Prof. Vimal Bhandari, Director, National Organ and Tissue Transplant Organisation (NOTTO), has flagged the organ transplant racket in Tamil Nadu in a message on a WhatsApp group set up for the express purpose of organ allocation.
Going by the rule book, allocation of organs to recipients on the waiting list is based on criteria that include the date of registration and the medical condition of the recipient. The wealth, race or gender of a person on the waiting list has no bearing on when and whether a person will receive a donated organ. The Transplantation of Human Organs Act of 1994 makes it illegal to buy or sell human organs in India.
“Now, the question is how will he (TRANSTAN Member Secretary) decide whether they asked Indian patients, how many (were found) fit... I think they are bypassing Indian patients and giving to foreigners. We had a meeting of all the stakeholders and decided on clear-cut guidelines in the case of allocating organs to foreigners. Three of four hearts in Chennai were given to foreigners... I was briefed by someone that there is something fishy and we should sort it out. Then we completely stopped going to foreigners for about two months,” Prof. Bhandari said, in a conversation with The Hindu .
He recommended that TRANSTAN form a committee to look into claims made by private hospitals to the effect that Indian patients developed fever or cold at the last minute and hence became ineligible for the transplant.
“Health is a State subject, we can only frame national guidelines. States should implement the guidelines. They have to take strong action... they are the appropriate authority to take steps to unravel the truth,” he added.
In 2017 alone, foreigners were the recipients in 31 heart transplants, 32 lung transplants, and 32 heart and lung transplants. During the same year, Indians were the recipients in 91 heart transplants, 75 lung transplants, and 6 heart and lung transplants.
Interestingly, while the wait list of active patients as on June 9, 2018 had 53 foreigners, it had 5,310 Indians.
Kerala CM intervenes
There are also allegations doing the rounds that organs were harvested without the consent of a brain-dead patient’s family to meet the needs of foreign nationals.
Last month, Kerala Chief Minister Pinarayi Vijayan wrote to his Tamil Nadu counterpart Edappadi K. Palaniswami seeking an investigation into an allegation levelled by a family in Kerala that a private hospital in Salem had retrieved organs from an accident victim without consent.
The heart taken from the brain-dead patient, P. Manikandan, was shifted to Chennai and given to an Ukrainian. The lungs were given to an Israeli national.
An in-depth investigation headed by a Deputy Superintendent of Police is on to unravel the circumstances that led to the harvesting of organs from the victim and how they were allocated to the foreign patients.
Even as the probe was gathering momentum, the Health Department relieved Dr. P. Balaji from the key post of Member Secretary of TRANSTAN. The official said he chose to resign from the post due to “personal reasons.”
Asked about allegations that hearts retrieved from Indian patients were given to foreign nationals, Dr. Balaji said the allocations were made strictly according to rules.
“We allowed the organ to go to international patients only after the private hospitals confirmed on the WhatsApp group that there were no Indian patients eligible for the transplantation. Though some hospitals initially proposed the hearts for Indian patients, they made a change at the last minute, saying that the patient had developed fever or that there were logistical difficulties, and hence the organ would be given to a foreigner. We have to go by what the transplant surgeon of that hospital says... there is no mechanism to ascertain the genuineness of the claim made by doctors that Indian patients suddenly developed fever or cold,” he said.
At a high-level meeting on allocation of organs to foreign nationals held in New Delhi on April 3, 2018, it was observed that “the cost of a transplant, especially a heart transplant, in Chennai is so high that only foreigners are able to afford (it).”
It was decided that strategies for maximising utilisation of organs by Indian recipients should be worked out by State governments and post-transplant data on follow-ups and outcome of transplants for every recipient be compiled.