 "organ donoation")
Last Wednesday, Rajiv Gandhi Government General Hospital in Chennai was witness to an unusual sight. Doctors, nurses, and other hospital staff were gathered, heads bowed with solemnity, in tribute to the body of a 36-year-old woman from Vellore. Lined up on both sides of the hospital’s driveway, the body’s route from the operation theatre to the mortuary, some saluted, some offered prayers, and some stayed silent.
An honour walk was organised at Rajiv Gandhi Government General Hospital in Chennai on Wednesday to pay tribute to a 36-year-old woman, whose organs were donated PHOTO: Transtan
Impressed as well as intrigued, a visitor wanted to know who the deceased person was. “She,” said a hospital staff member, “is an organ donor.” The woman’s family had agreed to donate five of her organs, giving hope to people the donor would never know. That was enough introduction and explanation. No further details given, none sought. Obeisance to donors is one of the initiatives by the Tamil Nadu government to increase awareness about organ donation and infuse a sense of pride and responsibility in families. Tamil Nadu is also the first state to provide financial assistance of up to Rs 22 lakh for transplants through the Chief Minister’s Comprehensive Health Scheme.
This is for not only the public sector employees, but also available to the private sector. No wonder, Chennai has emerged as an organ transplant hub, conducting the second highest number of organ transplants in the country, next only to Delhi. Data from the National Organ and Tissue Transplant Organisation (Notto) shows a total of 16,041 organ transplants in India in 2022. Of these, 11 per cent happened in Tamil Nadu, and almost all of them in Chennai.
In the case of deceased donor transplants, or organs donated by people who have died, the state — again, mostly Chennai — accounts for 21 per cent of the total cases in India (see chart). In heart and lung transplants, Chennai is already the number one in the country.
Interestingly, the state government says the actual numbers are higher than what Notto is reporting.
“I do not think the Notto numbers are actual in the case of living related donor transplants (organs donated by living relatives). If the number of transplants is more than 25, the hospital itself can set up an authorisation committee. Hence, some of them are not even reporting,” says N Gopalakrishnan, who took over as member-secretary of Transtan, short for the Transplant Authority, Government of Tamil Nadu. The state is trying to create a more authentic database covering all its 13 government hospitals and 124 private ones that have the licence to conduct organ transplants.
Anupam Sibal, Group Medical Director and a paediatric gastroenterologist at the leading healthcare provider, Apollo, agrees with the government’s view that the actual number is higher and that Chennai could be doing more than a third of all organ transplants in India.
“One tiny area with a population one-sixth of Tamil Nadu is doing 35 per cent of the transplants in the country,” Sibal says of Chennai. “It is becoming a hub because of several factors, including the infrastructure, available expertise, and multidisciplinary teams.”
In July, Apollo completed 23,000 transplants since the inception of the Apollo Transplant Program. In 2022 alone, it clocked 1,641 transplants across its facilities.
The biggest reason for Chennai’s emergence as a transplant hub is perhaps the rising availability of donors, both living as well as dead.
Bishnu Panigrahi, Group Head, Medical Strategy and Operations at Fortis Healthcare, says Chennai is coming up fast thanks to a rising acceptance of organ donation.
“More awareness and less stigma lead to more deceased organ donations, and the state is doing great in that. At Fortis network level we do 180 to 200 live donor transplants in the case of kidney or liver. Delhi tops the slot, but Chennai is a big hub,” he says.
Fortis Malar Hospital in Chennai had a growing lung transplant program, but the exit of a senior doctor has slowed its pace. Fortis Healthcare sold the Chennai hospital to Kauvery Group of Hospitals in June this year.
Vivek Kute, Secretary to the Indian Society of Organ Transplants, told Business Standard that Telangana topped the list in deceased donors, followed by Tamil Nadu, Karnataka, Gujarat, and Maharashtra. Delhi tops in live donors, followed by Tamil Nadu, making the latter the second in both the lists.
It is estimated 20 people die every day waiting for an organ. Of the 175,000 people in the list waiting for a kidney, only 7 per cent get one, says Kute. So, there is no dearth of people traversing the breadth of the country to get to Chennai.
When Asish Sharma, a 36-year-old techie from Jaipur, needed an organ transplant, his family first tried to get it done in Jaipur. Though there are hospitals in the city with the licence to conduct organ transplant, Sharma’s family was not sure of their expertise in handling complex cases. Besides, cadavers were hard to find not only in Jaipur but also in Delhi. Although Delhi holds the number one position in total transplants as per Notto’s numbers, it is nowhere in the top five in deceased organ transplants.
Sharma’s family finally decided to go to Apollo in Chennai following the guidance of a doctor from the All India Institute of Medical Sciences in New Delhi. “I found the doctors and nursing staff to be most efficient in Chennai. Their expertise saved my husband’s life,” says Sharma’s wife, who does not want her name used in this article for reasons of privacy. Sharma returned to work last month, though he still goes to Chennai for check-ups.
Sanjay Pal, a 49-year-old from Howrah in West Bengal, cited another reason to have his liver transplant done in Chennai.
“My sister was the donor. I was told by multiple people that the Chennai hospitals were the best. In addition, Kolkata hospitals were asking for Rs 27 lakh and here (in Chennai) the entire process happened at Rs 22 lakh,” Pal says.
“No other state can boast an active transplant ecosystem in both the public sector as well as private. Now, with government insurance, poor people can get their surgeries done in private hospitals as well,” says Gopalakrishnan of Transtan.
In addition to normal centres, the state has 26 organ retrieval medical colleges, where doctors counsel relatives of brain-dead patients to have them sent to a transplant hospital.
Sibal expresses the hope that organ transplants in the country will see at least a 20 per cent growth per annum in the years to come, with Chennai leading the way.
As that happens, people will definitely line up with bowed heads to pay obeisance.
(With Sohini Das)
