ANANI SAMPATH | DC CHENNAI, DEC. 11 Tamil Nadu has an impres- sive record in cadaver organ transplant. So much so, that the rest of India looks up to and wants to emulate it in this field of humanity. Most other states want to achieve Tamil Nadu’s deceased donor rate of [...]]]>

From Deccan Chronicle 12/12/2011

ANANI SAMPATH | DC
CHENNAI, DEC. 11
Tamil Nadu has an impres-
sive record in cadaver organ
transplant. So much so, that
the rest of India looks up to
and wants to emulate it in
this field of humanity.
Most other states want to
achieve
Tamil
Nadu’s
deceased donor rate of 1.3 per
million – the national average
is 0.5 to 0.8 per.
But of late, something has
gone wrong for the leader.
Though TN crossed the 1,000-
donor mark in April, the
number of transplants in the
state has fallen drastically in
the past few months.
The state had recorded 523
transplants last year, includ-
ing 250 major ones such as
heart, liver, lungs and kid-
neys.
This year, however, it had
recorded only 383 transplants
till November 2011. Of these,
195 were major. With yearend
days away, last year’s dona-
tion gala seems to be all but
over.
“The procedure has lost
steam only over the past four
months. In July, we hardlyhad time to sleep as we did as
many as 14 transplants and
our half yearly average was
seven to eight cases a month.
But in November, we did only
four cases and the month
before that just one,” said Dr
Amalorpavanathan,
chief
transplant coordinator at the
government
hospital
in
Chennai.
The reasons for the dip are
many. Superstition and reli-
gious restrictions for one still
hinder grief counsellors
approaching families of
prospective donors.
However, the most common
reason families refuse to
donate organs is the wait to
take bodies home. Sometimes
it takes three days to a week
to complete formalities and
paperwork before organs are
harvested and a body
released for last rites.
Doctors admit awareness
needs to be created among
paramedical staff rather than
the public.
“Early identification of
brain dead cases is needed.
Yes, TN is a pioneer in cadav-
er organ transplant, but a lot
more needs to be done,” said
Dr Amal.

CHENNAI: Last week, when the country observed the national organ donation week, many states planned to emulate the Tamil Nadu model. But experts say the state still has a long way to go as many people continue to die for want of organs.

This year, the state cadaver organ registry will conduct two [...]]]>

From http://timesofindia.indiatimes.com/city/chennai/State-organ-registry-to-compile-data-on-transplants/articleshow/11026573.cms

CHENNAI: Last week, when the country observed the national organ donation week, many states planned to emulate the Tamil Nadu model. But experts say the state still has a long way to go as many people continue to die for want of organs.

This year, the state cadaver organ registry will conduct two major studies-one on the requirement of organs and another to see the outcome of organ transplants done so far. “We don’t have data on how many organs are required so we don’t know how much we fall short of,” said registry convener Dr J Amalorpavanathan.

From October 2008 to October 2011, 215 brain dead patients donated their organs to the registry. Surgeons have harvested 35 hearts, four lungs, 190 livers, 399 kidneys, 268 heart valves, 333 cornea and skin from one person. At least 1,230 people have benefitted.

But many doctors say they have lost patients who were on the waiting list. For instance, Apollo Hospitals liver transplant surgeon Dr Anand K Khakhar said at least 15% of his patients on the waiting list die. The hospital currently has more than 100 patients waitlisted for a liver transplant. “On luckier days, we do about five liver transplants but we lose many patients. It’s sad because we know a good liver can change their lives,” he said.

There is also a lack of transplant teams didn’t help the situation either. Cardiac surgeons say more than 90% of the hearts had to be wasted because there aren’t enough heart transplant teams in the state. Also, when the donor is an accident victim, forensic experts say that hearts can’t be donated as the body has to be sent for postmortem. “It’s a complex issue. On several occasions, we have moved our patients from the pre-operative rooms back to the wards because the hearts don’t come,” said heart transplant surgeon Dr K M Cherian, who heads Frontier Lifeline.

At the advisory meeting of the registry, the officials promised to urge the government to relax postmortem norms further and urged surgeons to make judicious use of organs. They said the waiting list should be updated constantly. Currently, the organ registry does not have data on how many patients benefitted from it.

They said they will employ an external agency to study the outcome of every transplant done with organs given by the registry. Most countries employ non-medical persons such as mathematicians and statisticians to compile the data. The registry plans to get help from Anna University or IIT-M to study the data. “It’s time we compiled the data. It will help us standardise transplant surgeries. We must plan ahead,” said liver transplant surgeon Dr R Surendran.

MUMBAI: Taking a leaf out of Tamil Nadu’s health programme, the state government will soon roll out a plan to boost cadaveric organ donation in Maharashtra.

From seeking audits of brain-stem death patients in hospitals to sensitizing the police, state authorities on Saturday prepared a wish list in order to increase cadaver donations. [...]]]>

From http://timesofindia.indiatimes.com/city/mumbai/State-plans-TN-model-for-cadaver-donation-in-Maha/articleshow/10977147.cms

MUMBAI: Taking a leaf out of Tamil Nadu’s health programme, the state government will soon roll out a plan to boost cadaveric organ donation in Maharashtra.

From seeking audits of brain-stem death patients in hospitals to sensitizing the police, state authorities on Saturday prepared a wish list in order to increase cadaver donations. The plan was drawn up between government officials and doctors representing the zonal transplantation coordination committee (ZTCC), which oversees distribution of cadaveric organs in Mumbai, at a meeting held on Saturday. While Mumbai was the first city in India to conduct a cadaveric kidney donation in 1997, few donors have come forward in recent years.

On the other hand, Tamil Nadu has gone from being the hub of illegal kidney rackets, until a few years ago, to a model state that registers around 100 organ donations annually. Dr Pravin Shingare, acting head of the department of medical education and research , said, “Our first step will be to call up CEOs of private hospitals and ask them why they don’t send a list of brain deaths.”

The hospitals will then be given a three-month period to start reporting brain deaths or face punitive action. “We want to alter guidelines to make them more people-friendly ,” said ZTCC secretary general Dr Sujata Patwardhan. On Saturday, Tamil Nadu’s cadaver transplant programme coordinator Dr J Amalorpavanathan gave a presentation on the steps taken to increase cadaveric transplants.

In a bid to increase organ don at i o n , the Maharashtra government is planning to adopt what is increasingly being called across the country as the Tamil Nadu model. The southern state has managed to increase organ donation by deceased donor or brain-dead donors in the [...]]]>

by Malathy Iyer |
From TNN

In a bid to increase organ don at i o n , the Maharashtra government
is planning to adopt what is increasingly being called across the
country as the Tamil Nadu model. The southern state has managed to
increase organ donation by deceased donor or brain-dead donors in the
last couple of years.
“We have studied Tamil Nadu’s rules and are in the process of
adopting a few of them,’’ said Dr Pravin Shingare, acting director of
the Department of Medical Education who is also the secretary of the
Maharashtra Confederation For Organ Transplant (MCFOT).
The state government is keen on two ‘imported’ ideas. The first is
clearing the road for any ambulance or private vehicle carrying the
deceased donor or retrieved organs, and the second involves
recognizing already existing hospitals and nursing homes—with over
25-beds and intensive care units—as retrieval centres.
In fact, the man who has been credited with increasing cadaver
donation in Tamil Nadu, Dr J Amalorpavanathan, will address the Zonal
Transplant Cadaver Centre (ZTCC) at KEM Hospital on Saturday.
ZTCC chief Dr Sujata Patwardhan told TOI that the centre would be
happy if at least a couple of Tamil Nadu’s rules were adopted in
Maharashtra. “It would be great if we could recognize more centres for
organ retrieval. It would also be useful if Maharashtra has
on-the-spot recognition for such centres,’’ said Dr Patwardhan. So,
any hospital with an ICU setup that has a brain-dead patient can get
recognition at that moment to facilitate retrieval.
Dr Bharat Shah, a nephrologist with Lilavati Hospital in Bandra
said that the cadaver donation programme across the country cannot
improve unless the Tamil Nadu model is adopted. “With a simple move of
registering all hospitals in the state with 25 beds and ICU as
non-transplant organ retrieval centres, Tamil Nadu has increased its
deceased donor programme since 2008. It retrieves around 300 organs a
year as compared to 30 in Mumbai.’’
A senior doctor with a municipal-run hospital is hopeful that the
state government will adopt the Tamil Nadu rule in which a post-mortem
doctor goes to the hospital where the brain-dead person is admitted.
“It is emotionally draining for family members who have donated their
loved one’s organ to take the body to a designated postmortem centre.
The wait to get the body back is long is some cases,’’ the doctor
said.
Another city doctor felt that the state should take up sensitizing
the police force to ensure speedy paperwork for organ retrieval.
The Maharashtra government has already identified nine hospitals
with ICUs that can act as retrieval centres. “We are waiting for the
paperwork to be submitted,’’ said Dr Shingare.

On The Fast Track?

Mumbai registers less than 30 transplants using cadaver or deceased
donor programme in a year
Tamil Nadu registers little less than 300 transplants using retrieved
organs in a year
The state is keen on two ‘imported’ ideas. The first is clearing the
road for any ambulance or private vehicle carrying the deceased donor
or retrieved organs, and the second involves recognizing already
existing hospitals and nursing homes with over 25-beds and ICUs as
retrieval centres
Doctors are hoping that the state government will adopt the Tamil Nadu
rule wherein a post-mortem doctor goes to the hospital where the
brain-dead person is admitted

Times View

The number of patients with organ failure—be it kidney, liver or
heart— has been steadily increasing across the country. Not
surprisingly, the demand for organ replacement led to the infamous
Indian kidney bazaar where organs could be bought in the black market
at a premium. The Indian Human Organ Transplant Act managed to bring
about some order, but various states interpreted the rules a little
differently. Red-tape is slowing down the process of inter-state
transplants even within the same family. To ensure that India’s large
patient pool has access to a better quality of life, the government
would do well to not only address these issues but even promote the
deceased donor programme a bit more aggressively.

Too much red tape in Maharashtra?

There are limited centres for retrieval of organs from deceased donors
(braindead patients); roughly 28
In a medico-legal case such as a road accident, a clearance is needed
from the police station where the accident took place. So, even if a
patient who is brain dead is in a tertiary care hospital in south
Mumbai after an accident in, say, Turbhe, the family has to travel all
the way to the Navi Mumbai locality to get the required clearance
The deceased donor’s family has to take the body to the nearest public
hospital with a designated centre to carry out the post-mortem

An effective system in Tamil Nadu

Every medical set-up with an Intensive Care Unit that can support
brain dead patients medically, is authorized to retrieve solid organs
The police have been instructed to give clearances within two hours
A government doctor qualified to do post-mortem will go to the
hospital where the brain dead patient is admitted