Liver disease patients run out of time for organ transplant

Long waiting period, costly surgery, lack of funds put them to hardship.

It’s a tough battle for survival for patients suffering from chronic liver diseases. A long waiting period for organ donation, coupled with a costly surgery and acute shortage of funding, is putting them through an unsympathetic struggle. 

As of August 5, 2014, at least 263 patients had registered for liver transplant in Karnataka through the Zonal Co-ordination Committee of Karnataka for Transplantation (ZCCKT). This is the only committee recognised in the State for facilitating organ donations. The waiting period for organs stretches anywhere from four to eight months. 

On the funding front, even though the government launched the Liver Cancer and Transplant Clinic at the Bangalore Medical College and Research Institute recently—which promises surgery at as low as Rs 2.5 lakh—the scheme is yet to take off. The same procedure in a private hospital costs no less than Rs 25 lakh. 

Here is the case of 55-year-old Raghavan for instance: A former bank employee in Bangalore, he was recently diagnosed with end-stage liver disease. Doctors told the family that a transplant was absolutely needed within six weeks. His family left no stone unturned in ensuring a transplant at the earliest. 

But their wait only got prolonged due to a long queue of patients for B+ve blood group. The wait gets longer for both B +ve and O+ve blood groups. At present, 81 people with B+ve and 88 with O+ve blood groups are awaiting transplant. The family's search for partial funding has not yielded any result either. 

After being told to wait for at least six months, Raghavan’s son Srikanth K decided to go the ‘Live Donor’ way. But this too was ridden with hurdles. “I decided that I myself would be the donor. But I could not clear the requisite medical tests for the surgical procedure,” Srikanth told Deccan Herald. He has been asked to shed eight kilos in six weeks to be able for organ donation. 

The fallout of these situations is that a patient who could have been saved by timely transplant turns critical by the end of the waiting period. Dr Kaiser Raja, Consultant, Liver Disease and Transplantation, BGS Global Hospitals, said that at BGS alone, at least 45 people were currently waiting for liver transplant. 

On a rotation basis, hospitals secure cadaver organs available through the ZCCKT. The transplant is done for the patient who is most critical in the hospital at that moment. For live donors, organs of only family members of the patient are accepted. More often, the family members might not clear all the prerequisite medical tests. For instance, if a person is more than 50 years old or is diabetic or is overweight, they cannot donate. 

Dr Raja proposes a national and state registry of donors as one of the solutions to the crisis. He also points out that doctors have to proactively test for brain deaths in critical cases. “If doctors in ICU and trauma care test for brain deaths, the family can be consulted about donating that person’s organs. There have to be counsellors for this,” he explained. 

Meanwhile, the ZCCKT faces a challenge in securing cadaver organs. Manjula K U, chief transplant co-ordinator, said that while some people were too shocked about the prospect of donating their organs, others were driven by religious sentiments. There is yet another set of people who go after monetary benefit, she added. 

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