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Times of India
30 November 2011
By Malathy Iyer

Maharashtra Keen On Importing Ideas From Successful Tamil Nadu Model

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).

Govt Looks South To Boost Organ Donation

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

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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

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