Despite campaigns, kidney harvesting remains a herculean task in TN

CHENNAI: A 42-year-old person with disability, who is also a cancer survivor, requires a kidney transplant as soon as possible. Though he was already a kidney recipient over 20 years ago, the organ has lost its viability. So, he has been undergoing dialysis twice a week at a city hospital for the last one year.

“Since non-relatives cannot donate a kidney, as per the rule of organ transplants, my surgery has been delayed. Plus, I don’t have relatives,” said the patient.

He is not an isolated case. There are hundreds of patients who are waiting for a kidney transplant, as organ harvesting continues to be a herculean task. According to the Transplant Authority of Tamil Nadu data (Transtan), there are 7,228 active kidney patients awaiting transplants.

Dr J Amalorpavanathan, founder member secretary, Transtan, and member of State Planning Commission said that the main challenges in kidney donation and transplantation is identifying brain death and maintaining the organ. “In such cases, it involves family consent, and also overcoming medical challenges. Maintaining a brain dead patient has to be done in such a way to ensure the organ is not damaged,” he added. “Last year, the number of donors was high but the number of organs used is less due to these challenges. It’s always better to have organs of blood relations. However, nuclear families are prevalent these days. So, most relatives are reluctant to donate organs, both medically and emotionally.”

Another challenge is that blood groups and other criteria should match. Legally too, the organ donation has to clear hurdles as it must be given out of free will, and not out of coercion of any kind.

“The demand and supply ratio doesn’t tally. In India, around 2 lakh people await kidney transplantation but only 8,000 transplants are performed,” pointed out Dr Venkatesh Natarajan, nephrologist and VP, Doctors Association for Social Equality (DASE).

Brain dead identification is not available in several two- and three-tier hospitals. In such areas, logistical facilities are another challenge as it’s difficult to transport the organ to places like Chennai.

“In certain cases, it’s due to patient resistance where patients stick to certain misconceptions about the transplants and avoid it,” he opined.

Registering for transplantation is not a smooth process either. For instance, a patient who lives afar might have to travel to the city when a kidney is available. “The best treatment for kidney transplant is through organ donation. And it’s a one-time expensive method unlike dialysis where patients have to pay for each session,” explained Venkatesh.

In 2022, the number of donors in TN was 156, which increased to 176 the following year. In 2024, it shot up to 268. “The boost in organ donation is largely due to Chief Minister Stalin’s announcement of State honour for organ donors,” said Dr N Gopalakrishnan, member secretary, Transtan. “New medical colleges have advanced facilities which can identify and maintain brain dead patients well. Non-transplant organ retrieval centre (NTORC), where brain death is identified and organs are retrieved, is another major development.”