950 patients like  Tarun Gupta are waiting for kidneys in Mumbai

Former table tennis player Tarun Gupta has been waiting 2 years for a
kidney...

950 patients like Gupta are waiting for kidneys in Mumbai. At the present rate, it will take around 63 years for the backlog to be cleared. Here's why None of the hospitals HT spoke to had trained grief counsellors - a government requirement - to counsel relatives of brain-dead patients. The excuses ranged from "doctors are the best counsellors" to "the medical
superintendent himself counsels relatives" and the "ICU staff is trained to talk to relatives".
Neha Bhayana
Mumbai

THE CITY has 21 private and civic hospitals authorised to retrieve and transplant kidneys, but they average only 15 cadaver kidney (from the bodies of brain-dead patients) transplants a year. Clearly, the hospitals don't do what they are supposed to.Most of these hospitals don't report deaths when the brain stops working. They don't counsel relatives to donate organs, according to officials at the Zonal Transplant Coordination Centre (ZTCC), a government organisation that oversees the transplantation programme and maintains a waitlist.

Whenever a patient's brain stops functioning, hospitals must call in a team of experts to certify the patient brain dead, according to the Transplantation of Human Organs Act (1994).
The patient has to be screened for infections and consent of relatives sought to remove organs, either kidneys or others, including the eyes, heart and liver. If all goes well, the patient has to be operated on immediately and the coordination centre alerted. One kidney can be used by the hospital and one must go to a patient on the waitlist. "Even if one per cent of relatives of brain-dead patients in every hospital agree to donate the organs, the backlog could be cleared," said Dr. Vatsala Trivedi, General Secretary of ZTCC. Almost five to 10 per cent of deaths in intensive care units are brain deaths.Only Jaslok, Lilavati, Nanavati, Harkishandas and recently Wockhardt Hospital report brain deaths and carry out transplants. The others, especially civic hospitals, do not even report brain deaths regularly, said
coordination centre officials. Breach Candy Hospital in South Mumbai, for instance, has not carried out a single cadaver transplant.

While the hospital's CEO General Vijay Krishna agreed that they had not retrieved any organs, he said there had been only "1 or 2 brain-dead cases" and that the families had not agreed. "The Indian psyche is not geared up for this," Krishna said. "Families of braindead patients are resistant and don't want to give away the organs. We are trying." Bombay Hospital's Medical Director Dr. R B Patel, too, held the families of patients responsible for the lack of cadaver transplants at the hospital.

The state-run JJ Hospital is another that has not done a single transplant. Dean Dr. P H Shingare said this was because the hospital did not have the required experts. "Specialists are required to keep the kidneys live after death of the patient but we don't have a full-time nephrologist (a kidney-disease specialist)," he said.Asked why the hospital had not set up a transplant coordination team,Shingare said the hospital had appointed several doctors but they quit.The civic KEM Hospital has carried out only four to five cadaver kidney
transplants since 1997.

Dean ME Yeolekar said that this was because the hospital had "too much patient load and a range of activities to allow them to focus on cadaver transplant"."We carry out three kidney transplants from live donors every month," he said. "This shows that we are trying but there are many hurdles in carrying out cadaver transplant like public inertia and lack of awareness."
None of the hospitals HT spoke to had trained grief counsellors - a government requirement - to counsel relatives of brain-dead patients. The excuses ranged from "doctors are the best counsellors" to "the medical superintendent himself counsels relatives" and the "ICU staff is trained to talk to relatives". And so it's not surprising that 2007 has seen six kidney transplants so far. At this rate, it could take years before people like Gupta can be liberated
from dialysis machines. Or die waiting.

Neha.bhayana 'I am not rich enough to go abroad, so I just have to wait' TABLE TENNIS champion Tarun Gupta, 34, had returned from a national-level game seven years ago when he was put on medication for dehydration. His body didn't accept the medicine and his kidneys started shrinking till they became almost dysfunctional. As he does not have relatives who can donate a kidney - his mother is no more and father is over 80 years - he registered for a cadaver kidney in 2005.

Since then, he has not stepped out of Mumbai. He spends every day waiting
for the call that will give him a new life. "What if I get a call and I'm not ready?" said the BA graduate, who now works at a clerical level at the Employees' Provident Fund office.One year back Gupta did get a call. But he did not have the Rs four lakh required for transplantation and post-operative care. Now, he has collected money and says he is the first or second person on the list of 950 persons waiting for a kidney.Twice a week, Gupta is tethered to a dialysis machine. He also needs injections. All this costs him around Rs 10,000 every month, but Gupta earns only Rs 7,000 a month. His colleagues help him collect the required money. Gupta has done everything he could to get a kidney. He even ran for the
Standard Chartered Mumbai Marathon in January to spread awareness about
organ donation."I don't have any relatives who can give me a kidney and I am not rich
enough to go abroad for a transplant. I just have to wait," he said.16.5% Of Indians suffer from chronic kid ney disease, which requires dialysis or transplant 0.5% Of kidney transplants are cadaver transplants 2.5% Of those who need kidney transplants actually get it 1.20 lakh Is approx. annual requirement of kidneys in the country (Figures: National
Registry,Nadiad Kidney Hospital, Gujarat)

Publication : HT: Section : Metro; Pg : 2; Date : 30/8/07
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