The Government Stanley Hospital here will offer live donor (liver) transplants after the completion of at least 50 cadaveric liver transplant surgeries, the director of its Institute of Surgical Gastroenterology and Liver Transplant, R. Surendran, has said.
“Our primary liver transplantation mode will continue to be cadaveric, but after we reach a sort of milestone with that form, we have decided to start living-donor transplant surgeries too,” Dr. Surendran told The Hindu . The cut-off is 50 cadaveric transplants; the hospital has already performed 24 (out of the total of 155 in the state since the cadaver transplantation programme was started).
With anywhere between 125 and 150 deaths due to road traffic accidents occurring every day in India, the cadaver-based transplant programme is logically likely to yield more organs. “Even at a conversion rate of one per cent, we can do 10 transplants a day. If we increase the percentage of organs that are donated, the possibilities are huge,” he added. The step ahead should be to increase the number of cadaveric organ donations.
In fact, the world over, the bulk of liver transplantations are cadaver-based. Only 5 per cent constituted living donors. However, living donor transplantation had gained popularity in India in recent years, and the demand for such services was increasing. Thanks to the capacity of the liver to self-regenerate, a portion of the liver of a living, healthy donor can be transplanted onto a patient with liver failure with whom it shares a match. The liver, split into two, then grows back to its normal size in both the donor and the recipient.
Listing his reasons for preferring cadaveric transplant to a living donor transplant, Dr. Surendran said the mortality rate was about 0.5 per cent for donors, even in the best centres.
“Now we have to remember that these are perfectly healthy people who develop complications as a result of the liver surgery, which is major, or even die.” Donor morbidity is also high and there is a chance that the residual liver may be inadequate.
It requires great skill to perform a perfect resection of the liver, and achieve transplantation with success, Dr. Surendran said. “Our unit here actually has good experience of removing portions of the liver (for example, tumours). We have collectively done over 500 cases totally. So, we have the expertise, and there is a demand.
This prompted the decision to offer live-donor transplants.”
Also, with live transplants, the expenses will shoot up by several times (as against cadaveric transplantation), he pointed out. Currently, the government hospital is offering all transplants free to patients. However, the authorities are examining possibilities of charging for the live organ transplantation, at rates that will be subsidised compared to the private sector.
Principal Secretary, Health, V.K.Subburaj said the demand for living donor transplant had increased in Tamil Nadu.
As the single public sector unit involved in liver transplants, Stanley Hospital with its expertise could launch the programme to at least cater to some patients who want to go in for living-donor transplants.
