Wait for a liver lives on for over 500 patients across Maharashtra

Over 500 liver patients in Maharashtra sign up for transplants annually, but lack of cadaver donors keeps making the waiting list longer with every passing year

Illustration/Ravi Jadhav
Illustration/Ravi Jadhav

Every year, more than 500 patients in Maharashtra with end-stage liver ailments enlist themselves with the Zonal Transplant Coordination Committee (ZTCC) for transplantations. But sadly, hardly 50 cadaver to liver transplantations take place every year, thus making the waiting list even longer, with patients often succumbing to the wait.

In the past five years, only 257 liver transplants have been conducted in the state from cadaver donors. However, the number of donors has increased on account of more awareness, but it is still not enough to fulfil the demand. In 2013, 26 liver transplants were conducted, which increased to 43 in 2014 and 41 in 2015. 2016 recorded the highest number of liver transplants with 117 operations. This year, till March, 30 liver transplants were conducted.

Demand unequal to supply
Till March this year, 382 patients have already registered themselves with ZTCC for liver transplants. The Mumbai zone has received the highest number of requests, with 207 patients suffering from end-stage liver diseases. This has resulted in the need to augment the number of transplantation centres in smaller cities Nashik, Nagpur and Aurangabad. So far, only hospitals from Mumbai and Pune are registered for liver transplants, further increasing the waiting list.

Two new centres
To address the backlog, the Directorate of Health Department (DHS) has recently started two more ZTCC centres in Nagpur and Aurangabad. "In the past one and half year, the demand for liver transplants has increased from Nagpur and Aurangabad, so we have set up centres in these two areas that would help in facilitating more number of transplants," said Dr Gauri Rathod, head of organ transplant, DHS.

While the state increases the number of centres, several NGOs, along with the government and private hospitals, are keeping no stone unturned to make people conscious of the need for donations. "Several sections of the society are doing their best to reach as many people as possible, but still so far, we have able to reach a small part. There is a need for mass awakening through TV, newspapers and other mediums," said Dr Ravi Mohanka, Chief Surgeon and Head of Department of Liver Transplant at Global Hospital.

The fault in our system
While some doctors blame lack of awareness, a group of doctors also blame the medical fraternity. Dr Vinay Kumaran, consultant and head of hepatobiliary surgery and liver transplant at Kokilaben Dhirubhai Ambani Hospital said, "Rather than just blaming lack of awareness, there is also a fault in our system. Doctors fail to identify brain dead patients who can be possible donors. There is a need to include this in the syllabus of MBBS so that they [relatives] also equally contribute in the organ transplantation."

Lag in paediatric transplants
While lack of donors is a concern, the city is also short of hospitals to conduct paediatric liver transplants. In Mumbai, only two hospitals conduct such transplants - Kokilaben Hospital and Global Hospital - while in Thane, Jupiter Hospital conducts such surgeries. While Global only conducts these surgeries on those aged above five, Jupiter and Kokilaben conduct surgeries on those even younger.

Dr Sunil Shroff from Mohan Foundation, an NGO that is working with the government for organ donation across the country, said, "In Chennai, paediatric liver transplant started 10 years ago whereas in Mumbai, it has just begun. So, the doctors here lack the expertise to conduct such transplants."

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