Ray of hope for patients with end stage organ failure

Newdelhi,February17 2012: Patients with end stage organ failure in the state can hope to prolong their life with the state government launching the Cadaver Transplant Programme. The programme paves the way for transplantation of vital organs harvested from brain-dead person in patients with chronic ailments.The organs that can be transplanted include eyes, heart, lungs, liver, pancreas, kidneys, heart valves, skin, bones, bone marrow, connective tissues, middle ear, blood vessels and small intestine. Though the government of India had passed the Transplantation of Human Organs Act in 1994, the state government had not framed rules to implement it in the state, which has the highest number of heart patients in the country and a large number of patients with liver and kidney related diseases. The orders issued this week give legal backing for the organ transplantation. Issued under the Federal Act, the orders specify norms for determining brain death and procedures for removing and transplanting the organs. The consent of relatives is a must for removing organs from brain dead persons and the person requiring organs needs to register with the health authorities. The order contains detailed guidelines for determining priority in making the organs available to patients. A provision would be incorporated soon for allowing donors to make donations to patients of their choice. The government has set up a Core Committee for Cadaver Transplantation under the supervision of the Director of Medical Education to coordinate various functions related to the cadaver transplantation and a Cadaver Transplant Advisory Committee under the Health Secretary. The Cadaver Transplant Programme was formulated on the basis of the report of an expert committee, which studied the implementation of the programme in the neighbouring states of Tamil Nadu and Andhra Pradesh. Tamil Nadu has been a role model in cadaver transplantation. The state recorded a deceased donor rate of 1.3 per million as against 0.15 per million population in the country as a whole. Experts say that if the country can push the rate to the Tamil Nadu level it can easily meet the demand for organs. The current demand in the country for kidney transplants is 150,000; liver, 200,000 and heart, 150,000. India now does only 3,000 kidney transplants and 500 liver transplants a year because there are not enough donors. Though 140, 000 lives are lost in the country through road accidents every year, the precious organs that could save the lives of many have been going waste. Kerala too could meet the demand for vital organs to a great extent if a programme was in place to retrieve the organs of nearly 4000 road fatalities a year. The Cadaver Transplant Programme may help the state to tap this potential. However, experts say that simply laying the guidelines for cadaver transplant alone will not solve the problem. Though it simplifies the legal procedures there are social and ethical issues to be tackled. In spite of high literacy people have not been coming forward to donate the organs. Health activists believe this is mainly because of ignorance, superstitious beliefs and religious restrictions. Private initiatives in the past have not been able to break these barriers. The Society for Organ Retrieval & Transplantation (SORT), one such initiative launched under the auspices of Indian Medical Association in 2000 could attract only 1500 donors in the last 12 years. The society had to wait till 2004 for the first ever multi-organ transplantation. It was made possible by the members of the family of one Ramachandran Nair, who was declared brain dead following a road accident in June 2004. Three patients received the deceased’s live and kidneys. Sort has been organizing seminars on ‘Religion and Organ Donation’ involving religious heads to create awareness on organ donation. The Rotary Club of Trichur City has also been running a campaign involving doctors, NGOs, hospitals and others concerned to encourage organ donation. It has set up a body called RISORT (Rotary Initiated Society for Organ Retrieval and Transplantation) to popularise cadaver transplant in the state