Kerala witnessed multiple organ transplantations in a single day amid the COVID-19 pandemic.
The organs were that of 54-year old Sreekumar, a native of Otoor, near Varkala in Thiruvananthapuram.
Sreekumar died in a road accident after the scooter he was traveling collided with a bike on April 17. His death happened at a private hospital in the city.
While a patient at a private hospital received his liver and kidney, another patient at the Thiruvananthapuram Medical College was the recipient of his other kidney. A patient at the government medical college hospital in Kottayam was the recipient of his heart.
Sreekumar’s family had agreed to donate his organs.
“Organ transplantation has been mostly kept in abeyance because of COVID-19, the shortage of staff and also due to an inherent risk at this time. But when we just mentioned organ donation to the family members of the deceased person they were quite willing for that,” Dr Noble Gracious, state nodal officer of organ transplantation told TNM.
However, there were a number of risks involved given the COVID-19 pandemic. Dr Noble explains that because donor recipients need to be given immunosuppressants (medication given so that a patient doesn’t reject a donor organ), that makes them more susceptible to catching infections like COVID-19.
The team then discussed with the organ transplant experts in Spain and their advice was to go ahead with the transplantation if it was a non-epidemiological zone.
A meeting of the COVID-19 task force at the Medical College was soon convened. It was decided to first conduct COVID-19 test on the swab of the donor and to proceed if he was tested negative. Doctors also decided to choose the potential recipients from the regions where COVID-19 cases are less and also to test their samples as well. The swab tests of the donor and the patients were done on a priority at the lab, results were fast tracked and made available in four to six hours. The procedures were done soon after the relatives of the deceased gave consent for organ transplantation.
The team decided to proceed as the test result of the donor turned out negative.
“It was the potential recipients of the kidney that we informed first during transplantations to test if the organs match. We then informed six patients at the Thiruvananthapuram Medical College and a patient at a private hospital. The patient at the private hospital needed both kidney and liver transplants. COVID-19 test was done on all these patients,” Dr Noble added.
Medical College Thiurvananthapuram is one of the testing labs for COVID-19 in the state and hence the swabs were tested at the hospital itself. There was a shortage of staff for kidney transplantation at the transplantation theatre of the hospital, but that was sorted by calling back staff nurses who were off duty.
“The organ retrieval surgery was done at the private hospital, followed by a coronary angiogram. The angiogram was done by 10.30 pm on April 18, and by 11 pm we started the organ procurement surgery. The heart was procured by 1.30 am and sent to Kottayam at once. Liver was taken by 2.30 am and the kidney by 3 am. We reached the medical college hospital by 4 am. The kidney transplantation surgery of the patient at the hospital began by 5 am and was completed by 8 am. The condition of the recipients are stable, they all are doing well,” he added.
To transport the heart from Thiruvananthapuram to Kottayam which is 147 kilometers away permission was taken from the police to exempt the vehicle from lockdown related checking on the way.
Another challenge was the shortage of cleaning staff and those in the surgical team in these hospitals, that was also sorted out with resource pooling.