Cadaver organ transplants go up but demand outstrips supply

Cadaver organ transplants go up but demand outstrips supply

Organ donation: Kidney most sought-after body part for transplant

Cadaver organ transplants go up but demand outstrips supply

There seems to be a steady increase in the number of deceased donor organ donations (cadaveric transplants) in Karnataka.

From 39 deceased donor organ transplants in 2014, the number has risen to 70 in 2016. This year alone saw 32 organ transplants, with the number of kidneys being the highest.

“The demand for kidneys is more because a lot of diseases like diabetes, blood pressure, misuse of painkillers, use of aspirin due to over-the-counter sale, etc, affect kidneys more than any other organ,” said Dr T S Prabhakar, Joint Director (Medical), Department of Health and Family Welfare, Karnataka.

With 3,000 patients waiting for organ transplants, there is a shortage of organs being donated in the state.
“The number of organ transplants has increased, but there should also be a match between the donor and the recipient,” said Manjula K U, the chief transplant co-ordinator, Jeevasarthakathe.

Jeevasarthakathe, earlier known as ZCCK (Zonal Coordination Committee of Karnataka for Transplantation), is an independent body that monitors and operates cadaver organ transplants in the city. It is now taken over by the government of Karnataka and has been expanding its reach across the state.

Hospitals inform Jeevasarthakathe whenever there is an organ donation by patients who are declared brain-dead. It is through this committee that the transplants are routed as it holds a registry of people in need of organs.

According to doctors who conduct organ transplants, there are many reasons for considerable disparity between the requirement of organs and the number of donations that follow.

“The match between blood groups and body types of donor and recipient, availability of the organ at a particular time, proximity of the patient from the hospital, post-transplant medication that may cost around Rs 18,000, etc, play a great role in a transplant taking place,” said Dr Bhagirath Raghuraman, head of heart transplantation, Narayana Health City.

Counselling families
According to experts, people are not reluctant to give their loved one’s organs, but they are not aware of the nuances of transplant and the reasons why it should take place.

There is great potential in the number of cadavers that come into hospitals from which organs can be retrieved, while families have to be counselled clearly in order to get their consent, said Dr Olithselvan, chairman, division of liver transplant, Manipal Hospitals.

“We need to turn our attention to doctors. Not only surgeons, but also neurologists and neurosurgeons who need to come forward and do their job. We should be transplanting one organ every day with such a potential,” Dr Olithselvan said.

Doctors should know that this is not an extra burden but part of their curriculum to explain to the people.
“The doctors concerned do not find enough time to educate the general public about what is brain death, that it is as bad as death itself. That way with consent from patients and their families we can retrieve more organs,” Dr Prabhakar said.

Dr C N Manjunath, the director of Sri Jayadeva Institute of Cardiovascular Sciences and Research, said there were certain religious beliefs where the family thinks the person should not be ‘hurt’ after their death. Although such emotional barriers are breaking, the number of donations is much below the requirement. “ICUs in hospitals should also be sensitised and there should be co-ordinators who can manage such matters,” he said.

Future requirements
Jeevasarthakathe is planning to expand its reach for better service.  “Now organ transplant is being taken up only in Bengaluru and Mangaluru and to some extent in Belagavi. We are planning to start three more centres in a year. We are planning to retrieve the organs in all district hospitals. In each zone, we will create transplant centres,” Dr Prabhakar said.

Under the plan, all the 30 districts will have one retrieval centre. “We now have a position for a convener which did not exist earlier, who is supposed to look after awareness programmes. We have a set of five transplant co-ordinators to assist him,” he said.

According to doctors, there should be grief counsellors, who are non-medical staff, to help the patient’s family understand the nuances of organ transplant. They will be hired by the government.
A heart transplant that changed his life
Ashok Chungani, a 59-year-old wedding planner, is the recipient of a heart of a 30-year-old who died in an accident.
He underwent the heart transplant two years ago after a four-month wait. He was asked for a transplant as his heart was pumping at a rate of 20% and he was unable to even move around inside his house.
“I was care-free for the first two months, but the next two months, I did not want to live and was frustrated,” Chungani said. “I have the heart of a 30-year-old. I live on an angel heart. My energy is back,” he said.
Chungani has now resumed work and continues taking medication as advised by the doctors. He said he would love to meet the young man’s parents who gave him the heart.
“I will keep searching for them if it is possible,” he said.

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