Tamilnadu kidney transplant regarding

Tamil Nadu has been at the forefront of medical care in the country. It was the first state in the country that started a living kidney transplant program. It is also the first state to successfully start the cadaver programme after the passing of the “Transplantation of Human Organ Act” of 1994 and in the last 5 years has formed a network between hospitals for organ sharing. From the year 2000 to 2006 an organ sharing network was started in Tamil Nadu and the facilitator of this programme has been a non-government organization called MOHAN (acronym for Multi Organ Harvesting Aid Network) Foundation. The organs shared during the period number over 460 organs in two regions (both Tamil Nadu and Hyderabad). In Tamil Nadu the shared organs have included 166 Kidneys, 24 livers, 6 hearts, and 180 eyes. In 2003 sharing network was initiated by MOHAN in Hyderabad and to some extent the Tamil Nadu model was duplicated. with some success and 96 cadaver organs have been transplanted in the last 3 years. There are many advantages of organ sharing including the cost economics. At present there is a large pool of brain dead patients who could become potential organ donors in the major cities in India. Their organs are not being utilized for various support logistics. A multi-pronged strategy is required for the long term success of this program. These years in Tamil Nadu have been the years of learning, un-learning and relearning and the program today has matured slowly into what can perhaps be evolved as an Indian model. In all these years there have been various difficulties in its implementation and some of the key elements for the success of the program is the need to educate our own medical fraternity and seek their cooperation. The program requires trained counselors to be able to work in the intensive cares. The government’s support is pivotal if this program to provide benefit to the common man. MOHAN Foundation has accumulated considerable experience to be able to evolve a model to take this program to the national level and more so as it recently has been granted 100% tax exemption on all donations to form a countrywide network for organ sharing.

kidney patients concession in Indian Railways-2

clipped from www.indianrail.gov.in Ministry of Railways have decided to grant concession in basic Mail/Express fares to KIDNEY PATIENTS, WHEN TRAVELLING ALONE OR WITH AN ESCORT, FOR (i) Dialysis and (ii) Kidney transplant operation TO RECOGNIZED HOSPITALS. The element of concession will be 75% in FIRST, AC 3-tier, AC Chair Car, SLEEPER & SECOND CLASS and 50% IN AC First & AC 2-tier SLEEPER. THE SAME CONCESSION WILL BE ADMISSIBLE for RETURN also AFTER Dialysis and Kidney transplant operation . ONE ESCORT WITH EVERY PATIENT WILL ALSO BE ELIGIBLE FOR SAME ELEMENT OF CONCESSION.

Indian Railway concession to kidney patients-1

clipped from www.4to40.com Indian Railways in January announced it was considering offering concessions as high as 75% to people living with the virus regardless of their purpose for traveling. Indian Railways already offers fare concessions ranging between 50% to 75% to people living with various medical conditions, including tuberculosis, leprosy, hearing and speech disorders, and heart and kidney disorders.

An Article by C Maya

Patients need expensive medicines for two years

By C. Maya

Date:19/12/2004 URL: http://www.thehindu.com/2004/12/19/stories/2004121914550300.htm

THIRUVANANTHAPURAM, DEC. 18. With the Medical College hospital (MCH) preparing to resume its kidney transplant programme, attention should be given to evolving a proper mechanism to extend continued support to post-transplant patients who need life-long care, it has been pointed out.

A kidney transplant is just the beginning of treatment for a patient suffering from end-stage kidney disease. Once the transplant surgery has been performed, the patient has to be on immuno-modulatory drugs life-long to prevent the body from rejecting the transplanted organ.

Monthly expense

The monthly expense of these drugs could be Rs. 10,000-12,000, in the initial two years which most patients coming to the MCH cannot afford.

The success and sustainability of any transplant programme would thus depend on the extent of medical and monetary support that can be provided to patients post-transplant.

Renal failure

“The MCH has done 29 kidney transplants so far. The surgeries as such have been very successful but most of the poor patients are unable to continue medication beyond the first year and often end up with renal failures again. The success of the transplant programme depends on whether we can evolve a support agency to help indigent patients after the transplant,” says A. Vimala, the Chief of Nephrology, MCH.

There have been many attempts to form a corpus fund to extend monetary support to extremely poor patients after the transplant, but nothing has taken off so far. There have been occasions when patients manage to find the initial expense for a transplant through some funding or charitable agency. But the same agency might be helpless when it comes to supporting the recurring expense afterwards for medicines.

Mortality rate

The mortality rate of patients in the low economic strata, with end-stage renal diseases, is thus quite high, as both maintenance of haemo dialysis and transplants are equally expensive options for them. Dr. Vimala points out that few people are aware of the fact that post-transplant, patients have to be on medication life-long.

Discontinuing medicines even for a day could do a lot of damage and once the transplanted kidney is rejected, the patient will have to go back to dialysis or wait for a second transplant surgery.

The Kidney Transplant Patients’ Welfare Association, with 300-odd members, has been trying for a long time to convince authorities and NGOs that some support mechanism be set up to extend monetary support to those who have undergone transplants.

“We have appealed to the Government and many NGOs several times that some support be extended to these patients, at least for the initial two years when they have to be continuously on expensive immuno-suppressive drugs. But the problems faced by renal patients have never come up for discussion in any health fora,” points out a member of the Association.

No funding

The Association, though registered in 1999, has never had any solid funding and has not been able to float a funding mechanism to support patients. It is pointed out that in the neighbouring Tamil Nadu, the State Government has a programme to support indigent patients during the first year after transplant. Even drugs made available at subsidised rates would be a great help, the Association says.

Meanwhile, with diabetes emerging as a major public health concern, the number of people turning up with renal disorders has been on the increase. In the city especially, the number of patients in the 30-50 years age group, who end up with end-stage kidney diseases due to diabetes has been on the high side, doctors point out.

With the increase in the number of nuclear families, the process of finding a suitable donor from immediate relatives could be more difficult than ever, Dr. Vimala says.

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