Organ donation: Long waiting lists, winding procedures

Anant Acharya had two options when the doctors informed him that both his kidneys were functioning at 10% capacity. The first was to undergo regular dialysis and the second was to try for an organ transplant. “I began reading online, and learnt about the long waiting list and the many parameters involved. I began to wonder, how will the future be? Several sleepless nights of worrying followed,” says Anant.

In the state, the organ donation and transplantation network needs improvement. In fact, only 68 hospitals have been listed as registered organ transplant centres in Karnataka. This barely comes close to meeting the need, say experts and doctors.

Crucial to the process of donation according to Hemal Kanvinde, who works on advocacy activities with Multi Organ Harvesting Aid Network (Mohan) Foundation, is the presence of medical staff at hospitals who can make timely calls. “Certifying a brain death, for instance, is a very clinical issue that requires expertise. It is essential to take action for timely organ retrieval. While larger hospitals have brain death committees, composed of a neurologist, intensivist and other doctors, smaller hospitals do not have this facility at all,” she says.

In fact, beyond certification, brain death maintenance is so critical, it must be taught at all medical schools, says Hemal. This includes ensuring organs continue to receive blood flow and remain fit for retrieval, transport and transplantation.

When a hospital identifies and certifies a patient as brain dead, they inform the state authority with relevant details. The authority then identifies patients on the waiting list best suited for the transplant and alerts the concerned hospital. Organ allocation is determined by medical criteria. The transplant coordinators of the hospital then coordinate the process.

“We need to increase the number of hospitals that can certify brain death and ensure smooth protocols in hospitals when donation does happen. Every hospital should have a transplant coordinator and a grief counsellor to spend time with the family and support them,” she adds.

It was this long-winded process that seemed formidable to Acharya when he was diagnosed.

This was when his wife stepped forward to donate her kidney.

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Thus began a lengthy process of several rounds of counselling, medical evaluation and legal assessments. “Some of the tests cost Rs 25,000, others cost Rs 14,000. My wife’s medical evaluation alone cost Rs 1.5 lakhs and took around three months. Then, mine began.”

Legal assessments proved the biggest challenge, says Anant. “We had to run to and fro to hospitals and offices. Even with all the valid documents, the process kept getting pushed, had to pay bribes to get our applications processed,” A lack of awareness at government offices about procedures further hampered the process, he adds.

Finally, after nearly two years, the surgery was scheduled and the transplant was successfully completed.

“I waited for 24 months, but many wait for years. The expenses build up as your body deteriorates. Lots of people do not have a support system. I was able to manage because I had corporate insurance,” says Anant, who works as a support engineer for SAP Labs.