Transplants nodal body seeks clarity from hospitals

In a bid to ensure that comparatively wealthier foreign patients aren’t getting hearts out of turn, the National Organ and Tissue Transplant Organisation (NOTTO) is seeking greater clarity from hospitals on cadaver hearts allocated to foreign nationals for transplantation.

While there are robust rules in place that hospitals adhere to, NOTTO members, in a meeting in Delhi last week, discussed why an Indian patient may not be allocated the organ when it’s her rightful turn, and explored measures to remedy such practices. “We want to be sure that foreigners who are getting cadaver hearts are well within their turn,” Dr. Vimal Bhandari, director of NOTTO, told The Hindu .

“We don’t want to leave any scope where hospitals play up the cost factor to discourage Indian patients from accepting the organs,” he said, adding that last week’s meeting brought together members from all the Regional Organ and Tissue Transplant Organisations (ROTTO). They discussed the need for hospitals to share all the details of the foreign patients on their waiting list, including the time of registration and a detailed explanation on why an Indian patient could not be a candidate for the organ.

Priority list

“As per protocol, Indian patients are always given first priority. Only when we don’t have an Indian patient, say, due to a blood group or weight mismatch, or in cases when the Indian candidate refuses the organ for some reason, a foreigner is given the opportunity,” said Dr. Suresh Rao, head of the Cardiac Critical Care and Cardiac Anesthesia at Fortis Malar Hospital, Chennai.

The hospital has carried out 184 heart transplants in the past few years, of which 53 were of foreign nationals. “At times, when the organ is available in a different city, the cost of the air ambulance goes up to Rs. 15-Rs. 20 lakh. Stable Indian patients refuse to spend on an air ambulance... In such situations, foreigners get a chance,” Dr. Rao said.

Dr. S. Narayani, zonal director of Fortis, Mumbai, explained: “As per the protocol, available organs are matched with recipients waitlisted with the Zonal Transplant Coordination Center (ZTCC), then with ROTTO, and finally with NOTTO. If there is no match with domestic recipients, the organ is offered to international recipients.”

A spokesperson from Gleneagles Global Hospital, Chennai, said that priority is always given to domestic patients registered within Tamil Nadu.

The basis of the organ-sharing network is that organs don’t go waste. But doctors say that some organs are often wasted during the search for domestic patients. Sunil Shroff of Multi-Organ Harvesting Aid Network (MOHAN) Foundation said that the co-ordination has to be done in a limited time. “Instead of wasting the organ, if a foreign patient can be benefited, there is no harm,” he said.