Investigations into a planned kidney transplant at Global Hospital in March this year with a father supposed to receive a kidney from an adopted son has led the state government to approach the National Organ and Tissue Transplant Organisation (NOTTO) for clarity and guidelines in situations where adopted children are prospective organ donors to their parents. The Transplantation of Human Organs Act, 1994, currently makes no mention of this scenario. “In this case of Global Hospital, the transplant permission was rejected. We were suspicious of the donor’s intentions. But for future, we need clarity. It has to be ensured that the adoption papers are not falsely made just before transplant permission is sought,” said Dr Gauri Rathod, assistant director at the Directorate of Health Services (DHS).
In March, Suresh Dhangache (51), admitted in Global Hospital as a chronic renal failure patient, had approached the Directorate of Medical Education and Research (DMER) to seek permission for a kidney transplant from his son Rishabh Dhangache (21). While the hospital’s local authorisation committee had approved the transplant, DMER’s six-member committee rejected it, citing donation was “not out of love and affection”. “We were initially not informed that the son was adopted. He was presented as if he is a biological child. It was later, after the permission was rejected, that the father came with an affidavit showing the donor was his adopted son,” said a member of the DMER committee.
Following the kidney racket that has been busted at the Dr L H Hiranandani Hospital in July, the DHS took suo motu action to investigate the attempted transplant at Global Hospital. In a written response to the notice issued by the DHS, Parel-based Global Hospital stated that they were aware that Rishabh was an adopted child. The hospital’s CEO Manpreet Singh Sohal told The Indian Express that “all procedures for organ transplant were followed” by the hospital.
The father-son duo had later approached the medical education department in Mantralaya for a second appeal against the DMER decision but they never turned up for the meeting, said health officials. According to Dr Anil Kumar, additional deputy director general of National Organ Transplant Program, the state government has the option of approaching the central authority in cases where they require consultation for matters beyond the transplantation Act’s purview. “The state government has all powers to reject a transplant if they find anything suspicious. However, if there is consultation required, they can approach the Central authority in New Delhi. The law, however, does not state anything about adopted children,” said Kumar. In Dhangache’s case, the state panel observed that the “donor is possibly looking for some benefit out of the transplant”.
Under the Transplantation of Human Organs Act, 1994, every live organ transplant requires permission from a six-member local authorisation committee formed by the hospital. The committee has two doctors, the hospital’s medical director, one state government official and two members appointed by the hospital. If the patient is from outside Maharashtra, a second approval is required from the DMER. The DMER committee comprises its director, the DHS director, the dean of JJ Hospital, two medical social workers and a retired DHS joint director. Meanwhile, the state government will continue its probe in the Global Hospital case to ensure that the hospital did not knowingly approve an illegal transplant. The hospital has already submitted its response and case details to the DHS. The donor and recipient for the kidney transplant have returned back to their home town Jaipur.