New Way to Increase Supply of Organs

Transplant Surgeon Pioneers

New Way to Increase Supply of

Organs

http://www.newswise.com/articles/view/540154/

Newswise — Transplant surgeons such as Dr. Robert Love of Loyola University Hospital are pioneering a new way to increase the supply of organs from deceased donors.

Today, most organs are obtained from donors on life support who have been declared brain dead. The organs are in good condition because the heart is still beating.

But more surgeons are beginning to use organs from patients who have been declared dead after their hearts have stopped beating. Last year, there were 793 donations after cardiac death in the United States. That’s up from 117 cases in 2000.

Kidneys and livers are the most commonly used organs from cardiac-death donors, but surgeons also are using lungs and pancreases. Love has done about 30 lung transplants from cardiac-death donors.

Nearly 100,000 people are waiting for organ transplants in the U.S. Some people wait for years. And many die while still on the list.

“We must do everything we can to encourage people to become organ donors,” Love said. “And we also have to make sure that every usable organ is used.” Love is a professor of thoracic and cardiovascular surgery at Loyola University Chicago Stritch School of Medicine.

Steve Schumann of Palatine is among the patients of Love who have benefited from a cardiac-death donation. The 60-year-old pharmacist had pulmonary fibrosis, a progressive and incurable lung disease. Schumann had uncontrollable coughing fits, and needed oxygen 24 hours a day, even in the shower.

Without a lung transplant, Schumann did not have long to live. If his only option had been a transplant from a brain-dead donor, an organ might not have become available soon enough to save his life, Love said. Fortunately, Schumann’s time on the waiting list was shortened when a pair of lungs became available from a cardiac-death donor.

Last July, Love and Loyola surgeon Dr. Michael Eng traveled to the donor’s hospital in Joliet to recover the lungs. Love brought the organs back to Loyola in an ambulance, and performed the transplant along with Dr. Mamdouh Bakhos.

Shortly after waking up from surgery, Schumann’s new lungs filled with air. For the first time in more than two years, he could breathe without an oxygen tank.

“The feeling was indescribable,” Schumann said. “It was such a relief.”

Schumann can walk again, without gasping for breath or being tethered to an oxygen tank. He has just joined an over-fifty softball league, and plans to play as much golf as possible this summer.

“It was a miracle,” he said.

Obtaining organs from cardiac-death donors can be technically challenging. Organs begin to deteriorate as soon as the heart stops beating. Surgeons generally have only a 30-minute to 60-minute window to remove organs.

A typical case involves a patient who has suffered severe and irreversible brain damage from, for example, a car accident, gunshot wound or brain hemorrhage. The patient still has minimal brain function so is not considered brain dead. But the patient is near death, and further treatment is considered futile. The family agrees to withdraw the patient from life support and donate the organs.

The patient usually dies shortly after being taken off the ventilator and other life support, such as medications to maintain blood pressure. Five minutes after the patient’s heart stops beating, the body is taken to an operating room, where the organs are recovered.

Donation after cardiac death leaves the family little time to say goodbye. “But families are usually very understanding about this,” said Joyce Maly, Loyola’s in-house coordinator for organ and tissue donation. Maly’s position is a partnership between Loyola and Gift of Hope Organ and Tissue Donor Network.

Families take solace from knowing that their loved-ones’ organs will enable other people to live. “They are living on in someone else,” Maly said.

India ranks 2nd in kidney transplants from live donors

India ranks 2nd in kidney transplants from live donors
A ‘Kidney International’ report said India has no reliable national data to show how many kidney transplants occur
Seema Singh

Bangalore: Fifteen years after India passed the Transplantation of Human Organs Act, allowing organ retrieval from the brain-dead patients, kidney donations by live donors remain very much in vogue and, according to a recent study, the country sees more such transplants than any other country in the world barring the US.
Also See Top 10 Countries by Transplants (Graphic)
India, however, slips to the 40th rank in the study of 69 countries in terms of number of transplants per million population, with only three in a million getting the kidney in case of a renal failure.
According to a new report in Thursday’s issue of the Kidney International—the journal of the International Society of Nephrology—about 27,000 related and unrelated living kidney donor (LKD) transplants occur worldwide every year, of which 6,435 take place in the US and 1,768 in Brazil with India figuring in between with about 3,200 transplants, a number which the authors said, doesn’t represent “reliable national data”.
“It’s true, we don’t have any national registry and nobody knows how many kidney transplants occur in India,” said Sunil Shroff, managing trustee of the support group Multi Organ Harvesting Aid Network Foundation in Chennai. He estimates the number of transplants per year to be in the range of 3,000-3,500, with barely 5% coming from the brain-dead. The annual requirement is about 150,000.
The LKD rates in two-thirds of the 69 nations surveyed have been growing at 50% over the last decade, but India remains stuck at the same level, which Shroff attributes to lack of health insurance, and institutional and financial support. A kidney transplant costs about Rs3-4 lakh, with a lifetime monthly post-operative care costing at least Rs10,000.
Tracking the rate of LKD is important as the worldwide prevalence of end-stage renal disease is increasing and a global trend can help countries evaluate their performance, said authors Lucy Diane Horvat, Amit Garg and colleagues from the University of Western Ontario in Canada.
India is in an unenviable position when it comes to the disease burden, implementation of the organs Act and preventing kidney rackets that frequently rock the nation.
At present, brain-dead transplant, also called disease donation, amounts to 0.7 per million population, but if this is increased to one, then there would be 1,100 donors and 2,200 kidneys for transplants, said Shroff. If pushed further, to two per million population, then 4,400 kidneys could be retrieved, dramatically reducing the burden on living donors.
“We (surgeons) have a problem in LKD…operating on healthy people, who in many cases die or develop complications,” said Sandeep Guleria, a transplant surgeon at All India Institute of Medical Sciences. He said unlike the West, which started with cadaver transplants and took to living donors to bridge the gap, India started with living donors and even 15 years after the Act, has failed to adopt cadaver transplants in earnest.
Some of the ambiguities in the Act that led the kidney donor-broker-hospital nexus to thrive have now been cleared. The Act was amended with effect from 4 August, to make the procedure more transparent , said Harsh Jauhari, head of renal transplantation at Sir Ganga Ram Hospital in New Delhi.
But several problems remain and experts believe they can be addressed when the national organ transplant programme—ambitious but apparently hurriedly announced in November—on the lines of the National AIDS Control Organization will eventually be launched. “It will bear fruit only four-five years down the road,” said Jauhari.

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Request for helping kidney patients sent to ministers

dear friend

I have sent  email to finance minister, Kerala State and forwarded the request to the Chief Minister and health minister to kindly do something for kidney patients and those who have transplants done.

The letter copy is given below

Regards

Sreekumar

To the finance minister, Kerala State

Dear Sri.Thomas Isacc,

It is great to see that you have been sensitive to many social issues, as reflected in your budget and I appreciate you for the same.
However there are areas where I feel your attention has not yet reached. One such area is that of the suffering patients afflicted with chronic diseases in Kerala.
May I bring your kind attention to the pathetic situation of kidney patients who are in dialysis and in need of kidney transplant.

As a person of social sensitivity, you might not have missed the advertisements that appear almost everyday in newspapers, requesting financial help for kidney transplant operations. Any person can suddenly find himself/herself a patient with organ failure. It is devastating to the patient and his/her close ones. I request you to kindly visit my blog site


http://sree1010.wordpress.com/government_assistance/


ASSISTANCE SOUGHT BY KIDNEY PATIENTS

There is crying need for Government Assistance for the welfare of kidney patients and those who have undergone organ transplant.

Patients with organ failure and those who have undergone transplant, both need help of the government for their survival.

Following urgent actions are suggested :

Ensure job security and income security to patients and/or families so that they can meet the medical and other expenses associated with the the miserable situation arisen as a result of the disease.

Ensure Job Security

Measures to ensure that kidney patients are not laid off or dismissed from the institutions they work, particularly from the private sector institutions.

Kinder approach to patients with organ failure with generous working conditions allowed in government and non government institution so as to help them adjust job commitments along with their treatment for health.

Ensure job reservations for patients who are in dialysis and also those who have undergone kidney transplant so that they make some money to meet their treatment expenses and reduce dependency on others.

Ensure job reservations at least on contract basis  to aclose relative of a person afflicted with organ failure so as to enable him/her to support the patient. This may be limited to the period the patient suvive

Provide Insurance Coverage

Measures to ensure that kidney patients gets quality medical insurance coverage

Make Employees State Insurance (ESI) compulsory in all private institutions including educational institutions
Medical Infrastructure

Establish government dialysis centers in all districts where dialysis is given at subsidised /affordable rates.

Subsidise medicines and medical accessories used by kidney patients to reduce their financial burden

Increase the supply of dialysis units available in hospitals and make available affordable dialysis to all patients and make dialysis equipments tax free.

Welfare schemes

Rehabilitation schemes shall be introduced for kidney patients

Introduce concessions in all sectors for kidney patients and their supporting relatives including private and KSRTC buses.

Introduce concessions in both private and state transport corporation buses at par with railway concession for kidney patients

Reservations for children of kidney patients in private and government schools and provide educational supports including fee concessions

Introduce employment schemes tailor made for patients suffering kidney diseases or have undergone transplant operation.

Increase organ availibility

Appoint a task force to remove hurdles for facilitating organ transplant.

Encourage willing donors to donate kidney /organs. Make willing living donors symbols of human love and kindess and sacrifice and reward them with job reservations/ governmental assistance

Promote cadaver transplant for increasing organ availability by introducing generous incentives for relatives for the dead person, advertisements in media, compulsory retrieval of cadavers as done in developed nations, removing hurdles for retrieving organs from cadavers etc.

Promote living donor transplant and encourage willing donors by providing introducing incentive schemes and reservations for the living donor. Unfair kidney trade must be stopped by government stepping in to provide fair deal to the willing donors for their sacrifice.

Promote donor organ swapping by facilitating mass transplant operations where a group of patients and willing donors come together and donors with matching kidneys are swapped

Increase organ transplant infrastructure in government hospitals to highest standards

Other Measures

Promote medical research in the field of kidney diseases and introduce mechanisms to share information

Introduce a national directory for organ transplant

National policy for organ transplant and monitoring machinery to ensure better availibility of donor organs

Promote private sector and NGO involvement in supporting kidney patients
Anyone can be a patient. Losing health is devastating for the poor people and the middle class. They lose job and income source, they become dependent on others, The families are shattered due to loss of income and the miseries associated by having a chronic patient among them. Many families have become bankrupt and have even committed suicide due to unsurmountable problems due to a member falling ill.

A government aimed at people’s welfare cannot ignore the diseased and their families. Loss of health and associated problems is the cause of insecurity in the minds of most people and a progressive minded society do not leave the sick members to fend for themselves without helping.

I request you to read the above suggestions and take appropriate actions to ensure that patients are given kinder treatment.

Yours faithfully,

Sreekumar B
KSEB colony, 110 kv substation, Chevayur, Kozhikode-17
Phone: 9946554580
email: sree1010@gmail.com
website: http://sree1010.wordpress.com/