Last-minute patient transfers under scanner
CHENNAI, MAY 25, 2019 00:00 IST
CHENNAI, MAY 25, 2019 00:00 IST
Transplant only five days after admission, says Transtan
Eleventh hour transfer of patients waiting for liver transplants to hospitals, where potential brain dead donors are identified, has come under scrutiny of the Transplant Authority of Tamil Nadu (Transtan). Such patients will now be eligible to get the organ five days after transfer from one hospital to the other, instead of the previous 48 hours.
In a bid to streamline such patient transfers, Transtan, in a recently held liver committee meeting, obtained consensus of liver transplant surgeons, to extend the activation period for patient transfers from 48 hours to five days. With this, patients on transfer between transplant centres for gaining an early organ, will not be on the active wait list for five days. This, according to officials of the Health Department, was to prevent last-minute hospital transfers of patients soon after a brain dead donor is identified.
In Tamil Nadu, liver from a deceased donor is first offered to a patient listed as super-urgent. Next, comes the in-house priority. As per this, a patient wait-listed at the hospital where a brain dead donor is identified gets the organ. If there are no in-house recipients, the organ goes to the share pool — to licensed liver transplant centres on a rotation basis, officials explained.
“Earlier, we only had four to five hospitals for performing liver transplants. Now, 28 hospitals are authorised to do the transplants. A rotation system is followed to allocate the liver to these hospitals. Each hospital follows the Model for End-Stage Liver Disease score for their in-house priority. This score is to assess the severity of liver failure,” an official said.
In-house priority
A transplant surgeon pointed out that certain hospitals were shifting patients to the hospital where the deceased donor was identified, to facilitate an early transplant. “When these hospitals know that a brain dead donor is identified, patients are registered at that hospital.
“The reason being in-house priority. Previously, such patients became active on the wait list after 48 hours of transfer. So, hospitals managed to maintain the brain dead donors for 48 hours. Now, this has been changed to five days, and is a welcome move,” he said. It now becomes impossible to maintain a brain dead donor biochemically and haemodynamically for five days, doctors said.
R. Kanthimathy, member-secretary of Transtan, said the change was aimed at streamlining the system, and giving equal benefits to all hospitals and patients.
Eleventh hour transfer of patients waiting for liver transplants to hospitals, where potential brain dead donors are identified, has come under scrutiny of the Transplant Authority of Tamil Nadu (Transtan). Such patients will now be eligible to get the organ five days after transfer from one hospital to the other, instead of the previous 48 hours.
In a bid to streamline such patient transfers, Transtan, in a recently held liver committee meeting, obtained consensus of liver transplant surgeons, to extend the activation period for patient transfers from 48 hours to five days. With this, patients on transfer between transplant centres for gaining an early organ, will not be on the active wait list for five days. This, according to officials of the Health Department, was to prevent last-minute hospital transfers of patients soon after a brain dead donor is identified.
In Tamil Nadu, liver from a deceased donor is first offered to a patient listed as super-urgent. Next, comes the in-house priority. As per this, a patient wait-listed at the hospital where a brain dead donor is identified gets the organ. If there are no in-house recipients, the organ goes to the share pool — to licensed liver transplant centres on a rotation basis, officials explained.
“Earlier, we only had four to five hospitals for performing liver transplants. Now, 28 hospitals are authorised to do the transplants. A rotation system is followed to allocate the liver to these hospitals. Each hospital follows the Model for End-Stage Liver Disease score for their in-house priority. This score is to assess the severity of liver failure,” an official said.
In-house priority
A transplant surgeon pointed out that certain hospitals were shifting patients to the hospital where the deceased donor was identified, to facilitate an early transplant. “When these hospitals know that a brain dead donor is identified, patients are registered at that hospital.
“The reason being in-house priority. Previously, such patients became active on the wait list after 48 hours of transfer. So, hospitals managed to maintain the brain dead donors for 48 hours. Now, this has been changed to five days, and is a welcome move,” he said. It now becomes impossible to maintain a brain dead donor biochemically and haemodynamically for five days, doctors said.
R. Kanthimathy, member-secretary of Transtan, said the change was aimed at streamlining the system, and giving equal benefits to all hospitals and patients.
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