The 14th annual conference of the Indian Society of Organ Transplantation (ISOT), in Hyderabad, has called for amendments to the Transplantation of Human Organs Act, 1994, to promote cadaver organ transplants in the country. The participants at the three-day conference said they were committed to the promotion of cadaver organ transplants in the country for which some amendments to the Act were necessary.
Some of the amendments which were discussed and adopted at the conference included granting licence to all trauma and neuro centres for harvesting of organs, broad-basing the authorisation committee with 40-50 experts to avoid pressure on the members and an opt-in and opt-out clause in the driving licence in order to make organ donation voluntary. The conference was jointly organised by ISOT and Global Hospitals, which specialising in organ transplantation, from August 8 to 10.
Inaugurating the conference, Health Minister Dr Kodela Sivaprasada Rao said the government would take necessary steps to make organs available through various ways and means. He also underscored the need for amendments to the relevant Act in order to make the present rigid procedure of donation and transplantation of human organs easier. He said the government was ready to introduce amendments to the Act and asked ISOT to come up with valid suggestions after the conference.
The Minister said at present organs of only a few 'brain dead' persons due to accidents were retrieved with the consent of their kith and kin. It was not an easy task to convince the relatives for organ donation of their dear ones. Dr Rao asked the hospitals and NGOs concerned to educate the people and create an awareness on the need for voluntary donation of organs in case of their death due to accidents.
He said people should be taught about the humanitarian gesture of organ donation. The organs donated by a brain dead person could give a new lease of life to several people waiting for organ transplantation. The kidneys, the liver, the pancreas, the eyes, and various tissues of a brain dead person could be used for transplantation in different patients.
Dr R V S Yadav, president, ISOT, appealed to the state government to legalise donation of human organs made by a person while he/she was alive.
Dr P V L N Murthy, Chairman, Scientific Committee, told Pharmabiz.com that about 300 delegates from all over India were attending the conference and the various scientific sessions. The participants included urologists, nephrologists, gastro surgeons and physicians, cardiologists and cardiac surgeons.
Besides specialists from all parts of the country, guest lectures were being delivered by eminent doctors from the US, UK, Australia and Japan. The foreign guests included Dr Mohan Rao from Australia, who did the first successful kidney transplantation in India at CMC Vellore in 1971, Dr Ali Bakran from Liverpool, UK, Dr Pragat Pillai from Australia and Dr Rajagopalan from USA.
The scientific sessions concentrated mainly on kidney, liver and heart transplants and some 65 papers were presented. Some of the interesting presentations from Indian specialists included 'DNA Fingerprinting in Organ Transplantation' by Dr Thangaraj (CDFD), Hyderabad, and 'Immunological Predictors of Graft Function' by Prof. S C Tiwari, AIIMS, New Delhi. The conference discussed topics such as the ethics of renal transplantation in India, the concept of brain death, and heart & renal transplantation tomorrow.
The trauma underwent by a young Irish woman from the age of 16 to 28 due to immediate rejection of five liver transplants over a period of 13 years, the case of a woman who took a high dose Paracetamol and vitamin supplements and a liver transplant done to save her life were some of the interesting issues that came up at a tele-conference between a team of doctors of King's College Hospital, UK, and the delegates at a workshop on liver transplantation organised at Global Hospitals, as part of the conference.
The liver transplant on the Irish woman had raised a critical ethical issue among the delegates. It was a medical and ethical dilemma of physicians, said Dr Mohammed Rela, while speaking to his colleagues, John O' Grady and Nigel Heaton, during the video-conference. Dr Rela raised a question as to how justified was the society in giving six livers to a single patient when as many patients could have been saved at the same time. He also asked whether it fitted the tenets of medical profession by testing the tolerance of a patient for such a long period. People were generally tired and unwell after the third transplant and they would give up. Dr Heaton, who was involved in the transplant, described the woman as a 'liver eater.'
Dr O'Grady said after a futile liver transplants for five times, a combinatioin of bone marrow transplant and liver from a close sibling was experimented in May this year. Now the patient was doing well with some minor morbidity of bone marrow transplant.
Dr Rela said the woman, who had been suffering from Hepatitis since 1991, when she was 16, had an immunity system which rejected all the first five grafts. Only time would tell what would happen to the sixth one. He ruled out a seventh transplant on her. " There is no option before medicine but to give her up," he said adding that the medical profession had a lot to know from the case.
The video-conference also discussed the case of a woman who tried to commit suicide with an overdose of paracetamol, leading to acute liver failure. She had consumed 48 grams of the drug and was unlikely to recover unless the auxiliary liver transplant was carried out. In the background of increasing attempts by consuming paracetamol, the conference discussed the criteria in the selection of the patients for the transplant. Most of them did not require it.