Cadaver transplants: poor show by govt hospitals

Despite a positive trend in cadaver transplants this year with 13 organs already transplanted in the city-all in private hospitals,the government hospitals continue to fare badly.

Written by Jinal Shah | Mumbai | Published:February 22, 2009 2:10 am

Lack of awareness and shortage of counsellors hit initiative

Despite a positive trend in cadaver transplants this year with 13 organs already transplanted in the city-all in private hospitals,the government hospitals continue to fare badly. The main reason,according to Dr Vatsala Trivedi,Zonal Transplant Coordination Centre (ZTCC),is the failure of these hospitals in identifying brain dead patients.

“Four years on and none of the three civic body-run tertiary care hospitals registered to conduct transplants under the Transplantation of Human Organ Act,1994,has identified a single brain dead person,” said Dr Trivedi.

B Y L Nair Hospital at Mumbai Central,King Edward Memorial Hospital at Parel and Lokmanya Tilak Municipal General Hospital in Sion were authorised to conduct kidney transplants in 1995. Not a single brain dead case has been identified in these hospitals since 2005. There is a waiting list of 11,070 patients for kidney transplants and 55 for liver transplants in the city.

Apart from 20 private hospitals,one defence-run,one state-run and three civic body-run hospitals are authorised to conduct such transplants. “Last month,for the first time INS Ashvini identified a brain dead person,” said Dr Trivedi.

“We do not have dedicated counsellors,and a committee of physicians,neurophysicians and neurosurgeon cannot identify a case without a counsellor,” said Dr Ravi Ranade,dean,Nair Hospital.

The Brihanmumbai Municipal Corporation (BMC) is now planning to appoint transplant coordinators or counsellors at these medical institutions and five peripheral hospitals.

However,Dr Trivedi says appointment of counsellors will not be of great help in identification as the role of counsellors comes only after the person is certified brain dead by the authorised committee.

“When a person is dead,the treating doctor calls for a doctor on the panel to certify the death as brain death. The death is certified twice after a battery of tests and simultaneously transplant coordinators counsel the relatives. However,due to lack of awareness relatives do not agree for transplants,” said Dr T D Nadkarni,professor of neurosurgery at KEM Hospital,who is also a member of the committee to certify brain deaths. “The need of the hour is an awareness programme,” he said.

The BMC also plans to make five peripheral hospitals — Bhabha hospitals in Kurla and Bandra,RN Cooper Hospital in Vile Parle,Bhagwati Hospital in Borivali and Rajawadi Hospital in Ghatkopar — retrieval centres. “We are in the process of appointing dedicated transplant counsellors for cadaver transplants,” said Dr Sanjay Oak,dean of King Edward Memorial Hospital.

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