'Brain death certification still a challenge'

NEW DELHI: Calling for a social movement to promote organ donation, health minister JP Nadda said the gap between organ demand and availability is immense. Though the donation rate has improved, there is a long way to go.

“Systems have to be created to bridge the gap. We should understand how we go forward to address issues of retrieval, transplant, transportation, human resource and training,“ Nadda said at a TOI roundtable on organ donation.

Apart from the health minister and government representatives, experts from public and private healthcare institutions, including those from AIIMS, G B Pant, Ganga Ram Hospital, Fortis, Mumbai's Kokilaben Dhirubhai Ambani Hospital and Mohan Foundation brainstormed on challenges and hurdles to organ donation.

Nadda said the health ministry is working to bring on board all stakeholders. The government has already created organ donation registries at national, regional and state levels to create a systematic database to facilitate procedures of donation, retrieval and allocation.This has helped online donation and tracking of organ availability .

The ministry and the National Organ & Tissue Transplant Organisation (NOTTO) are working on policy frameworks to bring in transparency .

“We've come out with guidelines for kidney and heart, now we are finalising allocation norms for pancreas and intestine,“ said NOTTO director Dr Vimal Bhandari.

Though organ pledges have increased significantly , states should come adopt the law and guidelines and report data to make the registries more effective, Dr Bhandari said.

Highlighting the need for capacity building and spreading awareness, Nadda said all aspects should be worked on for a smooth and trans parent donation mechanism.

Even now many feel pledging organs may deprive a donor of the best of treatment. A family may get harassed while claiming a near one's body. There are fears that organs may go waste due to an inefficient system and time lag, said Dr Ram Narain executive director, Kokilaben Dhirubhai Ambani Hospital. “People want to know how the organs are being used.“ D-G health services Jagdish Prasad said there's need to train and encourage doctors to take up organ donation. This is because certification of brainstem death is a major challenge.

“Even in ICUs, doctors don't know how to certify brain death. We are training doctors and surgeons to fa cilitate retrieval of organs and carry out transplants,“ Prasad said.

Leading urologist and head of Mohan Foundation, an NGO, Dr Sunil Shroff, said: “People come forward to donate. But we need to create capacity in hospitals.“ He suggested that the government make retrieval centres mandatory at all medical colleges. Experts pointed to the disparity between the public and private sectors. “We've limited transplant centres; mostly in the private sector.Most donors are in the public set up,“ said Dr Aarti Vij, additional medical superintendent and incharge, Organ Retrieval Banking Organisation, AIIMS. Dr Anil Aggarwal from GB Pant, who also heads the Delhi organ transplant cell, suggested an aggressive donation campaign to be run through the year by the government and stakeholders.

Highlighting India's achievement in conducting successful liver transplants and attracting patients from the world-over, Dr Samiran Nandi from Ganga Ram Hospital said: “Doctors need to build trust and a corruption-free transparent system.“

Fortis's Dr Avnish Seth emphasised the need for speedy infrastructure upgrade. “The government should facilitate air lifting of organs.Green corridors aren't sustainable for long,“ he said. Experts urged the government to introduce a curriculum and mandatory training for organ retrieval transplant at UG and PG levels.