They are in dire need of a kidney, heart or liver, but the 80 potential recipients of these organs registered on the Transplant List in Karnataka, are still waiting. Not a single cadaver transplant (CT) has taken place in the State since the Zonal Co-ordination Committee of Karnataka (ZCCK) for Transplantation was set up under the State Government aegis in February 2005.

CT is a process by which organs, including kidney, liver and heart, from a brain-dead individual are retrieved and transplanted into an individual who has an irreversible end-stage organ failure. While only 43 CTs have taken place in Karnataka since 1995, Mohan Foundation, an NGO, has co-ordinated no fewer than 314 CTs in Tamil Nadu since 2000.

The ZCCK itself has had teething problems, taking two years to frame guidelines and overcome infrastructural constraints, to become fully functional by February 2007. To gain momentum, the programme itself has many challenges to overcome.

ZCCK Transplant Co-ordinator Jency Antony says there have been just two cases of brain death reported in the past one year. “Many doctors are reluctant as there is a misconception among patients’ relatives that the doctor did not do enough to save the patients and is more interested in retrieving the organs for transplantation to save someone else,” Ashley D’Cruz, Head of Pediatric Surgery at Narayana Hrudayalaya, says.

‘Awareness lacking’
A doctor who wished to remain anonymous recalls an incident a few years ago when police officials were called in to complete the post-mortem proceedings.

“Seeing the ECG ticking, they were upset with the hospital authorities as they were unaware of the concept of brain death, a condition where the heart beats, but the person cannot come back to life,” he claims.

For some on the Transplant List, it has been a futile wait. Anju Chengappa’s father, a chronic renal failure patient, registered in 2004. “Two years down the line, his diabetes has become so acute that even if a kidney is available today, it would be too risky to go ahead,” says Ms Anju.

Advantages
Despite these drawbacks, CTs can help avoid ‘live transplants’, where an organ or portion of it is transplanted from a living relative, says Dr D’Cruz. The potential risk involved, though small, to the donor by this method, can be completely done away with, if there is a cadaver programme.

To foster the programme, ZCCK has proposed to the Health Department that permits be issued to doctors to identify brain death and ask licensed hospitals to appoint trained counsellors, says Jency.

The committee also plans launching programmes to take on its biggest challenge: Lack of awareness among the public. “The onus is on the public to rise to this need and pledge their organs,” says Dr D’Cruz.