CHENNAI: Transplantation of major organs such as heart and lungs continues to remain a challenge in Tamil Nadu. In 2023, the state successfully transplanted 65 hearts and 50 lungs, but the utilisation rate has been pegged at a dismal 35% and 22%, respectively, concerning the number of organs harvested.
This is despite a 14% jump in cadaver organ donations in the state in 2023 compared to the previous year, according to data from the Transplant Authority of Tamil Nadu (TRANSTAN).
Transplant surgeons and senior health officials cite the short preservation time of organs and probability of infection of lungs in road accidents as the prime reasons for the low utilisation rate.
As per TRANSTAN data, the state transplanted 39 lungs (single and dual lungs), and 74 hearts in 2022. This puts the utilisation rate of heart at 44% and lungs at 29%. In 2019, before Covid, the utilisation rate was 47% and 31% for the organs, respectively. Tamil Nadu stands first in the country in utilisation of organs and tissues from brain-dead donors.
According to TRANSTAN officials, the reason for drop in utilisation rate of heart and lungs in 2023 was because the state was allotted more organs from other states compared to previous years. In some cases, by the time these organs were retrieved and could be transplanted to patients, they become unviable.
According to doctors, the age of donors and blood pressure were some of the factors that led to conditions which made these organs unusable.
TN performed 935 transplants in 2023, 6,318 await kidneys
TRANSTAN records reasons for organs that could not be used in every case. Some private hospitals, however, are making best use of organs by doing perfusion and have been more successful in utilising the organs.
Among organs donation for transplantation, heart and lungs have the shortest preservation time. They should be transplanted within 2-3 hours of retrieval unlike a kidney which can be stored for more than 24 hours, said a cardiothoracic surgeon of a government hospital.
Dr Gomathi Karmegam, associate professor, Emergency Medicine, Rajiv Gandhi Government General Hospital, said, during accidents, if the patient is unconscious, there is an increased tendency for the patient to vomit. While doing so, there are chances of aspiration where vomited products may enter the lungs. This causes infection and the lungs may not be fit for use, she said.
The other reason is that transplanted lungs have higher degree of rejection. Hence, the cardiothoracic surgeons have to be meticulous in assessing both the donor and recipient. These are the reasons why lung transplantation does not happen as frequently as other organs, Dr Gomathi said.
Speaking to TNIE Dr N Gopalakrishnan, member secretary, Transplant Authority of Tamil Nadu, said the waiting list for heart and lungs are also less when compared to kidneys and liver. The state is doing well in transplants. According to data, 6,318 patients are waiting for kidneys, 384 for liver, 70 for heart, and 62 for dual lungs. The state had performed a total of 935 transplants in 2023 compared to 878 in 2022.
In 2023, TN successfully transplanted 65 hearts and 50 lungs, but the utilisation rate was pegged at a 35% and 22%, respectively, with respect to the organs harvested