90% of end-stage renal patients don’t receive a kidney

Photo credit: Brian Wowkm, Wikimedia Commons

By Pallavi Ail

BANGALORE (Sept. 22)—Yogendra Srinivas, a father of two kids, is battling death as both of his kidneys have failed. But there is only a 10 percent chance that he will receive a kidney.

The Karnataka government has formed a committee to regulate transplants, the Zonal Coordination Committee of Karnataka for Transplantation (ZCCK), to set rules governing organ transplants from cadavers.  

Only 10 percent of patients suffering from end-stage renal disease get a kidney transplant, according to the results of a study conducted by the All India Institute of Medical Sciences and the Health and Family Welfare Ministry.

The report also states, “In spite of an organ transplant bill being passed in 1994, until now only approximately 700 cadavers renal transplants have been performed in India.”

More than 600 patients on waiting list

Manjula K.U., senior grief counselor at ZCCK, said there are 517 persons on the ZCCK waiting list for major organs like kidney, pancreas, heart and liver in Bangalore, while in the state there are more than 600.

K. Raghvendra, 30, is awaiting kidney transplant from a cadaver. He has sold his land in Bellary to fund his ongoing dialysis cost not knowing how he will manage the transplant cost of Rs. 300,000 to Rs. 400,000. He has a 6-month-old baby.

Patients are eligible for organs based in the order of their age, location and the time spent waiting on the transplant list.
Organs can be donated by living people, but this practice is governed by strict laws. Only first-degree relatives can donate in their lifetime.

The ZCCK said it is often approached by people who wished to sell a kidney or part of their liver. “We explain that selling is not an option,” Manjula said.

Brokers sell organs

Srinivas’ friend said there are organ “brokers,” middlemen, who negotiate the sale of organs. He recounted an incident where an acquaintance of his sold his kidney for Rs. 150,000 and a plot of land. He has received only Rs. 75,000 till date and no plot.

When Srinivas’ friend was asked whether he would consider the option of sourcing the organ from a broker, he said they would wait, but only for a limited period. They may look at other options eventually, he said.

The quality of life and life expectancy for a transplant patient is better than a person who is on dialysis. The total cost of transplant is less than costs incurred in lifelong dialysis, said Dr. Shivaprasad, head of department, Institute of Nephro-Urology.

Organs of brain-dead people not harvested

The organs of a certified brain-dead person can be harvested, according to the Transplantation of Human Organs Act, 1994. Four doctors must independently check and certify the patient as being brain dead, once the family wishes for the organs to be transplanted.

“The problem is that organs of many brain-dead people are not harvested,” said Dr. Ashish, “The government should step in and make a law where a mechanism should be set in motion as soon as a patient is identified as brain dead in any hospital.”

Usually, when a patient is certified brain dead and the family opts to take him or her off life support, there is a small window of six hours within which the organ can be harvested. He said that a grief counselor should convince the family to donate their relative’s organs.

The ZCCK said it regularly organizes workshops and seminars in schools, colleges and corporate offices to create awareness about the law and need for organ pledges.

“The media needs to hail organ donors as heroes,” Dr. Ashish said.

Meanwhile, K. Raghvendra will continue to receive dialysis three times a week, indefinitely, until a compatible kidney becomes available.