Organ transplant numbers still low in Tamil Nadu

Chennai: Tamil Nadu has been leading with 5,300 organ transplants since 2008, according to Transplant Authority of Tamil Nadu. Despite cadaveric organ donations witnessing an increase over the years, the demand-supply disparity in the state remains grave. An online organ sharing registry for deceased donation and transplantation is used by the state, not many have access to it and the wait-list of people in need of an organ transplant is greater.

Vikas Tiwari, a 40-year-old man diagnosed with chronic renal insufficiency,  was in urgent need of a renal transplant, but even after a year, he could not undergo renal transplants due to lack of volunteer donors.

In another instance, Rubha Abdulaziz, needed immediate lung transplant as he was suffering from respiratory failure. But he had to be dependent on oxygen cylinders for months and his surgery was delayed for seven months due to lack of lung donors.

Though facts suggest that one brain-dead person can save up to 8 lives by organ donation, statistics reveal that around 2.5 lakh deaths in India occur due to lack of organ transplantation.

“In 2016, there were only 720 cadaver transplants in India with the current organ donation rate being 0.26 donors per million population, which is comparatively low from other countries. We need to address the existing negative perceptions and a general lack of concerns among people on organ donation and its need,” said Dr K. R. Balakrishnan, director of cardiac sciences at Fortis Malar Hospital.

J. Senthamil, a resident of Avadi, met with a road accident and was declared brain dead, but his family volunteered to donate his cornea, cardiac valves, kidney, lungs and liver, which provided a new lease of life to many individuals. But the proposals of organ donation for the family of the deceased remain a scary scenario in our society.

According to a survey by WHO, 60 per cent of deaths in road accidents are of people in the age group of 15- 44 years, which constitutes young and healthy people and organ donation by their family members can reduce the gap between the organs required and organs received.

“In India, each year estimated 1.3 lakh people die in road traffic accidents and about 70 per cent of them are declared brain dead, from whom organs can be harvested. These show a resistance in people to donate organs after their loved one’s death, but opting for the organs of a brain-dead person is often the only option available for chronically ill patients. Society should wake up to the immense gain from a sustainable carry over of organ donation,” says Dr Georgi Abraham, professor of medicine, Madras Medical Mission Hospital.

Facilities such as cross-matching techniques in case of sensitised recipients and a basic complement-dependent cytotoxicity need to be necessarily available at all hospitals to facilitate easy organ transplant.

World Organ Donation Day observed on August 13 emphasises the need of awareness on organ donations, but a commendable change is yet to be witnessed. The wide gap in the demand and supply in organ donation demands a spread of awareness be stepped up to a higher level.

Grief counsellors not there to help victim kin

A significant factor in the lack of organ donors can be attributed to lack of a well-trained psychologist who can communicate and counsel the family of the deceased in an approached manner.

“Grief counsellors are not available in the majority of the centres where counselling is needed for the families of brain dead accident victims. Pre-sensitisation is hardly ever assessed in patients on the waiting list for deceased-donor transplantation,” says Dr Georgi Abraham, professor of medicine, Madras Medical Mission Hospital.

Psychological disorders present in people undergoing organ transplantation affect the post transplantation recovery. These facts often remain unknown to people and medicos too, that leads to poor results after transplantation.  Secondly, transplant is associated with significant emotional distress with lifestyle modifications and psychological stress in the recipient as well as donors in case of live donors.

“Organ transplant can trigger new psychological disorder or worsen the pre-existing disorders due to immunosuppressants, lack of emotional support or persevering treatment procedures. Psychiatrists are one of the members of the organ transplant team to connect with the transplant team and recipient, donor and family members, therefore, they need to be necessarily involved in organ transplantation,” said Dr Vivian Kapil, psychiatrist, Meenakshi Medical College Hospital.