NMC kidney patients worried

NEW DELHI, May 24: Many of the hundred-odd patients who received kidney transplants at the Noida Medical Centre NMC are worried about thei...

NEW DELHI, May 24: Many of the hundred-odd patients who received kidney transplants at the Noida Medical Centre NMC are worried about their fate because their doctors are in jail and no other specialist will treat them.The condition of two of the patients, one a woman, is critical. They were operated on just two days before the arrests of Dr. Harsh Jauhri and Dr. Sanjay Wadhwan following the sensational raid on NMC.

None of the patients want to be identified fearing arrest under the stringent provisions of the 1994 Human Organs Transplantation Act HOTA.

For the same reason, no doctor wants to be involved with a kidney transplant patient.

Life after a kidney transplant is not easy. Patients have to be kept on constant medication with immuno-suppressant drugs like cyclosporin to prevent rejection of the kidney. Antibiotics are given at the slightest hint of infection.

Besides, close and continuous monitoring of blood urea and creatinine levels has to be carried out and if necessary re-dialysis recommended. All this requires the supervision of a nephrologist

Improper dosage levels of medicines or fluctuations in urea or creatinine levels could mean irrevocable rejection of the kidney which if unattended is a sure invitation to death, a specialist said.

Some doctors blame the continuing racket in kidneys on the failure of the government to put in place a cadaver-based organ donation programme as envisaged under HOTA. Such a programme would entail motivating people to donate their organs, after their death, to an organ bank and setting up infrastructure for the efficient harvesting and transplantation of organs.In developed countries, such essential details as tissue and blood type are entered into a register of donors and matched against details of potential recipients through a computersied network. A similar register is being maintained at the All India Institute of Medical Sciences AIIMS.

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But abroad, cadavers or patients are often flown by helicopter to save time because kidneys do not last beyond 24 hours after death. Dialysis is at best a temporary life support system which is extremely painful apart from being unaffordable to most people. Patients on dialysis need frequent transfusions and suffer clots and fistulas. One kidney recipient said he would not have agreed to buy a kidney, except that there seemed to be no other way he would ever get to live a normal life and he was tired of waiting to be put on dialysis. The machines are in short supply.

Although donations by blood relations is allowed, a patient may not have a relation healthy enough or favourably disposed towards parting with a kidney.8220;There seems to be no dearth of poor people who have more pressing needs than an extra kidney in this country,8221; an IMA doctor said adding that the government could ensure handsome compensations for kidney donors until a cadaver-based programme comes into being.

According to Dr. H. Julka, a well-known city nephrologist who has carried out more than 500 kidney transplants, HOTA is unrealistic if only because there are few trained cadaveric transplant specialists in the country.But HOTA was prompted by the large-scale trading in kidneys with foreigners flying into the country by the plane-load for transplant operations and paying up to Rs 20 lakh for an operation.

An estimated 20,000 kidney transplant operations were carried out annually in India before 1994 when HOTA came into being, turning the country into a kidney-bazaar8217;. The actual donors received only a fraction of the proceeds with the money skimmed off by touts, doctors and nursing homes.

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