Hope resurrected

India has successfully revived organ transplants


Yogish, a driver from Tumakuru in Karnataka, was among the many patients in need of organ transplants who were driven to despair by Covid-19. The 25-year-old, who uses only one name, was suffering from end-stage renal failure and had several health complications, including breathlessness and weakness. He underwent dialysis and waited for eight months for a transplant.

Lithika, 7 (in picture) got part of her father's liver after the hopsital helped to crowdfund the surgery.

His turn finally came in February 2020. But, Covid-19 meant that elective surgeries were being postponed even before the lockdown. In July, he contracted the virus and the surgery was deferred for another two months as the risk of reactivation of the virus was high during that period. Yogish finally got the transplant, from his father, in October.

Patients in need of organ transplants sufferd a double blow because of the pandemic, says Dr Sonal Asthana, lead consultant, HPB (hepato-pancreato-biliary) and liver transplant surgery, Aster CMI Hospital, Bengaluru. “Being immunocompromised, patients with end-stage organ failure found themselves to be at an increased risk of Covid-19 and avoided hospital visits as far as possible,” he said. “Also, they could not access transplantation facilities because of fewer donations and most ICU resources being directed to Covid-19 care.”

Dr Shailesh Raina, director, urology and robotics, Jaslok Hospital and Research Centre, Mumbai, said the patients themselves were afraid when the pandemic was at its peak as they would have to go on immunosuppressants after the transplant, leading to a higher chance of getting Covid-19.

The health care crisis prompted the Liver Transplantation Society of India and the Indian Society of Organ Transplantation, supported by the National Organ Tissue and Transplant Organisation, to issue guidelines about how to care for a patient in need of a transplant. And over the last two months, there has been signs of revival. “There has been a spurt in organ donation and transplant activities have returned to near-normal levels,” said Asthana.

Despite Covid-19 wreaking havoc with India's transplantation machinery, there were also heartwarming stories that gave hope to all. Like that of Lithika. The seven-year-old had acute-on-chronic liver failure. Her father Channa Nayaka, 40, a security guard, was ready to donate part of his own liver (the organ can regenrate itself), but the family could not afford the surgery. The team at Aster RV Hospital, Bengaluru, stepped up and arranged the money through crowdfunding and the surgery was succesfully performed in October.

Interestingly, paediatric transplants seemed to continue despite the dip in overall transplants. Between March and November, when transplants were worst affected by the pandemic, paediatric transplats increased from 10 per cent of the total to 15 per cent. Children, yet again, provided a ray of hope amid the darkness.