Jeevasarthakathe: the perfect organ donor-beneficiary bridge

Kumaran P | NT

Nothing is more devastating than death in the family. Of the many thoughts that stream through the mind during that moment of realisation is, ‘If only my kin were alive now…’ The closest that one can get to keep the dead alive is through an organ donation. That too after critical legal detailing, which the organisation manages 24/7, finds out Kumaran P.

With Karnataka having 61 organ transplanta - tion centres, the Covid-19 pandemic was a challenging task for Jeevasarthakathe, the State Organ and Tissue Transplant Organisation (Sotto) of Karnataka. Many families did not agree for organ donation causing a number of patients to lose their lives in ICUs as Covid took over major sections of the hospital. Thankfully, after following the several Covid-19 protocols defined over the last two years or so, organ transplantation is again picking up in the State. In the year 2019, there were 105; in the year 2020, it dropped to 35 and in 2021 it was 70; this year, the number stands at 14, as of now.

Explaining the decreasing transplant number, Lijamol Joseph, chief transplant coordinator of the Organisation, said, “If you see, in the year 2019, we had the highest procedures in the State with 105 organs transplantations, which were done across the State. In the year 2020, when the pandemic hit mankind, organ donors in ICUs dropped and surgeries were also not happening. More than that, Covid patients took most of the ICU beds. There was no protocol set for transplants. Even before we could do something, a number of lives got lost. Families did not have the confidence to come and get admitted during the critical time of their patient fearing Covid-19, so getting donors and the retrieval became a big challenge.”

According to the Ministry of Health and Family Welfare Karnataka, there are 61 organ transplant centres spread across seven districts: Kalaburagi 1, Bengaluru 42, Mysuru 6, Dakshini Kannada 8, Udupi 1, Dharwad 2 and Belagavi 1. The SOTTO, Karnataka, is the primary agency that takes care of the end-to-end organ transplantation system in the State. This office works round the clock, attending to requests of hospitals, while maintaining a registry of beneficiaries and donors.

If we look at the number of organs retrieved to date, a total of 1,654 organs have been retrieved with the highest being the kidney with 908 numbers. This is followed by the liver at 524, heart 152, lungs 63, small bowel 6 and hand 1. There were also a number of multi-organs retrieved; heart and lungs 4, kidney and pancreas 17, liver and kidney 29, which is a total of 50 multi-organ retrievals.

In terms of tissues retrieved, the eye donation (corneas) is the highest with 940 in numbers. Followed by this is heart valves 242 and skin being the least with just 24 retrievals to date. Lijamol Joseph added, “The skin is the least retrieved till date because of the lack of awareness among people. People do not know that they can also donate skin and we ask the doctors to take it only in inches or centimetres from the body. Moreover, people fear that skin will be scrapped out of the body and it will not look good during the last rites. We need to break these myths and tell people that the skin is always taken from places that cannot be seen. For example, it is extracted from underneath the thighs or legs. This is then covered with bandage. It is properly closed in a way that the skin-graft area is of the body is not visible.”

The system at Jeevasarthakathe works 24/7 in ensuring that organs are retrieved from donors and sent to beneficiaries on time. Dr Kiran Kumar M, member secretary, SOTTO Karnataka, also the joint director of Jeevasarthakathe, said, “The way our system works is robust. We have adopted good practices and abide by every legal aspect when we take up organ transplantation. During Covid-19, we took the utmost care and changed set protocols to ensure that we get the RTPCR reports in one hour and finish all formalities, so that we can take up the retrieval and donation processes smoothly.”

Explaining one case at the Nimhans, Joseph said, “We got to know that a patient was brain dead in a hospital after they informed us. We have a team of expert doctors who assess the brain-dead situation and a committee to approve it. We connect with the in-charge doctor at the hospital with our committee of experts. They discuss how and under what situation the person died. They assess all organs. After this, we connect with our lungs team, heart team, kidney team, skin beside teams of other organs. Each organ or tissue is looked at by experts who see if their division of organ is in a good state for retrieval.”

“Only then do we inform the hospital, which needs the organ and which is on the waiting list. Should there be three hospitals in need of different organs, we de