People waiting with bated breath for various organs will have to sit tight longer than expected. The number of people on their death bed who part with their organs has plummeted in Telangana after the COVID-19 pandemic broke out. As on Sunday, as many as 2,438 people were waiting for organs.
Interestingly, along with the donations, which have dropped sharply, there has been a dip in the number of people who register for receipt of organ/ organs.
In 2013, when the State government initiated Jeevandan, a cadaver transplantation programme, 81 people in need of organs had registered and 41 people donated them. The numbers grew over the years. In 2019, as many as 1,129 people registered and 134 people donated organs. However, that changed this year (till September 10) — only 491 people registered as recipients while 39 people donated.
Multiple factors, some beyond anyone’s control, led to the dramatic drop in the number of people who can donate organs to give a fresh lease of life to those with little hope of survival.
In cadaver organ donation programmes, vital organs are harvested from a person who is declared brain-dead. During the COVID-19 lockdown, road accidents reduced drastically given the restrictions on movement. Thus, there was a corresponding drop in the number of people with serious head injuries and therefore, fewer brain-dead patients.
Between March and August last year, 66 people had donated organs. During the corresponding time this year, 19 people donated with May, July and August recording zero donations.
Besides, doctors and organ donation coordinators say that the identification of brain-dead patients at the right time and maintaining a record has become a challenge due to the shortage of doctors, nurses and ICU beds.
Jeevandan in-charge G. Swarnalatha, says that in time of the pandemic, a donor and a recipient have to test negative for COVID-19 for the transplantation procedure to be initiated. Since RT-PCR test is primarily used to determine COVID-19 status, it takes one to two days to receive the results. “It takes around six hours to evaluate and declare if a person is brain-dead. Thereafter, the longer it takes to harvest the organs, the faster the organs deteriorate,” Dr Swarnalatha said.
Liver transplantation specialist Manish Varma says the RT-PCR tests are only 70%accurate. “We use RT-PCR along with CT Scan. In some situations, RT-PCR results might be negative but CT scan reports reveal signs of COVID-19. So, our decision tilts towards not opting for transplantation if there is a doubt,” he said.
Reluctant recipients
If doctors clear a brain-dead patient for organ donation, the recipient is explained the risks involved. “We counsel recipients and their family members about the process involved in these times such as undergoing COVID -19 test, risk of contracting the infectious disease, time taken to recover post transplantation, etc. Some choose to postpone the transplantation,” senior transplant coordinator Bhanu Chandra says.
If someone chooses to postpone the transplantation, the organ available will be passed on to the next person on the waiting list. “However, in the current circumstances (COVID-19 situation), their name in the waiting list is maintained. So, they will be given preference when an organ is available once again,” Dr Bhanu adds.
Doctors said the number of people who register for the organ donations has dropped as people are avoiding hospital visits to avoid any possibility of contracting COVID-19 infection.