HT:Cadaver organ donation: state gets tough with hospitals :Nov 28th 2007

Cadaver organ donation: state gets tough with hospitals

Neha Bhayana, Mumbai 

Many people remain on the waiting list for over three years before they get a kidney. Several others don't even live to see the day when a cadaver organ is available. DR Vatsala Trivedi Zonal Transplant Coordination Centre general secretary

Hospitals Registered as organ transplant centres will have to carry out at least two cadaver transplants a year, failing which they stand to lose registration for organ transplant.

The move would give hope to hundreds of patients with failed organs. In Mumbai, around 900 patients are waiting for cadaver kidneys but only 14 transplants have been carried out this year, according to the Zonal Transplant Coordination Centre (ZTCC) that maintains a list of patients. At this rate, it would take about 60 years to clear the backlog.

Cadaver transplants are those in which organs of brain-dead patients are retrieved and harvested into those awaiting the organ. The state govern ment has mooted the plan to ensure that hospitals report brain deaths and counsel the kin of the brain dead person on the need for organ donation. If such an effort is not made, hospitals will not be allowed to carry out transplants using organs from living donors either.

"If hospitals want to remain registered for organ transplantation they should promote cadaver transplant which is legally recognised," said Amitabh Chandra, principal secretary of Medical Education and Drug Supplies. "De-registered hospitals may have to pay more to register again. We still have to work this out," Chandra added. Currently, hospitals have to pay Rs 1000 to register as transplant centres.

The Directorate of Medical Education and Research (DMER) will soon issue letters to over 50 hospitals across the state, which are recognised as organ transplantation centres, seeking explanation for the dismal number of cadaver transplants. "If the explanation submitted is not satisfactory, the hospital would be issued a notice and de-registered," said Dr Pravin Shingare, joint director of DMER.

HT had on August 30 reported that a majority of the 22 recognised private and civic hospitals in the city neither report brain-death cases nor make any effort to counsel relatives of brain-dead persons on the need for organ donation.

The JJ Hospital and Breach Candy Hospital stand to lose registration as not a single cadaver transplant has been conducted at these hospitals till date.

Vijay Krishna, CEO General of Breach Candy, termed the government's decision as premature. "The government should encourage hospitals, not force them," he said, adding that the government should first spread awareness about cadaver organ donation. "Our doctors counsel relatives of braindead patients but they do not want to donate the organs," Krishna said.

Organ Transplant Act

The Transplantation of Human Organs Act 1994 illegalised the buying and selling of human organs.

Living relatives - spouse, parents, siblings and children are allowed to donate a kidney to the patient.

Living donors who are not near relatives but willing to donate "by reason of affection or attachment" have to seek approval of an authorisation committee.

The Act recognised brain-stem death for the first time in India, paving the way for cadaver-based organ transplant.

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