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Key facility hiccups hit organ transplant

The government has not been able to start organ transplant in any of the state-run health hubs even five months after the notification of the Transplantation of Human Organs Act, 2002.

Sources at Patna Medical College and Hospital (PMCH) and Indira Gandhi Institute of Medical Sciences (IGIMS) said the necessary infrastructure for renal, cornea and liver transplant has still not been developed at these clinics and the situation is grim at other hospitals also.

“There is only one transplant surgeon in the PMCH kidney transplant unit while there is a need of more number of transplant surgeons. Besides a dedicated intensive care unit for the renal transplant, it also requires a panel of surgeons, urologists, anaesthetists and 24-hour available staff nurses and paramedics.,” said a doctor of the nephrology department on condition of anonymity.

About cornea transplant, Umesh Prasad Sinha, head, eye department, PMCH, said: “We have started the registration of the donor and recipient as the initial phase.”

The sources said the eye department still had not acquired the surgical instruments for carrying out enucleation (surgical removal of entire eye), muscle hook and trephine among others. Even Sinha admitted the problems: “We have informed about this to the health department last month.”

At the IGIMS, the condition is no better. A nephrologist associated with the hospital on condition of anonymity said: “For starting renal transplant, a hospital must have a good blood bank which has blood component separator for separating various components of blood like plasma among others. The blood component separator at IGIMS has become non-functional. There should be a medical social worker according to the act where any type of transplant has to be started but at IGIMS, we have none. The medical social worker acts as transplant co-ordinator. He/ she ensures that the donor gets his/her various kinds of tests done without any hassle and his/her health is not compromised with during the whole process but IGIMS still don’t have any medical social worker.”

The doctor added: “However, the biggest reason for which the health hub is not able to start renal transplant is that it does not have HLA testing facility. HLA test helps to detect whether the donor’s body would accept or reject the kidney or not. The IGIMS has still not been able to start this at its premises nor it has been able to start this test at PPP mode on the hospital. The dedicated ICU where renal transplant has to be started is also under construction.”

Indian Medical Association state president Rajiv Ranjan Prasad said: “Only notifying rules of the act would not ensure starting a transplant. The government needs to upgrade the infrastructure of hospitals.”