Grief counsellor C. Shanthi interacts with a patient at the Government Eye Hospital in Egmore, on Wednesday. — PHOTO: K. PICHUMANI.

At the Government Eye Hospital in Egmore, C.Shanthi chats with a middle-aged woman whose son Babu lost his sight after varnish spilled in his eyes. He recently underwent corneal transplant surgery. [...]]]> From http://www.thehindu.com/todays-paper/tp-national/tp-tamilnadu/article2613453.ece

Grief counsellor C. Shanthi interacts with a patient at the Government Eye Hospital in Egmore, on Wednesday. — PHOTO: K. PICHUMANI.

At the Government Eye Hospital in Egmore, C.Shanthi chats with a middle-aged woman whose son Babu lost his sight after varnish spilled in his eyes. He recently underwent corneal transplant surgery. Ms. Shanthi enquires about the medication and promises to follow it up with the doctor, if only to assure herself that Babu would recover sight.

She is employed by the Lions Eye Bank Trust and, on behalf of the hospital, networks with the Burns Ward in the government hospitals in Kilpauk and Royapettah.

“My job does not end with the donor family agreeing to donate the eyes of the dead patient or with the recipient being sent for surgery,” she explains as she prepares for the day ahead. “I canvass for eye donation in the hospital wards,” says the counsellor/coordinator with nine years experience. “I develop a rapport with the family. This gives me time to observe how the family is dealing with grief and identify the family member whom I can approach about eye donation,” she adds.

Experience enriches networking skills, says Ms. Shanthi. She learnt to network with the police after an unpleasant experience when a donor’s kin complained to the police about her. “At that time the consent forms were issued only in English and the family accused me of cheating the illiterate son,” she recalled.

With more organ transplantation being done in hospitals, it became necessary to appoint grief counsellors/transplant coordinators. While some have been trained before entering the profession others learnt it on the job. But it is their interpersonal and communication skills that ensure a successful donation.

S.Sagayam who works at Apollo Hospitals agrees with her. “We run the risk of being labelled insensitive and suspected of stealing organs. Sometimes it takes four to six hours to convince the donor family,” he says. “The family’s psychological needs must be met. It is only when they ask about the next step do I broach the subject of donation,” he adds.

At the Rajiv Gandhi Government General Hospital, five counsellors are available round-the-clock.

“Families handle grief in many different ways,” says counsellor R. Prakash. “We have to deal with denial, anger and depression among the family. Only after the family provides consent do we take up the paperwork for organ donation. It is also important to explain to the family the procedure and the time involved. The family may be amenable to donation but would get agitated with the time taken for harvesting and the autopsy procedure,” he adds.

The counsellors sometimes spend hours waiting for the family to come to terms with the inevitable. “We have to be transparent and sincere and establish credibility. There are those who would tell us to return the body intact. Each case is a learning phase for me,” Mr. Prakash says. Often the entire procedure of getting the consent may last several days.

The counsellors learn to explain the process and the concept of brain death in the most effective way, says R. Veena, who has been with the government general hospital since February 2010. “Organ harvesting cannot be done in medico-legal cases without police consent and opinion of the forensic expert. Sometimes it is easy to convince the donor but the recipient may not be found immediately. We may slog for two or three days and there will be burn out. But when the end result is good, it is motivating,” she adds.

MADURAI: Tamil Nadu is a role model for other states in organ donations, according to an expert in cadaver transplantation. Speaking at an awareness programme on organ donation organised on Friday by Meenakshi Mission Hospital and Research Centrein Madurai, convenor Dr J Amalorpavanathan said that more than 200 people have donated their organs between October [...]]]> From http://timesofindia.indiatimes.com/city/madurai/State-leads-the-way-in-organ-transplant/articleshow/9753131.cms

MADURAI: Tamil Nadu is a role model for other states in organ donations, according to an expert in cadaver transplantation. Speaking at an awareness programme on organ donation organised on Friday by Meenakshi Mission Hospital and Research Centrein Madurai, convenor Dr J Amalorpavanathan said that more than 200 people have donated their organs between October 2008 and July 2011 in order to save the lives of others.

“As per the current cadaver transplant census report, Tamil Nadu’s contribution is about 1.3% per million donations, in 2010. The deceased donors per million population per year are that of USA -20.7 percentage, Europe 15.9 percentage, Asia-1.1 percentage including Tamil Nadu contribution is 0.8 percentages.

Tamil Nadu is the number one state in organ donation in India. However, contributions from the southern districts, have been very poor,” Amalorpavanathan said.

He also said that since all major religions are now endorsing organ donations, medical administrative officials should create more awareness programmes in southern districts. “We have created three divisions for organ donation to enable speedy transplantation of organs on the patients. While the north division covers Chennai to Vellore, south division covers Trichy to Nagercoil and the west from Vellore to Coimbatore,” he said. He told TOI that medical officers were often confused about the laws related to transplantationand that is why they were conducting awareness programmes in second-tier cites like Madurai

. “Only four persons have donated organs to patients in the past one year,” he said. Some one brain goes steam death while four doctors confirmed it and convince the family members of the deceased and taken the organs from the body for save other persons life. The 99 percentage of organs have gotten from accident victims because their brains would be gone to steam death but other organs functions have worked very well”, he said.

Dr K Samapathkumar, nephrologist said that according to the Indian Medical Tribune survey there was less than 50% overall positive response in favour of donating solid organs. “In the last 10 years, 1000 cadaver organ transplants including 900 kidney and 100 liver and heart transplants have been performed. Almost 40% of the cadaver transplants in India are done in Tamil Nadu, and its organ sharing network could become the role model for rest of the country,” he said.

CHENNAI: A migrant labourer from Bihar, who had a fall from the second floor of a building under construction and declared brain dead by the Government General Hospital, on Tuesday gave life to three persons. His two kidneys and a liver were donated to patients in different city hospitals.

Rambabu, a 18-year-old migrant [...]]]> From http://articles.timesofindia.indiatimes.com/2011-04-28/chennai/29482417_1_organ-transplant-mohan-foundation-suitable-recipients

CHENNAI: A migrant labourer from Bihar, who had a fall from the second floor of a building under construction and declared brain dead by the Government General Hospital, on Tuesday gave life to three persons. His two kidneys and a liver were donated to patients in different city hospitals.

Rambabu, a 18-year-old migrant labourer comes from a family of eight members, including four sisters. He came to Chennai ten days ago, to join two of his relativeswho work in a construction firm. At the work site in Chromepet on Saturday, Rambabu fell from the second floor and lost consciousness. He was taken to the Government General Hospital.

When the condition became critical, he was later shifted from casualty trauma to the Intensive Care Unit of Institute of Anesthesia on Monday, where he was declared brain dead by a panel of doctors. “As his organs were still working successfully, they were harvested with the consent of the family members,” said R Veena, a grief counsellor of Mohan Foundation which plays a major role in counselling victim’s family at the Government General Hospital.

11 year-old boy’s organs donated

Karthik Madhavan

Eleven-year-old M. Sowdesh (second from left), whose organs were harvested for transplantation after he was declared brain dead at a private hospital in Coimbatore on Monday. His father R. Mani, mother M. Indrani [...]]]> From http://www.hindu.com/2011/02/16/stories/2011021656660700.htm

11 year-old boy’s organs donated

Karthik Madhavan

Eleven-year-old M. Sowdesh (second from left), whose organs were harvested for transplantation after he was declared brain dead at a private hospital in Coimbatore on Monday. His father R. Mani, mother M. Indrani and elder brother M. Poovannan are also in the picture.

COIMBATORE: Being shattered by sorrow at the loss of their child did not deter the parents of Sowdesh from making a decision that would make a difference to the lives of complete strangers.

R. Mani and M. Indrani, powerloom workers in Sirumugai, about 50 km from here, decided to allow doctors to remove the vital organs from their 11 year-old’s body, after he was declared brain dead on Monday.

Sowdesh’s eyes, liver, kidneys and heart valves were removed at a city hospital on Tuesday.

Sowdesh suffered head injury after a two-wheeler lost control and knocked him down while he was playing with his friends, near home, Mr. Mani said. He was rushed in a 108 EMRI ambulance to a nearby clinic, and from there, to the Government Hospital in Mettupalayam.

As doctors there asked the boy to be rushed to a city hospital, he was taken to Sri Ramakrishna Hospital, here.

At about 7.30 p.m. on Saturday, he was admitted to the intensive care unit of the hospital. However, he did not respond to the treatment, and confirmatory tests for brain death were done on Monday, according to Anil Kumar, dean of the hospital.

Once the parents heard of this, they actually came forward to donate the boy’s organs. The family was influenced by newspaper reports on organ donation that they had read while in Chennai.

“Newspaper reports and television news on organ donation and cadaver transplantation helped us understand the issue. Though at that time we never imagined we would have to do it ourselves, the time had come for us to make that decision. We were ready to help others with our son’s organs,” Mr. Mani said.

The hospital then got in touch with MOHAN Foundation, which had recently started a branch in Coimbatore, and the State Government’s Cadaver Transplant co-ordinator to coordinate the organ harvest and donation.

On Tuesday, medical teams from Apollo Hospital and Frontier Lifeline Hospital in Chennai were sent to aid in harvesting the boy’s organs.

Sowdesh’s liver went to a patient at Apollo and his heart valves to Frontier Lifeline. One kidney was used for a patient at Sri Ramakrishna Hospital itself, and the other taken to K.G. Hospital. The corneas were sent to Sankara Eye Centre, here.

Sowdesh’s older brother M. Poovannan is a second year student of a college in Periyakulam. The family, whose monthly income is only Rs.5,000, is shattered by the tragedy, but it derives some satisfaction from the fact that Sowdesh’s organs have been donated to persons desperately in need of them.

Mr. Mani is convinced that his son will continue to live on through the persons his organs have helped.

Last week, Frontier Lifeline Hospitals received six calls from the state organ registry asking them if it had a patient waitlisted for heart transplant. The hospital had several such patients, but it turned down the offer.

“None of them could afford the Rs 5-lakh-plus transplants,” said heart surgeon and Frontier Lifeline chairman [...]]]> From http://timesofindia.indiatimes.com/city/chennai/Hearts-go-waste-for-want-of-takers/articleshow/7498007.cms

Last week, Frontier Lifeline Hospitals received six calls from the state organ registry asking them if it had a patient waitlisted for heart transplant. The hospital had several such patients, but it turned down the offer.

“None of them could afford the Rs 5-lakh-plus transplants,” said heart surgeon and Frontier Lifeline chairman Dr KM Cherian. And it was not just his hospital, none of the 14 hospitals approved for heart transplants in the state took the offer. If unavailability of donor hearts was the problem till a few years ago, affordability is now proving to be a hurdle when organs are available in plenty.

Heart transplant is the only option left with patients who have end stage heart failure or irreparable coronary artery disease. During this procedure, doctors replace the ailing heart with a working one from a brain-dead patient.

Between October 2008 and December 2010, the registry received organs from 152 patients. The state recorded the highest number of organ donations in the country. While the registry facilitated transplants of 284 kidneys and 134 livers, it has recorded just 28 heart and four lung transplants. The registry had harvested 176 heart valves for future use.

“It is a pity that we had to discard hearts as young as 20 years,” says organ registry coordinator Dr J Amalorpavathan. The registry is planning a meeting with senior heart transplant surgeons to discuss causes for the high wastage.

The primary reason, says Dr Cherian, is the cost. While the transplant costs at least Rs 5 lakh, post-surgical drugs cost Rs 1,300 a day, for at least six months. “We can’t bring down the cost of treatment as it would mean compromising on quality and safety. Drugs, instruments and consumables used for the transplant are all expensive,” said Dr Cherian.

Sivaramakrishnan TS, who runs a private manufacturing unit in the city, is one of the patients awaiting a heart transplant. He got a call from the hospital nurse at midnight on a Saturday. The hospital wanted him to be admitted in an hour and pay an advance of Rs 3 lakh. “I didn’t want to wake up my son and ask him for money. I was sick then, but I wasn’t dying,” he said.

Senior cardiac surgeons say that unlike people with end-stage liver diseases, patients with heart failure aren’t so terribly ill. In an end stage liver failure, the patient is jaundiced, keeps constantly vomiting, has severe pain and is fatigued. In case of heart failure, patients do go breathless due to fluid accumulation, but on a comparative scale complications can be much lesser.

That’s possibly why patients with liver failure coughed up anything between Rs 25 lakh and 40 lakh for a new liver. Even at the government hospitals, where transplants are done free of cost, there were nearly 20 liver transplants against just four heart transplants, though a liver transplant is much more complicated than a heart transplant.

Doctors say the condition of all organ failure patients should be considered critical. “On many occasions we need to do counsel them on the benefits of transplant. On most occasions hospitals are given not more than an hour to find patients for transplant,” says transplant surgeon Dr Madhu Shankar, who heads the team at Global Hospitals. His unit was authorised for heart transplant unit more than six months ago. But the hospital is yet to do the first heart transplant.

Read more: Hearts go waste for want of takers – The Times of India http://timesofindia.indiatimes.com/city/chennai/Hearts-go-waste-for-want-of-takers/articleshow/7498007.cms#ixzz1E4Qskpzk

Thiruvananthapuram: Organ harvesting from deceased donors (cadavers) for transplant in patients with chronic ailments will soon be a reality in Kerala with the State government launching a major initiative to start the programme modelled on the Cadaver Transplant Programme of the Tamil Nadu government.

Convener of the Tamil Nadu Cadaver Transplant Programme J. [...]]]> From http://www.hindu.com/2011/01/30/stories/2011013062030700.htm

Thiruvananthapuram: Organ harvesting from deceased donors (cadavers) for transplant in patients with chronic ailments will soon be a reality in Kerala with the State government launching a major initiative to start the programme modelled on the Cadaver Transplant Programme of the Tamil Nadu government.

Convener of the Tamil Nadu Cadaver Transplant Programme J. Amalorpavanathan and R. Vijayakumar, Head of Nephrology, Stanley Medical College, Chennai, had detailed interaction with Health Minister P.K. Sreemathy, Health Secretary Davendrakumar Dhodawat, former Health Secretary Usha Titus and senior doctors from medical colleges and leading private hospitals here on Saturday, as part of the State’s efforts to get its own cadaver transplant programme up and running soon.

Kerala was keen on starting its own deceased donor organ transplant programme and was eager to learn from Tamil Nadu, which had the most successful government-facilitated cadaver donation programme in the country, Ms. Sreemathy said. She suggested that because Kerala had excellent infrastructure and trained manpower for performing renal transplant, the State could launch its deceased donor transplant programme in a small way by creating a network of hospitals for renal transplants. She said that the process of framing rules for implementing the programme would be initiated immediately.

Tamil Nadu’s tale

Tamil Nadu’s two-year-old cadaver transplant programme has been hailed as one of the best models for organ donation in developing countries by the WHO and is a sterling example of how a committed government can facilitate equitable allocation of vital organs harvested from cadavers in a transparent manner.

“We have, from October 2008 till date, transplanted 942 major and minor organs harvested from brain-dead donors. These include 304 kidneys, 143 livers, 29 hearts, four lungs, 196 heart valves, 265 eyes and one skin transplant,” Dr. Amalorpavanathan said. Thirty-seven hospitals, including two government hospitals, are registered under the programme.

Renal transplants from unrelated live donors and illegal organ trade rackets are now completely eliminated in Tamil Nadu because people now know that they can get a kidney in 10 months, he added.

Strict guidelines

Tamil Nadu has framed ample guidelines to ensure that the process is legal. There is a clear priority list of patients for hospitals as well as a common list of the State government and rules to guide the allocation of harvested organs. All immunosuppressant drugs are provided free of cost life-long to those who received transplants.

Kerala has a successful related live donor renal transplant programme but the potential of harvesting organs from brain-dead donors remains completely untapped.

“We have all the infrastructure for starting off deceased donor transplant for chronic renal patients. But we have a lot of legal, social and ethical issues to be resolved, including sensitising physicians and the public about the concept of brain-death before we can go ahead. But the State government coming forward to facilitate the process is the best thing to have happened to our transplant programme,” Ramdas Pisharody, Principal and the Head of Nephrology Thiruvananthapuram Medical College, told The Hindu.

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தமிழ்நாட்டில் மூளைச்சாவுக்கு ஆளானவர்களின் உடல் உறுப்புகளைத் தானம் பெற்று, தேவையானவர்களுக்குப் பொருத்தும் திட்டம் தொடங்கப்பட்டு, செப்டம்பர் மாதத்துடன் இரண்டு ஆண்டுகள் முடிவடைந்துள்ளன. தமிழகம் இதில் முன்னோடியாகத் திகழ்கிறது என்பது பாராட்டுக்குரியது. மாற்று உறுப்புகள் பொருத்தும் சிகிச்சையில் தனியார் மருத்துவமனைகள் மட்டுமன்றி, இரண்டு அரசு மருத்துவமனைகளும்கூட சாதனைகள் [...]]]> From Dinamani

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