RECIPIENT WAITS ON AS CADAVER LIVER `WASTED' DUE TO RED-TAPE DELAY

 The liver of a 28-year-old brain-dead patient could not be harvested in time for a transplant as organ authorisation committee asks pvt city hospital to seek approval from IKDRC; kidney hospital asserts it has no power to grant such permission

Karthik Patel, 33, needed a new liver and had been on the waiting list for several months. Navratri brought hope in the form of a 28-year-old brain dead patient who turned out to be a match. However, Karthik never received the life-changing organ transplant. Reason: The organ authorisation committee denied the private hospital's request to conduct the transplant without permission from the Institute of Kidney Diseases and Research Centre. Interestingly, IKDRC denies having the power to give permission to any private hospital to go ahead with a liver transplant.

The non-clarity of rules led to wastage of the liver in a state where hundreds of patients die every year due to lack of organ donors.

Confirming the incident, Reshma Vachchani, executive member of N M Virani Wockhardt Hospital in Rajkot where Karthik was admitted, said, “Bhavin D Patel, a 28-year-old resident of Rajkot was declared brain dead by medical experts at the hospital. His family opted for cadaver donation so IKDRC was contacted and their team came here to retrieve the cornea and kidney. However, the doctor responsible for liver transplantation was out of station so they could not harvest the organ.“

WHO'S RESPONSIBLE?

Wockhardt then contacted a private hospital in Ahmedabad, which is recognised by the state government to carry out liver transplants. While the hospital authorities refused to comment on the incident, a reliable source said, “According to Transplantation of Human Organs Act, 1994, private hospitals that are authorised to do organ transplantation need to take approval of organ authorisation committee -a government body responsible for monitoring organ transplantations. The hospital asked Karthik to get ready for the transplant.

Then, it called the committee for approval but was asked to get in touch with IKDRC for permission. The hospital tried calling IKDRC director but got no response till very late. While cornea, skin and other tissues can be donated after cardiac death, a braindead donor has a window period in which vital organs such as heart, liver, kidneys, pancreas, intestine and lungs can be retrieved. As organs deteriorate in the time after death is declared, the delay damaged chances of the liver being transplanted successfully.” Shedding light on the case, advocate Parth Contractor, who is familiar with the incident, said, “When the private hospital contacted the committee, the authorisation head asked them to take approval from IKDRC. This is against the law. Private hospitals are supposed to ask for approval only from the committee and not from IKDRC or any other research institute.”

Mirror made several attempts to contact Dr P D Vithalani, additional director of Medical Education and head of the authorisation committee, but he did not pick up the calls nor responded to SMSes.

Mirror also contacted IKDRC Director H L Trivedi who said he did not have the power to permit any private hospital to go for liver transplantation.

“The government provides the permission. The private hospital asked me to go to Gandhinagar in the middle of the night to get permission but I am not a member of the committee to authorise the operation,” Dr Trivedi clarified.

NEED CENTRALISED SYSTEM

According to health department statistics, only 88 cadaveric donations were made in Gujarat last year compared to 130 donations recorded in Tamil Nadu. Only 22 liver donations took place to fulfil the need of patients whose number runs into hundreds, the statistics revealed.

“In a state where hundreds of people lose lives due to lack of donors, cadaveric donation can act as a boon. But if organs are wasted in this thoughtless manner, the condition of patients on waiting list will worsen,“ said Bhavna Chhabaria, CEO of Shatayu, an NGO that spread awareness about organ donation.

Activists are raising the demand for centralized system like the one in Tamil Nadu Andhra Pradesh, and Maharashtra. “A centralized system will provide equal and better opportunity to both private and government hospitals in carrying out organ transplants. It will also make the system more transparent, which will increase the trust of people,“ added Chhabaria.

(Some names have been changed to protect identity)

CADAVER TRANSPLANT

A patient declared brain dead is qual ified for cadaver donation. Almost 37 vital organs and tissues can be donat ed. If family members are keen on ca daver donation, they can contact the hospital authority or the concerned doctor who will then connect to the hospital authorised for transplanta tion. They can also directly contact the hospital who has official approval from the government for organ trans plantation.