According to experts at the Post Graduate Institute of Medical Education and Research (PGIMER), the cost of cadaveric transplant for poor patients can reduce drastically if National Organ and Tissue Transplant Organisation (NOTTO) provides financial help and releases grants to support organ donation projects.
This includes giving out immunosuppressants (drugs that lower the body’s ability to reject a transplanted organ, otherwise called anti-rejection drugs) for free, which often turn out to be more expensive than the transplant itself. Keeping this in mind, PGIMER has written to NOTTO seeking details about providing free immunosuppressants to patients. They have also requested the organisation for more grants.
While the cost of heart transplant surgery is around Rs 80,000 to Rs 1 lakh, the cost of immunosuppressants is rather high and patients end up paying Rs 5 lakh per year.
Talking about the effectiveness of the scheme if it comes into practice, Dr A Bahl, cardiologist at PGIMER, said, “The regional transplant programme has a provision where immunosuppressants will be given to patients undergoing transplant. A heart transplant patient spends around `5 lakh during the first year after transplant and around Rs 1 lakh during the second year. The cost goes down in the subsequent years.”
Dr Bahl further said, “Now, if ROTTO provides these drugs, then the cost of heart transplant would really come down from Rs 5-6 lakh to Rs 1-2 lakh for the first year.”
Similarly, the cost of kidney transplant will also come down from `3.5 lakh in the first year to around `1 lakh.
But in this case, only those patients can receive help who have received organs from brain-dead patients.
Dr Rajesh Chhabra, neurosurgeon, PGIMER, said, “Brain death is the total and irreversible loss of all brain functions (the upper brain structure and brain stem). It is a death and should not be confused with coma or persistent vegetative state. Brain death is determined in the hospital by a team of doctors not associated with a transplantation team.”
Dr Vipin Koushal, nodal officer, ROTTO (Regional Organ and Tissue Transplant Programme), said there was one such provision in ‘Highlights of National Organ and Tissue Transplant Programme (NOTP) and Operational Guidelines for its Implementation.’
“As per the provision, an immunosuppressive regimen, that costs between Rs 6,000 and Rs 12,000 per month, is allowed for each cadaveric transplant recipient for up to 100 patients per year. This is given to those patients who fall below the poverty line and have received organ/tissue through the NOTP networking system,” said Dr Koushal.
He also added, “The PGI has already written to NOTTO seeking clarity on its implementation and requesting release of funds to support such patients.”
A PGIMER faculty member said, “Many patients do not come forward for transplant as they cannot afford the cost of treatment. Helping recipients financially will boost the organ transplant project and many lives can be saved.”