All Maharashtra hospitals with ICUs may be allowed to harvest cadaver organs soon
New guidelines mean that in addition to existing 200 centres, another 1,500 will be allowed to collect cadaver organs for transplantmumbai Updated: Dec 21, 2017 10:13 IST
In a move that could provide a major boost to cadaver organ donation, Maharashtra may soon allow private hospitals with intensive care units (ICUs) and trauma centres to retrieve organs from brain-dead patients. Currently, under the Human Organ and Tissue Transplantation Act, only hospitals with a licence to do so can harvest organs.
The new guidelines would mean that in addition to the 200 centres in the state already licensed to retrieve organs, about 1,500 more centres will be allowed to collect cadaver organs for transplant.
“This will most definitely improve the donor pool in the state,” said Dr Gustad Daver, who heads the Zonal Transplant Coordination Committee (ZTCC).
The state began framing the new guidelines after the Bombay high court, in August 18, expressed concern about non-utilisation of organs from cadavers. The court was hearing a petition filed by Swapnil Raut, a Dadar resident, who stood to benefit from a 71-year-old organ donor but did not get the organs because the private hospital the donor was admitted at did not have a retrieval licence.Though the donor had been declared brain dead, his organs could not be harvested.
The court said: “His vital organs… could have and should have been utilised for needy patients. It appears that there are no guidelines or mechanism available.”
According to data by ZTCC, there are approximately 3,500 patients waiting for a kidney transplant, 285 waiting for a liver and 30 for a heart.
An estimated 1.8 lakh people suffer from renal failure nationally every year; the number of renal transplants undertaken annually is only about 6,000.
It is the same for liver and heart transplants. An estimated 2 lakh patients die of liver failure or cancer annually in India, of which 105 to 15% can be saved with a timely liver transplant, according to NOTTO. While 25,000 to 30,000 liver transplants are needed annually in India, only about 1,500 are performed.
Dr SK Mathur, vice president, ZTCC, told HT that with more organ retrieval centres, more families may get convinced to take up the cause of organ donation, which will eventually shorten the wait for recipients listed for organ transplants.
“If the organ retrieval happens at the same place where the patient is admitted, the family does not have to run to another centre where the organs are retrieved,” Mathur said.
He said the process of shifting the patient from one centre to another could lead to cardiac arrest, drop in blood pressure, in which case the organs would not be healthy enough for transplant.
A state official, who is closely involved in the process of framing the guidelines, however, said, there is a flip-side to this issue. “There is a possibility that organ retrieval may now be undertaken in hospitals with operation theatres and ICUs that are below par, leading to infection in the organs. This is one reason the present laws need the hospital to acquire a retrieval centre licence, which they get only after the premise is inspected by officials from the government,” the official said.
Dr Ravi Wankhedkar, president elect of the Indian Medical Association (IMA), says there could be anywhere from 1,500 to 2,000 hospitals in Maharashtra with intensive care units and trauma centres.
According to guidelines that will be released soon, these hospitals will only have to inform the Zonal Transplant Coordination Committee (ZTCC) or the Regional Organ and Tissue Transplant Organisation (ROTTO) of the family’s consent in order to proceed with retrieval. The organs can then be transported to transplant centres.
“ZTCC or ROTTO officials will allocate the organs to the recipients according to the waiting list,” said an official from the Directorate of Health Services (DHS).