CHENNAI: Minutes after an Indian’s heart started beating inside a 65-year-old American, Ronald Lemmer, last month, there were celebrations at the 25-year-old Apollo Hospital. Not just because the heart transplant was a success the hospital had, symbolically, achieved something much greater.

“I built this hospital after I lost my first patient due to heart disease. He [...]]]>

From http://www1.timesofindia.indiatimes.com/city/chennai/Chennai-High-Showing-the-way-in-cadaver-organ-transplants/articleshow/6428637.cms

CHENNAI: Minutes after an Indian’s heart started beating inside a 65-year-old American, Ronald Lemmer, last month, there were celebrations at the 25-year-old Apollo Hospital. Not just because the heart transplant was a success the hospital had, symbolically, achieved something much greater.

“I built this hospital after I lost my first patient due to heart disease. He was just 39 years old and could not go to the US in time for treatment. I promised myself that I will bring international care to Chennai. Now, the heart we transplanted will beat in the US,” said Dr Prathap C Reddy, chairman of Apollo Hospitals. “But this could not have happened if the state did not push for an organ registry and promote cadaver organ donations. Our city is truly the capital of cadaver organ transplant in the country,” he adds.

When a patient is declared brain dead, mostly following heart disease, he/she is clinically dead. But vital organs like heart, kidneys, lungs and liver function with the help of life support system. In September 2008, when the parents of A Hitendran (19) Dr Ashokan and Dr Pushpanjali were told that their son was brain dead, they agreed to donate all his organs. “My house has never been the same after he left us. His death changed us for ever. We learnt that we can prolong the life of organs and help several others,” said Dr Ashokan. The ailing heart of a nine-year-old girl, Abirami, was replaced with Hitendran’s heart. She lived for almost a year with the heart.

“But story had a rippling effect,” said Dr J Amalorpavanathan, co-ordinator of state organ transplant registry, which began functioning a little after the Hitendran’s death. The number of donations in the state touched 111 on July 31 2010. “In the last two years, we received calls from several parts of the state for organ donations. Those who have donated include even people who are uneducated,” he said.

The registry networks with hospitals and allocates organs based on demand. “We don’t yet have a waiting list. But we have decided that that the first choice will be patients from the state. If we find none, we then offer them to other states. The foreign patients will be the last in the line of preference,” said Dr Sunil Shroff, a member of the advisory committee of the state cadaver organ transplant registry.

Besides Lemmer, the registry has allotted a liver to a 69-year-old Iraqi patient.

State health secretary VK Subburaj said the government had plans to hard-sell cadaver registry. “Though the number of donations have increased in the state, we still have a long way to go. In countries like Spain the rate of cadaver organ transplants exceeds that of the organ transplants from relatives (live-related transplant). With the number of people being declared brain dead in the city, we too have the option of ruling out live-related transplants,” he said.

Several donor families have themselves launched campaigns. The AP Hitendran Trust run by Dr Ashokan and Dr Pushpanjali, NGOs like the Mohan Foundation organise awareness programmes for the public.

Read more: Chennai High: Showing the way in cadaver organ transplants – Chennai – City – The Times of India http://www1.timesofindia.indiatimes.com/city/chennai/Chennai-High-Showing-the-way-in-cadaver-organ-transplants/articleshow/6428637.cms#ixzz0xcjckHfa

Tamil Nadu’s recent experience with the cadaver transplantation programme came in for commendation at a recent meeting of World Health Organisation (WHO) representatives in Geneva, where they discussed strategies for the 4D programme (Developing Donations from Deceased Donors).

Representatives of 14 nations along with WHO officials took part in the day long programme intended to prepare [...]]]>

From http://www.thehindu.com/news/states/tamil-nadu/article561438.ece

Tamil Nadu’s recent experience with the cadaver transplantation programme came in for commendation at a recent meeting of World Health Organisation (WHO) representatives in Geneva, where they discussed strategies for the 4D programme (Developing Donations from Deceased Donors).

Representatives of 14 nations along with WHO officials took part in the day long programme intended to prepare a blueprint for increasing the donations in all UN member nations.

India’s representative at the meeting, Vatsala Trivedi, chairperson of the National Deceased Donor Transplantation Network, brought up the success of Tamil Nadu.

In an e-mail communication to J. Amalorpavanathan, co-ordinator, State Cadaver Transplantation Programme, Dr. Trivedi said: “During the discussions, I …cited Tamil Nadu’s success. Till 2008 India was performing on an average 100 kidney transplantation from deceased donors (DD). Between October 2008 and December 2009, Tamil Nadu alone contributed more than 150 kidney transplants from the DD programme.

“The remarkable achievement would not have been possible without the government’s support, that too with your health secretaries who could implement the programme so smoothly.”

Dr. Trivedi goes on to add that this was well-appreciated and set down as one of the key points in the blueprint prepared at the end of the meeting.

Part of the reason for the success of the Cadaver Transplantation Programme in Tamil Nadu, was the effort put in by the top health department officials, Dr. Amalorpavanathan said, during the inaugural of ‘Organ-o-Cultural 2010,’ an inter-collegiate cultural competition organised by MOHAN Foundation.

Seven government orders were issued in quick succession to push ahead the programme, with focussed inputs by the Health secretary V.K. Subburaj and then Special Secretary PWC Davidar, he added. It was the government medical colleges – Madras Medical College and Stanley Medical College – that actually kicked off the programme.

Mr. Subburaj said the success of the State’s experience in cadaver transplantation was thanks to a team of dedicated individuals working in synchronisation. He accorded part of the credit to Dr. Amalorpavanathan, and MOHAN Foundation, who had collaborated to appoint grief counsellors.

The Health Secretary later felicitated staff members of Madras Medical College and the Government General Hospital for their role in the Cadaver Transplantation Programme and donor families.

J. Mohanasundaram, Dean, Madras Medical College, explained the process of setting up a system in place for implementation of the programme, in order that it ran smoothly.

Prizes were given to the winners of different cultural contests organised for college students, during the valedictory. Actor R. Sivakumar, who gave away the prizes, also pledged to donate his organs on the occasion, according to Sunil Shroff of MOHAN Foundation.

Part of “Special Report” that came with TOI

Gifting life : Is Chennai one of the best locations in the world for heart transplants? SHIVANI BAIL speaks to doctors and patients across the city to know more…

Asecond chance at life is the biggest gift a person could possibly give a fellow human being. Doctors have [...]]]>

From http://epaper.timesofindia.com/Default/Client.asp?skin=pastissues2&enter=LowLevel&AW=1280137624234

Part of “Special Report” that came with TOI

Gifting life : Is Chennai one of the best locations in the world for heart transplants? SHIVANI BAIL speaks to doctors and patients across the city to know more…

Asecond chance at life is the biggest gift a person could possibly give a fellow human being. Doctors have the opportunity to provide this gift to critically ill patients, everyday, by performing complex transplant surgeries. Of all such surgeries performed on people, a heart transplant is one of the most complex.

The city of Chennai is fast emerging as an important hub for patients suffering from end-stage heart failure.

“We performed 22 heart transplants last year,” says Dr KM Cherian, Founder of the KM Cherian Frontier Lifeline Hospital; the first surgeon in the country to conduct a heart and lung transplant and the second to conduct a heart transplant. Hospitals such as Apollo Hospitals and Dr KM Cherian’s Frontier Lifeline have pioneered advancements in the field of cardiothoracic medicine. In fact, today, even the Government General Hospital performs heart, liver and kidney transplants on a daily basis!

So, when does a person need a heart transplant? “There are several reasons why a person’s heart fails. Complications arise due to arterial blocks, malfunctioning valves or as the result of a congenital defect,” says Dr Paul Ramesh, a leading cardiothoracic surgeon from Apollo Hospitals. “Heart failure occurs in people who have had repeated heart attacks and it can occur in people for no apparent reason (idiopathic cardiomyopathy). It can occur in young people as the result of a viral infection (viral myocarditis) and it even affects women post-delivery (postpartum cardiomyopathy),” says Dr KM Cherian. “Heart transplants are useful for a small percentage of patients with heart failure. We decide to put a patient on the transplant list only after carefully weighing associated risks and benefits. It is only when the benefits outweigh the risks that we recommend and go ahead with surgery. This is why it is very important for patients to reach us when their condition is stable, when they can be involved in the decision-making process.” Most people find this potentially life-threatening operation extremely scary and blanche at having to decide whether or not to opt for the surgery.

However, ask the patients themselves and they tell you that more than the thought of being operated on, it is the wait for a donor that is extremely difficult. “I had almost given up hope of ever receiving a heart,” says Sheela P (name changed), a patient from Mumbai, who suffered from Sarcoidosis of the heart and was operated on at Frontier Lifeline. “I missed three opportunities to undergo a transplant! Every time I missed an opportunity, my husband would calm me down and say that even though we missed this opportunity, we had to realise that for me to live, someone had to die; we couldn’t get impatient.”

Even after the surgery, a patient’s life is in danger. They have to take immunosuppressant drugs for the rest of their life, so that their new organ isn’t rejected by the body. However, this makes them vulnerable to other illnesses.

“A good transplant programme must have a multi-disciplinary approach with good coordination between the various departments of a hospital, as well as between different hospitals and the Government. In addition, post-operative care is extremely important,” says Dr Paul.

One of the reasons why Chennai is a popular medical tourism destination for people suffering from heart failure is because the Government machinery here is highly efficient. The Tamil Nadu Government has the most streamlined transplant programme in the country. By making the organ donation process transparent and by setting stringent rules for private hospitals, it has drastically brought down the instances of organ trafficking in the State.

“There was a time when Chennai was famous all over the world for organ trafficking,” says Dr J Amalorpavanathan, Convenor, Cadaver Transplant Co-ordinator, Tamil Nadu and Consultant Vascular Surgeon, Government General Hospital. “With the current system, it is difficult to breach our protocol. We work in coordination with almost every hospital in the State. It is impossible to bypass our system. Every patient’s life is important to us.”

So how does the system work? “Recipient lists are created based on a patient’s blood group. Each list is uploaded on the internet and constantly updated. As soon as the Government receives information about a donor, they first contact patients from within the same hospital. If a recipient is not available there, we allocate the organ to another hospital in our database,” says Dr Amalorpavanathan.  “There is no competition when it comes to transplants. Every hospital has to work with every other hospital in the State,” adds Dr Paul.

When did the Government begin implementing a central system for organ coordination?
“In October 2008, a young boy named AP Hithendran died in an accident. His heart was donated by his parents, who were both doctors, to a young girl named Abirami. This attracted a lot of publicity, prompting the government to put the present system into place. However, despite the positive outcome of that incident, I believe that both donors and recipients should not receive any media attention. There are times when donor families feel the need to contact recipients and this creates a lot of problems for both families,” says Dr Amalorpavanathan.

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Bushra Baseerat | TNN

For the last many years, Andhra Pradesh ranked highest in the number of organ transplantations. However, the state has now lost its envious position to Tamil Nadu, not because the awareness levels among organ donors in AP has dipped but because of government apathy.

Statistics in city hospitals throws up an ironical situation. About [...]]]>

From

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Bushra Baseerat | TNN

For the last many years, Andhra Pradesh ranked highest in the number of organ transplantations. However, the state has now lost its envious position to Tamil Nadu, not because the awareness levels among organ donors in AP has dipped but because of government apathy.

Statistics in city hospitals throws up an ironical situation. About 10-12 people are dying daily in various hospitals awaiting organs that can be sourced from brain dead patients. And at any given point of time there are 8-10 brain dead patients in different ICUs of city hospitals but only a small per cent of them become organ donors.

It was the same scenario in every state until two years ago when AP was dethroned from its number one slot by Tamil Nadu, whose government took a progressive step, making it mandatory for hospitals to list out its brain dead patients and aggressively started promoting cadaver transplantations. The result? The number of organ donations in the state has doubled ever since the government took this initiative in October, 2008, say experts.

In stark contrast, AP is moving backwards. For two consecutive years — 2008 and 2009 — the city saw only 17 families coming forward to donate organs of brain dead patients. While this year, there has been a slight rise with 16 donors donating 112 organs and tissues. Experts say the numbers are a drop in the ocean.

In 2009, the state had planned to promote cadaver transplantations by easing the organ retrieval norms and by appointing a centralised agency to streamline the organ allocations on a priority basis with Nizam’s Institute of Medical Sciences (NIMS) as the nodal agency.

Till date, this exercise has remained on paper. Experts say that there is a need to use the huge pool of brain dead donors. “Hundreds of fatal road accidents are reported each month but just about 5% of the transplants are cadaveric. Rest of the donations involve living donors,” says Dr S Saharia, former president, Indian Society for Organ Transplants.

The number of waitlisted patients runs into hundreds in each hospital. Those who do not have a suitable donor in the family enrol themselves for a cadaver transplant and join the scores waiting for for months.

CHENNAI: For grief counsellors at the Government General Hospital (GH), the noble deed of an uneducated, homeless migrant family showed them the power of the human spirit. Hailing from Andhra Pradesh and surviving against the odds by eking out a living working on construction sites, relatives of Ramesh, a 23-year-old labourer, moved doctors with their [...]]]>

From http://timesofindia.indiatimes.com/City/Chennai/Brain-dead-migrant-workers-family-come-forward-to-donate-his-organs-/articleshow/6169101.cms

CHENNAI: For grief counsellors at the Government General Hospital (GH), the noble deed of an uneducated, homeless migrant family showed them the power of the human spirit. Hailing from Andhra Pradesh and surviving against the odds by eking out a living working on construction sites, relatives of Ramesh, a 23-year-old labourer, moved doctors with their decision to donate his organs follwoing his death in an accident.

Ramesh was rushed to GH for treatment after sustained injuries in an accident at a construction site. Doctors declared him brain dead on Tuesday. Since it is imperative to have family members present in a situation like this, GH authorities tracked down Ramesh’s family and asked them to reach the hospital immediately.

When they arrived, hospital authorities found that none of the members could speak Tamil, they were all illiterate and that Ramesh’s wife was a minor. The young bride’s tragedy was compounded by the fact that she had known her husband for only a year since the couple got married only recently. As migrant workers in an alien city, the family did not even have an address to put on the forms and entered their address as Retteri platform’ instead.

Though in a state of shock and bewilderment, the family listened patiently to grief counsellors (persons designated to talk to relatives of a patient about the uses of organ donation if an individual has been declared brain-dead) as they told them about organ donation and its formalities.

With the help of translators, the counsellors told Ramesh’s family how donating his organs will help give life to others. The family took some time to discuss the issue among themselves and came back to tell doctors that they were willing to donate Ramesh’s organs.

According to Dr J Amalorpavanathan, coordinator, state organ registry, “One kidney was used for another patient at the GH, one was sent to Stanley Medical College, his heart valve was sent to Madras Medical Mission, liver to Christian Medical College, Vellore, and eyes were sent to the Eye Bank of Government Ophtalmic Hospital, Egmore.”

While organ donation in Tamil Nadu has progressed swiftly with the state organ registry having facilitated more than 100 cases, doctors said the situation in India was rather dismal. “We found it very moving that this family who are living in the most dire straits and have nothing going for them, came forward and agreed to sign the papers agreeing to donate his organs. They have set an example for us all by salvaging their boy’s death to help give life to others,” Dr Amalorpavanathan added.