Allegations of “delay” and “negligence” in surgery against doctors at the Government Medical College Hospital, Thiruvananthapuram, following the death of a kidney transplant patient and the government’s threat to take strict action against doctors seem to be snowballing into a controversy, which Fear can seriously hurt the state’s deceased organ donation program (Mritsanjeevani) for many struggling to survive.
Even after 10 years, the program has yet to find its footing, as it was nearly stalled by numerous and harrowing lawsuits over the authenticity of brain-death certification.
The current controversy, fueled by allegations of delay in surgery and claims that it caused the death of the transplant recipient, could arguably hurt the reputation of Thiruvananthapuram Medical College Hospital, a leading kidney transplant center in both the public and private sectors. This wrangling may undermine the public’s confidence in the Mrity Sanjeevani program.
The preliminary inquiry report by the Additional Chief Secretary (Health) reportedly reveals little about any medical negligence and points to some “best avoided” technical errors.
The issue caught public attention and triggered a media trial, prompting the transplant medicine community to publicly express their anguish.
Chacko Jacob, former head of nephrology, CMC Vellore, and a doctor who has been part of thousands of transplants since 1972, says there was “a knee-jerk reaction by the media” (in punishing doctors) before detection. Only through a proper investigation, whether any negligence contributed to the death of the patient, it is not good for the health system of the state.
Unlike a living organ donation, in which everything is planned well in advance, a deceased donor transplant can throw up many last-minute hassles, medical as well as management issues, all of which require an actual transplant. It has to be solved before it happens.
The preparatory work involved – blood tests, radiology and cardiac evaluations, crossmatching, etc., can itself be time-consuming. In this case, the patient who had multiple co-morbidities and was classified as high risk required hemodialysis before surgery. When Anga arrived at the hospital, the patient was still on dialysis, which was why the surgery had to be “delayed”.
“The so-called delay of four hours in performing the surgery is of no consequence because even without machine perfusion, a harvested kidney can be preserved for more than 24 hours, without any adverse consequences. Even the issue of “outsiders” receiving organs in the hospital has no significance as far as the patient is concerned because the organ was not misplaced,” says Dr.
Across the world, deceased donor organ transplant programs rely heavily on public trust and confidence and the community of transplant specialists is concerned that the current uproar may damage an already fragile plan, which has long been stalled.
The transplant recipient, who died on Monday at the Medical College Hospital, was also on the kidney waiting list for five years before being informed about the available organ.
“Dead organ donation is the only hope for many people suffering from end-stage organ failure and currently, less than 10% of the requirement for kidney transplants is met through deceased donation. Programs across the country are responsible for COVID-19. and these wild allegations of negligence may affect the morale of transplant professionals and withdraw the programme,” said Sunil Shroff, President and Vivek B Kute, Secretary, Indian Society for Organ Transplantation Hindu.