVID-19.
Infection control steps
“We took extreme infection control measures to prevent all adverse events and tested both donor and recipients for COVID-19 using RT-PCR before proceeding with the transplant. The families of deceased donors are eager to save the lives of others. Somehow, in this mirthless pandemic season, the public seems to have rediscovered the joys of altruism,” says Dr. Gracious.
A couple of external factors too helped. The government’s order delinking brain death declaration from organ donation early this year, giving families the clear options of termination of ICU care or organ donation, took a lot of pressure off doctors.
‘Trust regained’
H.V. Easwer, consultant neurosurgeon at the Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST), who was part of the brain certification team for all donations, says that if till now a trust deficit between the medical fraternity and the public stood in the way of organ donation, in the COVID-19 season, doctors seem to have regained that trust and credibility.
“This situation could be altered by the changing epidemic situation in Kerala. For now, we are happy that Mrithasanjeevani is looking up,” Dr. Gracious says.
