Four months after Karnataka became the first State to frame guidelines allowing multi-pair kidney paired exchange transplants , the initiative is yet to result in a single such transplant, with only one request having reached the State Authorisation Committee so far. August 13 is observed as World Organ Donation Day.
The request, involving a multi-pair swap arrangement for patients with incompatible donors, was approved by the committee but the transplant did not materialise following a misunderstanding between the donor-recipient families. M. Dr. This involved patients enrolled with two private hospitals in Bengaluru and one in Hubballi. “The framework is available, but people have to understand the process and come forward. The guidelines were framed in response to the difficulty faced by patients with incompatible donors, including those with ABO blood group mismatch, positive crossmatch or HLA incompatibility. Where multiple hospitals are involved, the institutions have to submit an inter-hospital coordination plan, while the transplant procedures are to be performed simultaneously, as far as possible, to prevent the arrangement from breaking down.
Because of incompatibility, “Before the guidelines were framed, we were receiving requests from patients who had willing donors but could not proceed with transplantation. Because of a misunderstanding between the families involved, shivalingaiah said the single application received by the committee was approved after scrutiny, but the arrangement could not proceed.
Shivalingaiah, chairman of the State Authorisation Committee, who heads the State-run Institute of Nephro-Urology, told The Hindu that the guidelines were framed and notified in April to provide an avenue for patients who had willing but medically incompatible donors. The idea behind the guidelines was to provide a structured mechanism for such patients to benefit from paired exchange,” he said. The benefit cannot reach patients unless the donor-recipient pairs are willing to cooperate and proceed together,” he said.
However, it is unfortunate that even after four months, such multi-pair swap transplants are yet to materialise in Karnataka,” he added. Because of donor incompatibility, “We had expected that the guidelines will provide an additional avenue for patients who otherwise face difficulty accessing a kidney transplant.
