BENGALURU: Dr Keerthiraj enlisted his father-in-law Gopalkrishna for receiving a liver around six months ago when he was diagnosed with liver cancer. He is ninth in the queue and says the waiting list is not transparent and there is no way to track it.
"We stay in Saligrama and the transplant hospital is in Bengaluru, which is seven hours away. As organ transplants are sudden and time-sensitive, we do not know when we need to stay close to the hospital as the call could come any time. The waiting list is slow to move due to lack of incentive and motivation on the part of donors," Dr. Keerthiraj said, while speaking at a panel discussion on 'Making Organ Donation Easy', organised virtually by the Institute of Medicine and Law on Tuesday.
Dr Amberkar Vinayak who was the recipient of a liver from his son last year said he faced two challenges -- documentation and finances. As he moved from Davanagere to Bengaluru for the transplant, his address had to be changed on the Aadhaar. He needed to visit government offices to get proof of the family tree and the process was bureaucratic.
"The officials did not understand this was for organ donation as family tree proof is usually given for property. The cost was high to begin with at Rs 18 lakh to Rs 20 lakh and then extra charges of Rs 3 lakh to Rs 5 lakh piled on post operation. It needs to be made more affordable," Dr. Amberker said.
Dr. Sunil Shenvi, Consultant Hepato-Biliary-Pancreatic Surgery and Multiorgan Transplantation, said there are not enough centres of organ transplantation outside metro cities. District hospitals and medical colleges run by the government do not have specialists trained in it. The cost too is exorbitant and out of the reach of the poor. He added that the legal process was made too stringent due to organ trafficking that happened illegally earlier but now that has turned into red tapism, making it difficult to get police clearance.
Mahendra Kumar Bajpai, advocate, Supreme Court of India and Honorary Director, Institute of Medicine Law, pointed out other challenges such as lack of a single definition of death. "The Registration of Birth and Death Act does not include brain-stem death as a form of death but the Transplantation of Human Organs Act does. This will help the cause of organ transplantation. Statutory requirements should not be done by the doctor, which is causing doctors to be disinterested. It should be done by administration or hospital staff," he said.
He also pointed out that the police can waive post mortem in medico-legal cases such as crime and accidents as organ transplant is time sensitive. Even the opening of three cavities by forensic experts can be done away with, he said. Though there are rules to transplant organs from unclaimed bodies, the procedures are not prescribed and hence they are not used for it.
Dr Kishore Phadke, Convener, Jeevasarthakathe, and nephrologist, and Dr M. Kirankumar, Joint Director (Medical), both from the Karnataka Health and Family Welfare Department, said there is transparency.
"Under Ayushman Bharat, funds are well allocated for BPL patients requiring transplant. Last year, Rs 11 lakh was spent on it for 7-8 cases in Bengaluru. For APL patients, there is a 30 percent discount. We are planning to start non-transplant organ retrieval centres in district hospitals and medical colleges. We are also working on training critical care specialists and employing grief counsellors for possible donor families," Dr Phadke said.