As patients get pandemic panic, organs for transplant end in the bin

A viable kidney from a brain dead donor had to be discarded in early October because the recipient did not turn up in the hospital fearing covid 19 infection. A team of doctors led by Chennai based senior transplant Surgeon Dr Karthik Mathivanan, who harvested the organ said that it was a healthy kidney and could have replaced the diseased kidney in the patient. The patient’s family opted to continue with dialysis instead of the transplant as they did not want to risk morbidity during the pandemic and the healthy donor kidney ended up as medical waste.

Tamil Nadu is known as the best state in India and has been awarded as such for the sixth consecutive year. Surgeons and transplant coordinators said that they have faced many dire straits during the pandemic. There has been a steady fall in transplants with a low number of brain deaths resulting from hesitation in patients to seek healthcare and lack of adequate healthcare personnel.

The Covid protocol also adversely affected hospital working conditions with one-fourth of the staff kept under reserve. Under these circumstances, transplants were only done on priority. The hospitals were cordoned off into parts with covid and general patients treated in different sections. Doctors involved in transplant made sure not to be acquainted with patients with covid and vice versa. And doctors were mindful that contraction of covid 19 needs to be carefully allayed.

“Kidneys, unlike other organs, have a shelf life of 24 hours if preserved properly. In spite of transplant coordinators having sufficient time to identify recipients, there were times when vital organs were wasted. Some recipient families could not find ways to travel or stay during the course of the surgery, while many others were scared of being infected with Covid-19. They are willing to continue dialysis or medically manage the illness instead of going through the risk of morbidity due to the pandemic,” Dr Karthik said.

The present crisis apart, for the past five years, the number of donations in the state has been steadily declining. From 185 donations in 2016, it came down to 127 in 2019. At least 90% of the organ donations were from victims of road accidents in Tamil Nadu. This year, with the lockdown, the number of vehicular accidents came down. “Obviously, donations were also low,” said Dr Kanthimathy, while recognising the need for more awareness programmes to ensure more donors come forward.

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