The document discusses organ transplantation in Tamil Nadu, India. It outlines how the state government established a Cadaver Transplant Programme in 2008 to increase deceased organ donation and reduce reliance on illegal organ trade. Key aspects included forming a network for organ sharing, maintaining a common waiting list, and prioritizing allocation of donated organs. These initiatives helped increase annual deceased donations from less than 50 before 2008 to over 350 by 2013, making organ availability 10 times the national average and benefiting over 1000 patients in need of transplants.
Original Description:
Renal Transplants, Liver Transplants, Heart Transplants - How TN Reversed the Trend
The document discusses organ transplantation in Tamil Nadu, India. It outlines how the state government established a Cadaver Transplant Programme in 2008 to increase deceased organ donation and reduce reliance on illegal organ trade. Key aspects included forming a network for organ sharing, maintaining a common waiting list, and prioritizing allocation of donated organs. These initiatives helped increase annual deceased donations from less than 50 before 2008 to over 350 by 2013, making organ availability 10 times the national average and benefiting over 1000 patients in need of transplants.
The document discusses organ transplantation in Tamil Nadu, India. It outlines how the state government established a Cadaver Transplant Programme in 2008 to increase deceased organ donation and reduce reliance on illegal organ trade. Key aspects included forming a network for organ sharing, maintaining a common waiting list, and prioritizing allocation of donated organs. These initiatives helped increase annual deceased donations from less than 50 before 2008 to over 350 by 2013, making organ availability 10 times the national average and benefiting over 1000 patients in need of transplants.
When One Kidney fails . . . The other kidney does the work Rarely Symptomatic When Both Kidneys Fail Acute Renal Failure Chronic Renal Failure Acute Renal Failure
Chronic Renal Failure. . . How to get the other Kidney Relatives of a Patient whose Brain Stem is Dead agree to donate the patients kidneys A Live Relative or Some one with an emotional bond Donates one of his kidney A stranger sells for money (This is ILLEGAL)
Unfortunately . . . The least preferred route was being widely used
http://photography.nationalgeographic.co.in/photography/enlarge/kidney- donors_pod_image.html Villivakkam kidneyvakkam Not limited to one locality . How to tackle this Multidisciplinary Approach Legal Lawmakers Judiciary Police
From Health Point of View Kidneys Needed + Patients with Renal Failures Number of Kidneys Available + Kidneys donated by live donors + Kidneys donated from Brain Stem Dead Patient Rearrange this Chronic Renal Failure = Live Donor + Cadavers Live Donors = Chronic Renal Failure - Cadavers
Reduce Live Donors Reduce the Need by reducing Renal Failure Increase Donation from Brain Stem Dead Patients
Reduce Demand Reduce Renal Failure Life Style Modifications
What is meant by Brain Stem Death A Dead Brain stem in body whose heart is still beating is what is Brain Stem Dead in simple terms This has become a reality because of advancement in intensive care / pharmacotherapy etc.
Brain Stem Death Do all human beings who die pass through this stage? No. Only 1% of all death pass through this stage The state of brain Death is a brief period in minutes Donation from Brain Stem Dead Patients . . . . . .
March 2007
March 2007 Four Working Groups: Cadaver organ donation Cadaver organ transplantation Coordinating Organization for organ sharing Live donation and transplantation 33 recommendations for follow up action.
Lack of proper mechanism for identifying the recipients Trauma Centres Transplant Centres Lack of Co ordination Mechanism
After March 2007 The participants felt that there were many grey areas in the Transplantation of Human Organs Act. In particular, no guidelines on who will get the donated cadaver organ The Government followed up with a series of consultative meetings held with groups of doctors by Mr.P.W.C.Davidar
Series of Government Orders in 2008 Brain death Declaration of brain death made mandatory in Government Medical College Hospitals in Chennai Orders Issued. Brain death Declaration of brain death made mandatory in Government Medical College Hospitals in Chennai Procedure for declaration of brain death orders issued. Health & Family Welfare Department Organ Transplant Authorization Committee Procedures Additional responsibilities Detailed instructions orders issued. Series of Government Orders in 2008 Health & Family Welfare Department Organ Transplant Cadaver Organ Transplant Program Procedure to be adopted for cadaver transplant by the Government and Private Hospitals approved for organ transplant by the Appropriate Authority orders issued. Health and Family Welfare Department Organ Transplant Responsibilities of Transplant centers in hospitals Detailed instructions Orders issued. Cadaver Transplant Programme, Government of Tamil Nadu Prof Dr J Amalorpavanathan, Professor of Vascular Surgery, MMC & RGGGH appointed as Convenor, Cadaver Transplant Programme in honorary capacity Office space provided at the Government General Hospital Advisory Committee headed by Health Secretary, GoTN Mr Davidar, DMS, DME, TNMSC, Police Dept, 2 NGOs, 1 Medical Ethicist, 3 Government Hospitals, 4 Private Hospitals
Tamil Nadu Network for Organ Sharing Initiatives for forming Tamil Nadu Network for Organ Sharing and maintaining a common online waitlist for all potential recipients in all hospitals who choose to come under this network in Tamil Nadu and allotment of organs by the Network Common Waiting List (based Blood Group) visible to all stakeholders Allocation based on waiting List
Initiatives for Transplantation from Deceased Donors Transplant co ordinators Elective Operation theatre to be used at the Night Time and Odd Hours for Organ harvesting and Transplants
20th September, 2008
2008 : Turning Point 8 Government Orders Noble Gesture of Dr. Ashokan (Alumni of Chengalpet Medical College 1980 Batch) and Dr. Pushpanjali, Thirukazhukundram, More Brain Dead Certification More Donation More recipients benefited From 2008 Convenor runs the CTP Overseen and supported by the Advisory Committee which keeps watch and amends Guidelines as needed Participating hospitals to keep providing inputs to improve the Guidelines
CoTP - GoTN Register willing transplant hospitals in the organ sharing network Keep them posted of the regulatory framework Convene meetings of the Advisory Committee and take follow up action
CoTP - GoTN Take calls 24X7 from donor hospitals, allocate organs and co-ordinate till transplants take place Send periodic reports Maintain database of cadaveric and live donor transplants Maintain website www.dmrhs.org Convene meetings of hospitals for ideas on improving the framework
CoTP - GoTN Hospitals treating patients with End Stage Organ Failure (Kidney failure or liver failure or heart failure) register those willing for transplant at the online database www.tnos.org Waiting List is maintained online and is watched by all hospitals in the programme
One Master List for each Blood Group and based on it, lists for Each hospital All Government hospitals combined All private hospitals combined and All Hospitals Combined
Donated at Government Hospital 1st priority - List of the Government Hospital where the deceased donor is located, for liver, heart and one kidney. The other kidney world be allocated to: 2nd priority - combined Government Hospitals list 3rd priority - combined Private Hospitals list 4th priority - Government Hospitals outside the State, 5th priority - Private Hospitals outside the State Finally, if the organ(s) remains unutilized by the above criteria, it may be offered to a foreign national registered in a Government or Private hospital within and then outside state. (This is to ensure that there is no wastage of organs donated)
Donated at Private Hospital 1st priority - the list within the Private Hospital where the deceased donor is located, for liver, heart and one kidney. The other kidney world be allocated to: 2nd priority - the combined list of Government and Private Hospitals 3rd priority - Government / private hospitals outside the state Finally, if the organ(s) remains unutilized by the above criteria, it may be offered to a foreign national registered in Government or private hospital within and then outside the state, provided earlier information and such a request has been registered with the Advisory committee /Convenor, Cadaver Transplant Program, Tamil Nadu.
From 2008 Till Jul 31,2013 374 Donors From Tamil Nadu 58 Heart 24 Lung 339 Liver 689 Kidney 1110 Major organs 390 Heart Valve 578 Cornea 1 Skin 2079 Total Organs 689 Kidneys donated means 689 Patients with Chronic Renal Failure have been benefitted + 689 Healthy patients were not operated 4 Heart Transplants in RGGGH Only State Government Hospital to do Heart Transplants And Totally Free of Cost Liver Transplants in Stanley Medical College Hospital Only State Government Hospital to do Liver Transplants And Totally Free of Cost 10 times National Average Deceased Donation (ie Donation from Braid Stem Dead patients) Rate in TN is 1.3/million/year which is 10 times the national average WHO In July 2010, a 14 nation WHO meet in Geneva to establish a blue print to improve organ donation in UN Countries, put in TN Experience as a key point in the blue print prepared Many states have followed TN Model Hindu Op-Ed article, 25/10/2010 New lives out of deaths V.K. Subburaj, P.W.C. Davidar, J. Amalorpavanathan and C.E. Karunakaran Tamil Nadu shows the way in organ transplantation. If your liver has failed and you need a functioning organ to be transplanted for you to survive then go to Chennai: this is the buzz among liver-failure patients across India The State has done 110 deceased donor liver transplantations in a period of less than two years. All other States put together have not done even half this number.
British Medical Journal
HOW DECEASED DONOR TRANSPLANTATION IS IMPACTING A DECLINE IN COMMERCIAL TRANSPLANTATION - THE TAMIL NADU EXPERIENCE TRANSPLANTATION JOURNAL
Yuvaram N V Reddy(1), Milly Matthew(1), Saravanan S(1), Amalorpavanathan(3), Georgi Abraham(1,2), Sunil Shroff(4) Abstract India with a population of 1.2 billion has a renal transplantation rate of 3.25 per million population. The major cause of chronic kidney disease is hypertension and diabetes. The crude and age adjusted incidence rates of ESRD are estimated to be 151 and 232 per million population respectively in India. There was a remarkable lack of knowledge in the public about deceased organ donation until a decade ago. However, the role played by the media and Non Governmental Organizations in partnership with the government has emphasized and implemented deceased donor transplantation in certain states in India - to mention particularly, the Tamil Nadu model. In the last two years, deceased organ donation has reached 1.3 per million population in Tamil Nadu thereby effectively eliminating commercial transplantation. There is no religious bar for organ donation. A central transplant coordinator appointed by the government oversees legitimate and transparent allocation of deceased organs both in the public and private facilities as per the transplant waiting list. This model also takes care of the poor sections of society by conducting donation and transplantation through government run public facilities free of cost. In the last two years, deceased donor transplantation has been performed through this network procuring organs such as the heart, heart valves, lung, liver, kidneys, cornea and skin. The infrastructural lack of immunological surveillance - including donor specific antibody monitoring, HLA typing, panel reactive antibody except in a few tertiary care centres - prevents allocation according to the immunological status of the recipient. This private-public partnership promoting deceased donor transplantation has effectively eliminated commercialization in transplantation in the state of Tamil Nadu with a population of 72 million which is a model for other regions of South Asia and developing countries.
CADAVER TRANSPLANT PROGRAM, TAMIL NADU News Articles CADAVER TRANSPLANT PROGRAM, TAMIL NADU Take Home Message Any Surgery Carries a Risk, Lets not subject a healthy human to a risk by being a donor Discourage Live Donors Encourage Registration in TNOS and wait for Cadaver Donor
Take Home Message Deceased Donor Transplant will eradicate women slavery where more than 90% of living related Kidney Donors are women This is a social responsibility of the Doctors for the Society from which they should not shy away Though Tamilnadu is way ahead other states in Deceased Donor Transplant we still have to work hard to move forward in other states and centres
We gratefully acknowledge Extremely dedicated Neuro consultants Intensivists who are willing to manage the patients with severe Brain Stem Dysfunction Anaesthesiologists who are willing to do Apnea testing Administration who are willing to support this programme
We gratefully acknowledge The contributions made by all the patients The relatives who took the noble, valiant, gallant decision of donating the organs of the deceased
We gratefully acknowledge Officials in Government Thiru.V.K.Subburaj I.A.S., Secretary to Government, Health and Family Welfare Department, Government of Tamilnadu
Dr.GIRIJA VAIDYANATHAN, I.A.S., Secretary to Government, Health and Family Welfare Department, Government of Tamilnadu
Dr.J. RADHAKRISHNAN, I.A.S., Secretary to Government, Health and Family Welfare Department, Government of Tamilnadu
Thiru.P.W.C.Davidar IAS, Principle Secretary, P & AR, GoTN
Prof.Dr.K.Deiveegan MS MCh Professor of Neurosurgery and Head, Institute of Neurology, Madras Medical College and Rajiv Gandhi Government General Hospital
Prof.Surendran MS MCh Former Professor of Surgical Gasteroenterology, Stanley Medical College
NGOs
Dr.Shroff Mr.CE Karunakaran Future . . . Split Liver : Single Liver for an Adult and one more child Utilize More Hearts Study the Outcome of Transplant Recipients Increasing awareness of whole body donation One of the Oldest Hospitals . .
Road Safety Government General Hospital Established in 16 Nov 1664 Road Safety Now in its 350 th Year Now named Rajiv Gandhi Government General Hospital 06-Jan-2012 Road Safety 66
67 Madras Medical College Established in 1835 Road Safety Now in its 179 th year
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