Organ transplantations have been one major casualty during COVID-19. At present, all transplant procedures across the nation have been halted, as disease posed “severe consequences” to organ recipients and their healthcare teams in hospitals.
However, the opposite seems to have been true in Kerala. Deceased donor organ transplantation, which had all but gone into extinction, is suddenly hogging the limelight, raising hopes of a new revival for Mrithasanjeevani, the State government’s deceased donor organ donation programme.
The State has done seven deceased donation organ transplants this year, five of which were in April-May, in the thick of COVID-19.
With National Organ and Tissue Transplant Organisation issuing a directive that all operations of transplant be suspended during the pandemic, nationwide, all major hospitals doing organ transplants had shut shop.
The sudden revival of public interest in deceased donor organ donation has had the healthcare professionals and transplant surgeons brainstorm seriously on the risks of performing transplants during the pandemic.
“The answer to whether one should risk performing a transplant surgery during COVID-19 entirely depended on the disease epidemiology in Kerala. The emergency COVID-19 task force meeting convened last month concluded that transplant surgeries did not carry an additional risk as disease transmission here is under control. So far, our “at risk” group (chronic diabetes patients, those undergoing dialysis, etc.) has been safe from COVID-19,” says Noble Gracious, nodal officer, Kerala Network for Organ Sharing (KNOS).
The risk to dialysis patients and transplant recipients are very real because they are immuno-compromised and across the world, there have been several reports of post-transplant infections as well as long-term transplant recipients suddenly dying due to COVID-19.
“We took extreme infection control measures to prevent all adverse events and tested both donor and recipients for COVID-19 using RT-PCR before proceeding with the transplant. The families of deceased donors are eager to save the lives of others. Somehow, in this mirthless pandemic season, the public seems to have re-discovered the joys of altruism,” says Dr. Gracious.
A couple of external factors too helped. The government’s order de-linking brain death declaration from organ donation early this year, giving families the clear options of termination of ICU care or organ donation, took a lot of pressure off doctors.
H.V. Easwer, consultant neurosurgeon at Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST), who was part of the brain certification team for all donations, says that if till now a trust deficit between the medical fraternity and the public stood in the way of organ donation, in the COVID-19 season, doctors seem to have regained that trust and credibility.
“Curiously, the doomsday feeling evoked by COVID-19 seems to have spurred many thoughts on the transient nature of life and how one’s good deeds can have a lasting imprint...,” he feels.
Dr. Gracious adds that because of COVID-19 and lockdown, only near relatives were involved in crucial decisions on organ donation. Also, relieved of the social pressures of conducting a ritualistic funeral, the families found it easier to make decisions.
“This situation could be altered by the changing epidemic situation in Kerala. For now, we are happy that Mrithasanjeevani is looking up,” he says.
