Times of India
26 March 2011
By Malathy Iyer
Mumbai, India

Hospitals Asked To Maintain Monthly Data
The state government plans to get tough in order to boost organ donations across the state. It wants every hospital that is licensed for cadaveric organ transplant to present a monthly audit of brainstem deaths, said medical education authorities.

Brain-death audits are commonplace in the West where cadaveric organs are the main source for transplants; transplants in India mostly involve organ donation from living relatives. Sunday will be observed as the 11th Maharashtra Cadaveric Organ Donation Day to coincide with the first cadaveric kidney transplant carried out in Sion Hospital in 1997. However, there has been a dearth of cadaveric or brain-dead organ donations. Mumbai records 20-odd cadaveric donations a year.

The belief in the state health administration circles is that brain-death audits will boost cadaveric donations. “We want to compel hospitals to record brain deaths in the first phase," said acting director of medical education department, Dr Pravin Shingare.

According to sources, state health minister Dr R Gavit held a meeting on with officials on Friday morning to work out the details of the brain-death audits.

Brain deaths, feel officials, will bring out transperancy and accountability. “It is estimated that 5% of all deaths in any ICU would be due to brain-stem injuries. Many road accident victims, for instance, could be brain-dead," said the source. Yet, Maharashtra that has hundreds of hospitals with hundreds of ICU beds barely registers a twodigit donation of cadaveric organs.

If a brain-death audit is maintained, it would be clear how many relatives of brain-dead patients are counseled to donate organs of theirdearones.Thecountry’s Human Organ Transplantation Act states that special counselors should be appointed by hospitals to approach relatives of braindead patients in ICUs.

“In the first phase, the state want a brain-death audit. In the second phase, we will issue warnings to hospitals that don’t maintain such audits," said Dr Shingare. As the last step, hospital could lose their licence for transplants, he added. Incidentally, the state government in January approved in principle a move to allow all hospitals with 25 or more beds to act as retrieval centres. This means families of brain-dead patients in any hospital could be counseled to donate organs that would be retrieved and transferred to big hospitals that can conduct transplants.

The state government last month issued a resolution allowing the setting up of Zonal Transplantation Coordination Centres (ZTCC) in Nagpur and Aurangabad. The state now has four ZTCCs, including those in Pune and Mumbai. Sources in the state government indicated that the Mumbai ZTCC, which has a computerized waiting list to coordinate trabsplants, would get special aid.