Contact : mohamed.rela@ildtindia.com

Doctors’ dilemma: To transplant or not to transplant

As transplant procedures gain momentum across the country, doctors are beginning to increasingly rely on donor organs to save lives. Not everyone needs the cut, or a new organ, said doctors, expressing concern over the rise in such surgeries.

Around 600 liver surgeons congregated in Chennai on Friday to discuss diagnosis and treatment of acute liver failure – a condition often treated with liver transplantation.

“Only 30% of these patients would really need a donor organ, the rest can be treated with proper medical intervention,” said Dr Mohamed Rela, director, Institute of Liver diseases and Transplantation, Global Hospitals.

Acute liver failure is caused by overdose of certain medication, Hepatitis and other viruses, herbal supplements, autoimmune and metabolic diseases.

Dr Rela observed that most doctors are in a dilemma whether to do a transplant or not. “Though we do have a set of guidelines to ascertain patients who need a donor organ, they are not strictly followed,” he said.

From 2008 to 2015, 573 livers were harvested in Tamil Nadu from cadaver donors, with 147 being donated in 2015 alone.

Julia Wendon, senior hepatologist and consultant Intensive Care at King’s College, London, said a needless transplant procedure could put an otherwise healthy person on lifelong immunosuppressants.

 “King’s College in the early 90s came out with a criterion to decide on when to do a transplant. In the UK, a patient is assessed by a group of specialists at multiple levels before the nod is given,” said Dr Wendon, who has been actively campaigning against unnecessary transplant procedures.

With close to 80% of the liver being donated by live donors, several ethical issues come to the fore as well. “There is a lot of psychological pressure on the donor. The recipient may be a close family member and they feel it’s their obligation to donate,” said Dr Rela.

 Dr Wendon felt a transplant procedure can be avoided if the liver disease is detected early. “The problem is, most patients here don’t immediately seek help in a tertiary care centre until it’s too late. An integrated approach to medical care is also needed,” she said.
Courtesy: TOI 

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