There is a dearth of organ donation and good quality transplant centres in Northern states: Dr. N. K. Pandey – ET HealthWorld

Organ Donation: Challenges
One of the major challenges in organ transplantation today in our country is perhaps the availability of organs. The infrastructure that we need for an organ transplant and the post-operative care of the transplanted patient are the three major challenges that we face today. As far as organ transplantation is concerned, it is a big issue if you look at the Indian data. If you analyze at the load of diabetes in the country and the load of hypertension in the country, that will give you some clues as to what kind of figures we are talking about.

And these patients required some kind of support—left ventricular support, right ventricular support, or looking for a heart transplant—but that is one section. Transplant itself is a big area, there is kidney transplant, liver transplant, and others. During the COVID times, we saw a large number of people who developed terminal lung failure, and at that time, we got totally exposed that we didn’t have the availability of lung transplants.

Most of the patients have been travelling outside. So, when it comes to healthcare and medical education, more than half of medical schools are located outside of the country. If you look at organ transplants, most of the donations come from outside. The waiting list for these was so long to get lung and heart transplants that we thought we needed to use this programme in North India as well, and that is why we had this meeting today.

The Government’s Role in Organ Transplantation
When we look at any organ transplant, be it heart, be it lungs, be it liver, or kidney, the cost is a very important factor. When we look at the cost, there are three components to it: one is pre-operative cost, the second is operating cost, and the third is post-operative management.

Whenever we put a foreign organ inside you, there is a reaction. The body tries to reject it, and to control that reaction, we use drugs that are very, very expensive. When we are talking about the long-term survival of the patient, we are talking about the huge cost input that goes into the management of these patients, apart from what is visible to the people, which is the transplant, as such, as that is where I think there is a role for the government.

We have to bring some working participation where these patients can be supported by the government in terms of supporting their after care, giving them drug immuno separation and even helping hospitals to create infrastructure, like giving them land at a subsidised cost or asking them to keep transplants down. It can reduce wear of duties and import duties, so there are a variety of things that the government can do to deal with the situation, and the government can ask for cost reductions, so I believe the government plays an important role.

The next responsibility is training and skill development, and I believe that these skills should be promoted and mentioned proactively and that the government can play an important role in this regard. This is a common misunderstanding.

Organ Transplant: Asian Healthcare & MGM Healthcare collaboration
Today we signed a collaboration agreement with MGM Healthcare, Chennai, and the Asian Institute of Medical Science for the development of a transplant program. Basically, what we want and what we are looking for is how we can benefit from what a very experienced institution has to offer. They have done close to 500 cardiac transplants and 18–19 lung transplants. Perhaps our team can be part of the programme where organs are available, so nobody needs to go to Chennai.

The Asian team can be harvested because time is a very important factor, particularly in heart itransplants where we have a 5–6 hour window to actually remove the heart, put it in a new patient, and start the heart beating. All this, when you are fighting with time and a lot of logistics, comes in, and that is where we can be helpful. If you are going to lift a heart from somewhere in Odisha or Bihar and then transport it a very long distance, then a lot of logistics go into it.

So the purpose was to see how we can give transplant facilities to remote patients, how we can make our transplant outcomes better and how we can control the cost. Eventually, the cost has to be borne by somebody. Unfortunately, at the moment, patients pay all the costs. So how can we optimise these 4-5 points that we want to address by this collaboration over the institute to get recognised as a major cardiac and lung transplant center?

I would like to see a future institute where we don’t have to rush patients to another state for this high-end problem, and next time something like COVID comes or something like a different pandemic comes, we are much better prepared to handle the complications, and this time we felt part of terminal lung failure.