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THE GOAN SPECIAL
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The first step for cadaver transplants in the State has been taken. Now, the government has to take the second step. And the Goa Medical College is waiting.
For swift and successful implementation, personnel training is essential, but establishing a tissue typing lab, according to doctors, is most important. A proposal to set up the lab has been sent to the government.
GMC Dean Dr Pradeep Naik speaking about the achievement said the move would open up avenues for cadaver transplants in the state, but added that there was a lot to be done before it can be successful.
“Currently we can only do kidney transplants in the facility but with the coming of the 500 bedded super specialty block, the scope can be extended too,” said Dr Naik. GMC has so far conducted 14 live kidney transplants.
Spearheading the entire process of bringing cadaver transplant to the state is Dr Madhumohan Prabhudesai, urologist at the GMC along with a team of nephrologists. According to him, the problem so far has been that the system was undefined and had been the cause for several hiccups.
February this year was an important month for Goa Medical College (GMC) after it was registered as an institution that could undertake cadaver transplant in the state making it a reality. But the state still has a long way to go before it can actually begin
The induction of GMC under the National Organ Tissue Transplant Organization (NOTTA) is crucial to creating a corridor with the rest of the region and the country as a whole.
Setting up of a tissue typing lab to test compatibility of donor and patient tissues is also to be taken up. A proposal for this lab to be set up at the hospital has already been sent to the state government.
The central agency, NOTTO has divided the entire country into five regional divisions called Regional Organ Tissue Transplant Organizations (ROTTO). Goa fits in region number 2 has its main centre at KEM, Mumbai with the other states being Maharashtra, Chhattisgarh, Madhya Pradesh and Gujarat.
Each state has one centre called State Organ Tissue Transplant Organization (SOTTO). For Goa, this is the GMC that in addition to carrying out the procedure, are to keep track of all kinds of transplants, live and cadaveric. NOTTO being the centre keep a central registry of all the organ failure from across the country.
The success of a cadaver transplant lies however in how quickly an organ can reach the patient. Dr Prabhudesai taking the case of a cadaveric heart transplant said the usual time period for such operations is to be done in four to six hours.
Creating awareness among other doctors and the general public is also necessary, they say.
“Brain Stem Death is a science in itself and is a big challenge. Training to maintain blood pressure and other vitals is crucial for not only doctors but other medical personnel involved. There is an art in retrieving the organ without causing any damage. The entire process also needs other departments including the state government, police and post mortem personnel and forensics as well,” said Dr. Prabhudesai.
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ORGAN EXTRACTION: THE PROCESS
* Only a certified brain dead patient can fit the criteria for cadaver transplant
* A committee of four doctors, unattached to the operation itself, will ascertain if a person is brain dead
* Permission from the family has to be sought
* Kidneys, liver, heart, lungs, corneas, intestines, muscles, bone and skin can then be extracted
