Shortage of surgeons & retrieval centres hinders organ transplants

NEW DELHI: India requires to perform at least one lakh kidney transplants in a year. However, data shows that only 13,476 kidney transplants could be carried out in 2024, meaning that the rest of individuals in need continued to suffer with kidney dysfunction or, in some cases, succumbed due to complications. Similarly, patients suffering from end-stage failure of other organ systems face the same crisis. Recently, govt held a review meeting to assess what ails the organ transplant process in the country.

A government report, accessed by TOI, is based on a recent review of organ transplantation activities in government hospitals by the National Organ and Tissue Transplant Organisation (NOTTO). It suggests mandating govt medical colleges and associated hospitals, including trauma centres, to establish organ retrieval facilities even if they do not perform transplants themselves.

Also, it has been strongly recommended that liver and heart transplants, including the lifelong costs of immunosuppressants for transplant recipients, be comprehensively included under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana.

The review meeting was chaired by NOTTO head Dr Anil Kumar. More than 130 medical superintendents, nodal officers for transplant centres and transplant surgeons, among others, participated.

Govt hospitals, with their extensive infrastructure and high patient volumes, particularly in trauma and critical care units, are in a position to expand the national deceased organ donation programme. However, it was noted at the meeting many govt institutions that have been granted licences for organ transplants were not performing them in adequate numbers, with number of deceased donations being either nil or very low.

For example, while govt institutions like IKDRC Ahmedabad (508 total organ transplants in 2024, including 195 cadaveric transplants), PGIMER Chandigarh (320 total organ transplants in 2024, including 55 cadaveric transplants) performed adequately well, institutions like GB Pant Hospital in New Delhi did not carry out any transplant despite having the physical infrastructure and licence.

It is important that before considering financial support for establishing new transplant/retrieval centres, the status of existing transplant/retrieval centres and the factors which impede their performance are ascertained, the NOTTO meeting concluded.

Some centres reported inadequate funds to initiate or restart specialised transplant programmes such as lung transplantation, which requires expensive equipment and preservatives. The issue of high cost of immunosuppressant drugs, which patients must take for life, was also raised at the meeting.

The national organ transplant body has suggested the introduction of a system of financial incentives for key organ donation and transplant team members (surgeons, coordinators, etc.) for each successful transplant and/or organ retrieval case.