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1,400 lives on hold

Samiir Halady (36) has been waiting for seven years for a kidney donor. Tired of the wait, the Tardeo resident has now started a blog to record his life punctuated with painful dialysis sessions, reports Raghav Rao.

mumbai Updated: Mar 04, 2010 01:40 IST
Raghav Rao

Samiir Halady (36) has been waiting for seven years for a kidney donor. Tired of the wait, the Tardeo resident has now started a blog to record his life punctuated with painful dialysis sessions.

For patients like Halady, the wait for an organ transplant has only got longer. A primary reason for this is that hospitals are not identifying brain dead patients who can become potential donors.

In the last five years, the city’s four major public hospitals — JJ, KEM, Nair and Sion —authorised to conduct cadaver transplants have carried out only one such transplant.

Currently, there are more than 1,400 patients registered for organ transplants with the Zonal Transplant Coordination Committee (ZTCC). Nearly 300 are added to the waitlist every year.

“People usually have to wait for six to seven years before they receive an organ for transplant. Most don’t even make it that long,” said Dr A.P. Doshi, a nephrologist at Hurkisondas hospital.

Organs such as kidney, lung, liver and pancreas need to removed from a donor’s body before the heart stops beating. The Transplant of Human Organs Act, 1994, allows for transplant of these organs from patients certified as brain dead by means of tests such as the Apnoea test (see box).

According to ZTCC statistics, JJ hospital has the worst record. It has not identified a single potential brain dead donor since 2004. During the same period, KEM and Nair hospitals each reported two cases of brain deaths but neither resulted in transplants. Sion hospital has been the only one to carry out an organ transplant from a brain dead patient in the last five years.

On an average, city hospitals report about 246 deaths every day. Doctors claim that five per cent of total deaths in intensive care units (ICUs) are linked to brain stem death and such patients can be potential donors. The city’s record for the highest number of transplants in any year is a meagre 40.

Private hospitals fared better

Private hospitals have a better record. The 21 private hospitals with facilities for such transplants have collectively performed 119 transplants in the last five years.

“Private hospitals have fared better because they take the initiative to identify more cases of brain deaths. This becomes a secondary objective in government hospitals that are already overburdened by the high demand for intensive care beds,” said Dr Gustad Davar, director of professional services at Hinduja Hospital and former dean of JJ hospital. Some private hospitals have appointed grief counsellors who work with patients’ relatives to gain consent for organ donation.

Lack of identification of brain death cases

Medical practitioners blame the disinterest of doctors to identify cases of brain deaths for the deficit.

“The family’s consent for donation is sought only after the patient has been tested and diagnosed with brain stem death, but even that isn’t happening on a regular basis,” said

Dr Atul Adaniya, administrator of a private hospital in south Mumbai.

Convincing relatives is also tough. “It is an uphill task to convince relatives of patients to donate the organs. The only way to deal with this problem is to improve counselling efforts and increase awareness among the people,” said Dr Sandhya Kamat, dean of Sion hospital.

In other countries, a patient’s consent to donate organs is taken for granted unless they opt out during admission.