Stanley records a first in liver transplant

www.thehindu.com/2009/01/30/stories/2009013060840100.htm

 

Stanley records a first in liver transplant

Ramya Kannan

 

— Photo: V. Ganesan

PROUD MOMENT: Dr. Surendran and his team of surgeons who successfully performed the liver transplantation at the Government Stanley Hospital in Chennai on Thursday.

CHENNAI: South India’s first successful liver transplant in the public sector was performed at the Government Stanley Hospital’s Centre for Surgical Gastroenterology and Liver Transplantation, here, on Thursday. The recipient, a 40-year-old woman with cirrhosis of the liver, was operated upon early Thursday morning and was said to be doing well after surgery.

Led by S. Surendran, head, Surgical Gastroenterology, a large team comprising nearly 40 people, helped perform the nearly 12-hour-long surgery.

The donated liver came from 19-year-old Karthik, who was declared brain dead after a road accident. Kumaran Hospital, where he was admitted, informed the Tamil Nadu Organ Registry and the transplant coordinator about the availability of organs, including the liver. The availability of a matching recipient at Stanley Hospital and the fact that the team was finally ready to perform its first transplantation seem fortuitous.

“For us, it is a dream come true,” says Dr. Surendran. He explains that a decade ago, an attempt was made at liver transplantation, but it was premature and unsuccessful.

Health Secretary V.K. Subburaj, lauding the team, said, “It is a historic day for us. We have been waiting for this day for a long while.”

Stanley Dean J. Mohanasundaram said this achievement would encourage more people to enrol with the organ liver registry at the hospital.

Yet another liver surgery was done in Tamil Nadu on Thursday at the Christian Medical College, Vellore. The Tamil Nadu registry coordinated with its Karnataka counterpart to procure the organ from Manipal Hospital, Bangalore.

http://www.hinduonnet.com/thehindu/holnus/004200901251351.htm

Chennai (PTI): Creating history, a three-year-old brain dead girl ended up saving three lives including that of a 21-month-old boy with timely transplant of her organs through a well-coordinated effort by doctors.

The case was also historic for another reason as the 21-month-old heart patient ended up as the youngest recipient of a donor organ in the country.

The donor, three-year-old Tamanna, had met with a road accident in Bangalore on January 20 and was declared brain dead, and her father, who was injured, signed the papers for donating his daughter’s organs from the hospital bed.

The boy, hailing from Ahmedabad, suffering from heart ailment was in ‘bad shape’. His name was put on the Heart Registry and his parents had decided to go home when the call came from Bangalore, Dr K M Cherian, Director, Frontline Hospital at Mogappair here, told PTI.

“We formed two teams to do this whole process. One team went to Bangalore (by flight) to harvest the heart from the girl and came back to Chennai and another team transplanted the heart on the boy in the hospital here”, Dr Cherian said.

The recipient had a new heart in a procedure which lasted just two hours and 42 minutes. That was the time it took for harvesting, transporting and transplantation, he said. A team of nine doctors performed the heart transplant.

He said while inter-state transplantation had become common now, what was important in the case was that the father of the girl agreed to donate the organs.

“The operation was performed at 0500 hrs on Thursday”, he said.

Tamanna and her parents Renilson and Nisha, both hailing from Kerala, were driving back home on Tuesday last when their car collided with a truck.

Renilson sustained multiple fractures and was recovering from surgery in Manipal Hospital. However, his wife died on the spot and his daughter was declared brain dead.

The donor had the universal blood group ‘O’ positive, which made things easier for the surgeons, Cherian said.

Tamanna’s liver was also brought to Chennai for transplant on a two-and-a-half-year old child at the Chettinad Hospital, while a 60-year-old man received her kidneys at the Manipal Hospital.

“The entire operation would not have been possible but for the cooperation of the Chennai police and co-ordination between the transplant teams of both hospitals”, Cherian said.

Sunil Kumar, Additional Commissioner (Traffic) said steps were taken to keep the road free so that the donor’s heart reached the hospital from the airport as quickly as possible.

“It took just 13 minutes to reach the hospital from Airport” (a distance of 25 km), he added.

Organ Transplant FAQ

Do you want to Donate
or
Do you want to receive

http://www.hindu.com/2008/10/25/stories/2008102554950500.htm

Ramya Kannan and R. Ilangovan

K. Radhakrishan

SALEM/CHENNAI: A second cadaver donation in Tamil Nadu within the space of a month took place on Friday.
K. Radhakrishnan, who was declared brain dead on Friday morning, was rushed to Chennai in a fully-equipped ambulance from the hospital in Salem where he was admitted. He was brought to Dr. Cherian’s Frontier Lifeline Hospital, wired to life-support systems and his organs were removed by surgeons at the hospital.
The family members of Radhakrishnan, 42, decided to donate his organs after he was declared brain dead. Radhakrishnan suffered head injuries during a road accident near Salem a couple of days ago.
Apparently, they were inspired by the gesture of the Ashokans who donated their 16-year old son Hithendran’s organs after the boy was declared brain dead on September 23.
Co-incidentally, Radhakrishnan and his wife Latha, like the Ashokans, are both medical professionals- while he was an operation theatre assistant in Kamala Hospital, Salem, she worked as a staff nurse in the same hospital. K. K. Rajagopal, a critical medicine expert of Kamala Hospital, who motivated Latha and other relatives to donate Radhakrishnan’s organs since he was ‘brain dead,’ told The Hindu that their best efforts to revive him had failed. “His brain, we found today, was dead,” he said.
After obtaining the ‘go-ahead’ from Latha, Dr. Rajagopal contacted Dr. Ashokan for guidance on how to proceed with the cadaver donation. He tried to call several hospitals in Chennai but found them reluctant to take up the case as the distance between Chennai and Salem was about 6 hours by road.
They struck it lucky with Frontier Lifeline in Mogappair. Dr. K.M.Cherian advised Dr. Rajagopal and his team to rush the patient to Chennai in a fully-equipped ambulance with Radhakrishnan immediately.
As with Hithendran’s case where Additional Commissioner Traffic Sunil Kumar facilitated free flow of traffic in the city so that the heart reached the recipient well before time, Salem City Police Commissioner N. Chenbaharaman also alerted the police stations on the way to provide security and ensure free passage for the ambulance carrying Radhakrishnan to Chennai.
While Radhakrishnan’s heart was used for a patient at Frontier Lifeline, his liver and one kidney went to Apollo Hospitals and one kidney was given to the government hospital.

http://www.thehindu.com/2008/09/24/stories/2008092452320100.htm
Ramya Kannan

CHENNAI: A.P. Hithendran’s parents are grieving at the same time they feel a sense of fulfilment.

On Tuesday, S.Ashokan and Pushpanjali, took the bold decision of donating the organs of their brain-dead 16-year-old son.

Hithendran’s heart, kidneys, corneas, and liver were removed by doctors at Apollo Hospital, where he had been admitted, to be used on patients waiting their turn for a fresh lease of life. While the heart is already ticking inside a child at Dr.Cherian’s Frontier Lifeline Hospital, the corneas have gone to Sankara Nethralaya and the kidneys and liver were retained at Apollo.

Hithendran fell from his bike and sustained head injuries while trying to avoid an oncoming bus at Teachers’ Nagar, between Thirukazhkundram and Chengalpattu on Saturday evening. He was not wearing a helmet. Precious minutes lapsed as the boy, who could not be identified immediately by the locals, was brought home to his doctor parents more than 15 minutes after the accident.

“We were such a happy family,” Dr.Ashokan said heaving with sobs. “I thought my son would take care of me.” However, as both parents were doctors, well aware of organ donation, they decided to take a bold step. “We did not want to burn his body. We decided that his organs, at least, should help others. I do not want to know who gets Hithendran’s organs, but I hope they all survive and praise my son.”

http://www.luckylookonline.com/2008/09/blog-post_24.html
http://thamira-pulampalkal.blogspot.com/2008/09/blog-post_24.html
http://nallananban-babu.blogspot.com/2008/09/blog-post_24.html
http://tvtamil.blogspot.com/2008/09/blog-post_24.html
http://pathivubothai.blogspot.com/2008/09/blog-post_24.html
http://vettyofficer.blogspot.com/2008/09/some-good-news-about-chennai-police.html
http://www.tamilvanan.com/content/2008/09/23/hithendran/
http://aammaappa.blogspot.com/2008/09/blog-post_24.html
http://www.ponniyinselvan.in/history-discussion-f26/thyaga-sudar-t26969.html#p110484

http://www.hinduonnet.com/fline/fl1425/14250700.htm

India’s National Magazine
From the publishers of THE HINDU

Vol. 14 :: No. 25 :: Dec. 13 – 26, 1997
For a cadaveric transplant programme

ONE of the objectives of the Transplantation of Human Organs Act, 1994 was to clear the decks legally for the development of a cadaver-based organ transplantation programme. Towards this end, the Act recognised and defined, for the first time in India, the concept of “brain-stem death”.

Since the Act came into force, however, only about 110 kidney transplants from cadavers have been performed in the country, according to Dr. J.V. Thachil, Chief Urologist at the Apollo Hospitals, Chennai, and Dr. J. Amalorpavanathan, Transplant Coordinator at the Government General Hospital, Chennai. Tamil Nadu is the clear leader in the field, with three leading medical institutions in the State accounting for 79 of these. Apollo Hospitals, Chennai, has done 53 cadaveric renal transplants; the Sri Ramachandra Medical College and Research Institute, Chennai, 14; and the Christian Medical College and Hospital, Vellore, 12. In addition, the Government General Hospital, Chennai, has done 8 cadaveric kidney transplants, and K.G. Hospital, Coimbatore, 2.

Leading nephrologists and urologists argue that the continuing commerce in kidneys acts as a disincentive to investments in cadaver-based programmes by capable medical institutions. There are, however, a few hospitals and organisations that are working with the objective of putting in place an effective cadaveric transplant programme and changing social attitudes towards organ donation.

Apollo Hospitals, Chennai, is way ahead of the rest. It performed the country’s first renal transplant from a brain-dead person in October 1995. Since then the hospital has performed 52 more, making its programme the best cadaveric transplant programme in the country.

One lesson to be learnt from the Apollo experience is that a cadaveric transplant programme cannot take off unless the paid-donor programme is stopped and independent investments are made in setting up the infrastructure for a cadaveric programme. “What a hospital needs for a cadaveric transplant is a 24-hour laboratory that can do cross-matching as soon as we harvest a kidney from a cadaver,” notes Dr. Thachil. “It must have a physical plan and an infrastructure for transplants; not just doctors, but theatres and nurses in a constant state of preparedness. We have done up to five transplants in a day.”

A kidney can be harvested from brain-dead accident victims and also from victims of brain haemorrhage and cardiac arrest. Apollo has up to 35 persons on a waiting list for cadaver-based kidney transplants. Many of these patients, who are on dialysis, return to their cities and workplaces, and come when the hospital finds a kidney to match their specific needs. Apollo has given six kidneys that it harvested from brain-dead persons to other hospitals for transplantation as it could not find a match for persons on its waiting list.

On November 21, Dr. Thachil performed a renal transplant surgery on a 75-year-old patient from South Africa. Two kidneys harvested from a cadaver were transplanted into the recipient using what is called a “piggy-back technique”. The patient had been on the waiting list for almost four months. Dr. Thachil says: “This man could easily have bought a kidney, but he chose to wait.”

Once a brain-dead person’s relatives have agreed to his or her organs being harvested, the transplant team has to move fast as delays affect the success rate; the best results are obtained when the kidney is harvested while the heart is still beating. The hospital bears the expenses of keeping the person on a life-support system; the organ retrieval costs are passed on to the recipient.

Asking for permission to harvest a brain-dead person’s organs requires sensitivity to the family’s grief. Dr. Thachil says that in 90 per cent of such cases, the relatives have given permission. “We brief the family fully and we tell them that the organ can be taken without any physical disfigurement of the body. Whenever I give a lecture, I tell people: when you die let you soul go to heaven, but leave your organs behind.”

A donor card programme, under which a person may give consent for doctors to harvest his or her organs in the event of death, is at work in its initial stages in Chennai, Bangalore and some other cities. Such programmes are popular in other countries. Moreover, in several countries, the Law of Assumed Consent prevails: the state assumes that it has an accident victim’s consent to harvest his or her organs in the event of death, unless he or she has left a statement expressly forbidding this (see interview with Dr. Christiaan Barnard, Frontline, November 14).

Dr. Thachil, however, believes that such a law may “backfire” in India. “In India you cannot overlook the family’s wishes after a death has occurred. Apollo’s experience has shown that you can have a cadaveric programme and can convince persons on a case-by-case basis.”

AN organisation whose objective is to change social attitudes to organ donation is the Chennai-based Multiple Organ Harvesting Aid Network (MOHAN). MOHAN was launched in January 1997 by Dr. Sunil Shroff, a transplant surgeon who heads the Department of Urology and Renal Transplantation at the Sri Ramachandra Medical College and Research Institute, Chennai. It has begun a donor card scheme to raise awareness about the need to donate ‘solid’ organs (kidney, heart, liver, lungs and pancreas). A person who enrols in the scheme signs a card and thus consents to his organs being harvested after his death. MOHAN has distributed 17,000 donor cards so far.

The SRMC&RI has performed 57 kidney transplants (including 14 cadaveric kidney transplants) since 1995. A team of doctors from the Department of Urology and Renal Transplantation at SRMC&RI conducted a sample survey in Chennai to test social attitudes towards organ donation. The sample was stratified to capture different socio-economic classes and religious groups in Chennai’s population. Individual questionnaires were given to 8,000 persons, of whom 5,008 responded. Their responses indicated that awareness about organ transplants was high; more than half the people who responded expressed “some degree of familiarity” with the concept of brain-death. More than 70 per cent were willing to carry a donor card. The most significant finding was that the proportion of people who were willing to donate their eyes was substantially higher than the proportion of people who were willing to donate solid organs after death.

The survey’s results point to the significant success of the campaign for eye donations. Such a campaign could serve as an example for a similar effort to raise awareness about the need for donating other organs.

NO cadaveric renal transplant has yet been performed in Karnataka. However, the Foundation for Organ Retrieval and Transplant Education, a non-profit trust founded in September 1996, is helping put in place a programme under which people can signify their willingness to allow doctors to harvest their kidneys, liver, pancreas, heart, heart valves and eyes after their death. The programme was begun by Dr. Philip G. Thomas, a transplant surgeon at St. John’s Hospital, Bangalore, and his wife Rebecca Thomas, a trained transplant coordinator who worked at the Centre for Organ Recovery and Education (CORE), Pittsburgh.

FORTE works with the 10 Bangalore hospitals that are authorised by the Karnataka Government to perform cadaveric transplants, and coordinates the donation and transplantation of organs. It has distributed 1,000 donor cards and received consent from 200 persons for the harvest of their organs after death. Nine patients with End-Stage Renal Disease and one heart patient are currently registered with FORTE seeking organ donors.

http://www.hindu.com/2008/09/17/stories/2008091760731000.htm

Ramya Kannan

• He will report to the government directly on all matters
• He will prepare and maintain a computerised waitlist of potential organ recipients
• Will seek reports from hospitals on occurrence of brain death and transplant activities every month

CHENNAI: Following up on the three recent orders to regulate organ donation and transplantation, including cadaver-based transplant, the State government has appointed a Convenor for the Cadaver Transplant Programme in Tamil Nadu.

J. Amalorpavanathan, Reader in Vascular Surgery, Madras Medical College and Vascular Surgeon, Government General Hospital, was appointed to the post, as per a government order issued Tuesday.

In an earlier order issued on September 5 (as reported in The Hindu on September 7), the government committed itself to formulating a detailed procedure for cadaver-based transplant in government and private hospitals. It also promised to appoint a convenor to co-ordinate all activities relating to the programme. Dr.Amalorpavanathan, who is working as the transplant co-ordinator in the government hospital, has been roped in, considering his experience, and his familiarity with the issues relating to cadaver-based transplant.

Appointed in an honorary capacity, the convenor will report to the government directly on all matters relating to cadaver-based transplantation, the order says. He is expected to design and maintain a computerised waitlist of all potential organ recipients for heart, lung, liver and kidneys as received from the participating hospitals of the State. When organs become available, he will allocate them to the participating hospitals as per the guidelines issued by the government. He will also convene a meeting of the Advisory Committee, constituted under the Transplantation of Human Organs Act, once in two months, or as per requirements, to seek guidance on the detailed functioning of the State-level transplant coordination within the framework of the orders.

Among his other tasks are to seek and receive status reports from all participating hospitals on the occurrence of brain death and transplant activities every month and their outcomes; send to the government every month a consolidated status report on the cadaver-based transplantations that took place during the month; and report any violation of the rules and guidelines by any hospital to the Advisory Committee.

With the government focussing on awareness generation to increase the donations, the convenor will also co-ordinate and undertake such activities and motivation programmes for all involved in brain death certification and organ transplantation among the hospitals and the public.

The office of the convenor will be located in the Tower Blocks in the government hospital. Dr. Amalorpavanathan said the office of the Convenor invites suggestions from the participating hospitals at cadavertransplant@gmail.com and organstransplant@gmail.com.

http://sify.com/news/fullstory.php?id=14602228

Before he was caught, handcuffed and thrown into a police cell, Indian kidney racket kingpin Amit Kumar Raut lived life king size thanks to the nearly 200 per cent profit he gained per illegal transplant, according to his reported admission to Nepal Police.

He also denied having any links with the underworld or doing anything illegal.

“I am a doctor by profession,” the unshaken 43-year-old, who holds just a diploma in ayurveda and is not a qualified doctor, told the police after being arrested from a holiday resort in south Nepal on Thursday.

“I did people a service (through the transplants). I ran the Star Max Life Care Hospital in Gurgaon in India’s Haryana State,” Amit Kumar told police in his statement, a news report said on Saturday.

“Transplanting kidneys is my main business. I have been doing this for 15 years.”

According to the Nepali tabloid Naya Patrika, Amit Kumar told the Metropolitan Police’s crime division, who began interrogating him afresh on Friday, that patients from the US, Canada and European countries used to come to his clinic for transplants.

“I have conducted about 3,000 transplants for patients from these countries,” Amit Kumar reportedly told the police.

He said there were legal complications about kidney transplants. Several States had tight laws preventing such acts.

“In Haryana, the laws are slightly more lenient, which is why I opened my hospital there,” he reportedly said.

Amit Kumar is said to have told police that he used to charge per kidney recipient Rs 3,00,000-4,00,000 for a transplant.

“The poor and unemployed in India are interested in donating their kidneys,” the tabloid quoted him as saying to the police. “I used to pay the donors Rs 25,000 to Rs 100,000.”

However, Amit Kumar insisted that he had not done anything wrong.

“I did not force anyone to donate their kidneys,” he said. “I did not dupe anyone. The kidneys were extracted with the consent of the donors. Therefore, it was not a crime.”

“The sellers were poor Indians and buyers rich foreigners. I acted as the go-between and did people a service. I took money only after offering my services, it can’t be construed as robbery.”

Amit Kumar rejected the allegations that he had links with the underworld.

“I did not take the help of the underworld for my transplant operations,” the father of two said.

“At times I have also worked without profit to transplant poor and unemployed donors’ kidneys.”

Kumar blamed the Indian media for his plight.

“After the media targeted me, the Moradabad authorities filed a case against me in Uttar Pardesh state,” he alleged.

Asked why he was on the run if he had not done anything wrong, Amit Kumar said he was not running away but trying to defend himself.

RESULT OF THE AUTHORISATION COMMITTEE MEETING HELD ON 14.9.2007

S.N

Name of the Hospital

Name of the Patient

Name of the Donor

Approved Or Not Approved

Reason for Not Approved

1

Coimbatore Kidney Center Coimbatore

Mr.R.Thirumani

Mrs.Kousal Rani

Approved

———-

2

Kovai Medical Center Coimbatore

Mr .Kamakhya Patowari

Mr. Swapan Roy

Approved

———-

3

Kovai Medical Center Coimbatore

Mr.K.K.Sathyavan

Mr.T.V.Sudheer

Approved

———-

4

MIOT Hospital Chennai

Mr.Iyamuremye Octavien

Mr.Hashakimana Jacaues

Approved

———-

5

Chennai Kaliappa Hospital,Chennai

Mrs.Vijayalakshmi

Mrs.Suguna

Not Approved

The identity with reference to residential address and photograph are not clearly established.

Donor and her spouse are ignorant about the nature of organ donation.

6

Coimbatore Kidney Center Coimbatore

Ms.Virundha Nair

Mrs.M.Poongodi

Not Approved

The genuiness of the person who has attested the photograph is not proved.

The donor and her spouse are contradicting their statement .

The consequences and the nature of organ donation are not fully known.

7

Chennai Kaliappa Hospital,Chennai

Mrs.Pratima Shou

Mr.Biswambhar Chakraborty

Approved

———-

8

Chennai Kaliappa Hospital,Chennai

Mr.Consain

Mrs.Mary

Not Approved

No Objection Certificate from the Srilankan Embassy is not in proper format.

Chairman

Authorisation Committee

Chennai

To

Coimbatore Kidney Center

738-B Puliakulam Centre

Coimbatore-641 045

Kovai Medical Center And Hospital

Post Box.No.3209

Avanashi Road

Coimbatore 641 014

Chennai Kaliappa Hospital

52,Second Main Road,

Raja Annamalai Puram

Chennai 600 028

MIOT Hospitals

4/112 Mount Poonamalee Road

Manapakkam

Chennai.600 080