COVID-19 holds back Chennai government hospitals from resuming organ transplant surgeries

Doctors say it is risky to perform surgery in a high viral atmosphere; however, few private hospitals have resumed transplants.
Firefighters spray disinfectant at Rajiv Gandhi General hospital amid coronavirus threat in Chennai. (Photo | R Satish Babu, EPS)
Firefighters spray disinfectant at Rajiv Gandhi General hospital amid coronavirus threat in Chennai. (Photo | R Satish Babu, EPS)

CHENNAI: Government hospitals in Chennai are yet to resume organ transplant surgeries after it was stopped in March due to the Covid-19 pandemic. Doctors say that the pandemic isn't over yet and there are several risks in performing transplant surgeries.

While the Transplant Authority of Tamil Nadu (TRANSTAN) released regulations in June for hospitals that wish to resume organ transplants, government hospitals in Chennai are still hesitant.

Senior surgeons and doctors from Rajiv Gandhi Government General Hospital, Kilpauk Medical College Hospital and the Stanley GH are all of the opinion that it is still hard to resume organ transplant operations due to various reasons such as determining the Covid status of donors, risk of recipients getting infected during or post-transplant, and ensuring a safe atmosphere for the surgery.

Dr N Gopalakrishnan, Director of Institute of Nephrology, RGGGH, said resuming renal transplant fully depends on the Covid trend in the near future. "There are challenges in cleaning the donors and getting swab results. Also, it is risky to perform surgeries in a high-viral atmosphere and the patient too is vulnerable to infection post-surgery as they would be on immunosuppressants," Gopalakrishnan said. He added that there is of course a demand for renal transplants but the effectiveness of surgery in such an atmosphere and safety of patients need to be viewed. "Covid cases have come down now, but we have to wait and see," he added.

While about 55-75 transplants are done at the RGGGH every year, this year, only 20 transplants have been performed till March. A senior doctor with Stanley GH said the donor list is ready and doctors are ready to perform the surgery too, but the atmosphere is not conducive. "We are observing a second wave across the globe in various countries. So, we have to wait and see if cases further go down in the city. We can't put patients and doctors at risk," said the doctor.

The doctor added that if the body of the patient rejects the organ, then the recovery becomes harder, especially during these Covid times.

Dean of KMCH Dr P Vasanthamani said the hospital mainly does only skin and renal transplants but the Covid situation has not yet improved.
"Firstly, doctors are involved in Covid treatment and it can't be said for sure when transplants will begin," she said.

However, some private hospitals in the city have resumed organ transplants months ago and doctors say it is picking up pace. Dr Rajnikanth, Clinical Lead in Liver Transplantation at Gleneagles Global Health City, said they had resumed operations in May but only in November it is picking up pace. "As of November, we have performed about 80 per cent of the transplant surgeries we annually do in normal times. Surgeries were lesser during the initial stages of the pandemic but it eventually picked up," said Rajnikanth.

Dr Gomathy Narasimhan, Senior Liver and Renal Transplant Surgeon with Dr Rela Institute and Medical Care, said transplants have been happening since May and the pace is gradually picking up. "We have done close to 60 per cent of the transplants which are done annually. The outcomes too have been good," she said.

According to data from TRANSTAN, close to 7,000 recipients are on the waiting list for various organs in Tamil Nadu. Among them, the majority - 5,810 - are awaiting kidney donors, while 468 are waiting for liver transplants.

The number of organ donors too has been increasing annually, with kidney being the largest donated organ. In 2019, out of the 107 organ donors in government hospitals, 33 had donated kidneys while 42 donated corneas. Whereas, out of the 655 donations to private hospitals, 179 people donated kidneys, 144 donated corneas and 97 donated livers.

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