PANAJI: Goa's attempts to have benefited from organs of local deceased donors was not possible on several counts, in the absence of a State Organ and Tissue Transplant Organisation (SOTTO), criteria based, transparent waiting lists and cross matching facilities in Goa.
This was stated in a detailed letter by Dr Astrid Lobo Gajiwala, director, Regional & State Organ & Tissue Transplant Organisation, Western Region, Ministry of Health and Family Welfare, KEM Hospital & GS Medical College, Mumbai, in response to Goa's first deceased organ donation that occurred on April 5 and 6 at Manipal Hospital and allocation of organs to hospitals in Mumbai.
In her letter to Director of Health Services Dr Sanjeev Dalvi on Tuesday, Dr Gajiwala explained that “cross matching of donor and recipient is also essential for kidney transplantation. Currently there are no cross matching laboratories in Goa.”
“In the absence of a State Organ and Tissue Transplant Organisation SOTTO, criteria based, transparent waiting lists and cross matching facilities in Goa, as per requirements of the THOTA Rules, Dr Mahesh Panche, Nodal Officer, Deceased Organ Donation Program, Goa Medical College, requested ROTTO, Western Region, to coordinate the retrieval, storage, transportation, matching, allocation and transplantation of the organs retrieved in Goa Manipal Hospital.”
“Since the THOTA Rules also require ROTTO to coordinate the establishing of new transplant and retrieval centres, ROTTO, Western Region, also helped facilitate the emergency registration of a Non Transplant Organ Retrieval Centre (NTORC).”
“This was achieved thanks to the support in the middle of the night, of the Principal Secretary, Medical Education and Drug Department, Government of Maharashtra, Sanjay Deshmukh, and the timely intervention and orders issued by the Goa's Health Secretary Ashok Kumar,” stated Dr Gajiwala.
She clarified that ROTTO would very much have liked to oblige the request of Goa Medical College Dean Dr Pradeep Naik for allocation of a kidney to a patient in his hospital.
“However, this could not be done because we could not bypass the system. First, Goa had no approved waiting list of kidney recipients, so there was no one to whom the kidney could be allocated at midnight. Second, no emergency cross matching facilities were available in Goa,” explained Dr Gajiwala.
“To prevent the wastage of organs and facilitate timely transplant, it was therefore decided that for this one time, until Goa puts its systems in place, the organs could be utilised in the nearest State in the Region, best connected by air, namely, Mumbai.”
“In view of the belated demand for organs made by Goa Medical College, it may also be noted that last minute changes in allocation cannot be permitted in this system as it involves the life of recipients and logistics of great magnitude,” said Dr Gajiwala.
“In Mumbai, five patients are sent for cross matching as the possibility of a positive cross match will lead to disqualification of the recipient making the next person on the waiting list eligible.”
“All the recipients are required to be in the city and their blood samples must reach the cross matching centre within two hours as the test takes 6-7 hours. In this particular case, a flight too was chartered at great expense to the recipients,” she added.
Dr Gajiwala assured that the ROTTO would, in future, “be very happy to see organs that are donated in Goa being used by recipients in Goa itself, and the inclusion of Goa in ROTTO/NOTTO allocation of organs from other States when they become available.”
“This can only happen however, if Goa ensures the establishment of SOTTO, maintenance of criteria based, transparent waiting lists for organs and linking the same to ROTTO and NOTTO, establishment of emergency cross matching laboratories and availability of local organ retrieval teams. ROTTO would be happy to help with this if required.”
“ROTTO looks forward to working with Goa and assisting it in whatever way possible to get its Organ Donation and Transplant Program on the road. It would be a great achievement for the Region to have Goa counted among the States doing organ transplants,” said Dr Gajiwala.
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Why not a single donated kidney for
GMC? Govt fumes, orders probe
Role of Dean, Asst Lecturer in Dept of Casualty & Emergency Medicine under scanner
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I have asked them to find out what went wrong and why. Two patients in Goa could have got a new lease of life--------------------------------------------------------------------------
- Vishwajit Rane
PANAJI: The Government of Goa has initiated an inquiry into how the organs that were harvested from a brain-dead donor at Goa’s Manipal were agreed to be transported to recipients outside the state ignoring the possible beneficiaries within the state.
Health Minister Vishwajit Rane, who ordered the inquiry has said that it was disappointing that the Goa Medical College and Hospital did not even secure one kidney, from among those organs harvested, to be transplanted into a local patient among the many waiting for a donated kidney in the state.
The role of both the Dean of the Goa Medical College as well as one Dr Mahesh Panche, an assistant lecturer in the Department of Casualty and Emergency Medicine who is the ‘organ coordinator’ for the state of Goa is under the scanner.
In an order issued on Tuesday, Dean of the Medical College asked Dr Mahesh Panche not to proceed on leave or proceed anywhere out of Goa for any training programme within or outside the State of Goa and to make himself available for the inquiry till its completion.
Rane has asked for an inquiry with the report to be submitted on Friday.
According to sources, the Goa Medical College’s Urology and Nephrology Departments, through an internal communication, asked the Dean to make arrangements for organ transplants with expectations that two kidneys would come to GMC last week.
However, this internal communication was leaked and potential recipients outside the state were alerted to the possibility of the availability of organs leading to a ROTTO team to fly down to Goa and ship the organs out through the ‘green corridor’ that was created late last week and flown to Mumbai by a specially chartered flight.
“I felt that the GMC should have got at least one kidney. It is good news that the organs were harvested and our health secretary gave permission to the Maharashtra government to harvest the organs,” Health Minister Vishwajit Rane said.
He said that the government-run hospital by virtue of being a recognized premier institute, which only recently conducted to kidney transplants should have been given first preference.
“I have asked them to find out what went wrong and why. Two patients in Goa could have got a new lease of life,” Rane, who chaired a two-hour meeting to discuss the issue before instituting the inquiry said.
Rane said he took this as a personal failure, even though he was unaware of what was happening as the doctors did not bring it to his attention. “We need to put on record the reasons why this has happened,” Rane said.
The inquiry report is expected by Friday.
