In post-Covid-19 Bihar, kidney transplants pick up amid fears of infection

Most of the post-Covid-19 renal transplants in the state have been done in the last two months. The Paras HMRI Hospital, did three of them, while the Indira Gandhi Institute of Medical Sciences (IGIMS), an autonomous institution funded by the state government, and the Ruban Hospital did two each.

Kidney transplants are gradually gathering momentum in Bihar after a gap of nearly six months due to the Covid-19 pandemic. Doctors though are guarded given the second wave of coronavirus infections with the state reporting over 2,000 cases and 13 deaths over the last eight days — the highest single-day spike in cases being 488 on April 1.

Bihar reported 12 kidney transplants in the last six months at the four facilities approved by the health department. Doctors had put on hold all such procedures given the high probability of infection among patients on immunosuppressive drugs. (Image used for representation). (AFP PHOTO.)

Bihar reported 12 kidney transplants in the last six months at the four facilities approved by the health department. Doctors had put on hold all such procedures given the high probability of infection among patients on immunosuppressive drugs, after the Centre announced a nationwide lockdown on March 23, last year.

The Ruban Memorial Hospital, accredited to the National Accreditation Board of Hospitals (NABH), had done the last such procedure on two patients on March 20. The two male patients — a 34-year-old from Hajipur and a 19-year-old from Patna — were discharged from the hospital on Thursday.

“These were our first post-Covid-19 renal transplants since the previous one done at our hospital in 2019,” said Dr Satyajit Kumar Singh, managing director and senior urologist of the Ruban Hospital.

Most of the post-Covid-19 renal transplants in the state have been done during the last two months. The Paras HMRI Hospital, accredited to the NABH, did three of them, while the Indira Gandhi Institute of Medical Sciences (IGIMS), an autonomous institution funded by the state government, and the Ruban Hospital did two each.

The Paras HMRI hospital, however, was the first facility in the state to do a renal transplant post Covid-19, when it successfully undertook the procedure last October.

“After our last pre-Covid-19 renal transplant in February 2020, we had temporarily stopped doing the procedure at our centre till last September. We gradually re-initiated it, having done one renal transplant in October, two each in November and December last year and three in February this year,” said Dr Syed Asif Rahman, medical superintendent, Paras-HMRI hospital.

The IGIMS did its first post-Covid-19 kidney transplant in February and then in March, said Dr Om Kumar, professor and head, department of nephrology.

“The first post-Covid-19 renal transplant at IGIMS was done in February on a 24-year-old man from Patna’s Baktiyarpur block and the second in March on a 25-year-old man from Munger. Both are doing fine,” he added.

“We have planned another kidney transplant on April 6, but we will wait and watch the trend of Covid-19 infection in the state because we do not want to put the patient and their kidney donors at risk if the coronavirus infection increases in the state,” added Dr Kumar.

Dr Pankaj Hans, head, department of nephrology, Ruban Memorial Hospital and an associate professor at the Patna Medical College Hospital, said putting on hold renal transplants was not the solution in the present scenario.

“We are much better prepared to tackle the pandemic now and have also gained in experience. Kidney transplant is a better mode of therapy in comparison to dialysis, as the patient’s quality of life improves. We should not deprive those who have donors and are willing to undertake the procedure,” said Dr Hans. He, however, cautioned, that doctors need to be on their guard.

“The new strain of the Covid-19 virus may have higher transmissibility but is less severe in terms of mortality rate. We will adopt a cautious approach in doing kidney transplants, given the second wave of Covid-19. We need to be careful with patients taking immunosuppressive drugs and regulate their medicines because they are prone to contracting the infection,” he added.

The Ruban Memorial Hospital, which was the first in the state to carry out a successful kidney transplant in 2008, has done 14 such procedures so far.

“The state government told us to wait till it framed its own rules, governing organ tissue transplant. We then lost three to four years because of a change in ownership of our hospital and the government rules on the mandatory three-year cooling off period,” said managing director Dr Singh.

Ruban Hospital now plans to initiate bone marrow transplant next year. It will also add to its existing capacity of 210 beds and an additional 186 beds in its annexe building next month. In addition, it has 50 existing beds for Covid-19 care that is separate from its main building, and another 50 beds for women and children in the hospital.

In terms of kidney transplant, the IGIMS leads the pack in the state, having done 73 procedures so far since it initiated it in 2016. The Paras-HMRI hospital had done 38 after introducing the facility in January 2018.

The BIG Apollo hospital hasn’t done any kidney transplant procedure.

“We got the government approval to perform kidney transplants only last month. We have the requisite infrastructure in place,” said nephrologist Dr Harsh Vardhan.

Quoting statistics, Dr Hans said 1.50 lakh patients required kidney transplant but only 7,500 transplants, on an average, were done in India every year.