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FORTE makes headway in organ transplant

Anjali Prayag

BANGALORE, Dec. 27

LAST week at midnight in Bangalore, when doctors in a private hospital declared a patient `brain dead' much action took place in the city. The hospital informed FORTE (Foundation for Organ Retrieval and Transplant Education) about it.

Immediately, Ms Anita Swami, the Transplant Coordinator got into action. She scanned through her list of `waiting patients' and found only one in Bangalore whose blood grouping matched with that of the donor. The other kidney could not be wasted. Ms Swami found a patient in Mumbai who `could' accept the kidney. And by 5 p.m. the next day, both the kidneys were implanted into the patients.

FORTE was started in Bangalore as a non-profit medical service organisation in September 1996. The scenario then was very different. The Government had come out with the Human Organ Transplant Act in 1994, which prohibited commercial dealing in organs, accepted brain death as a definition of death and defined that only first-degree relatives could donate kidneys or other organs.

Racketeers in the human organ trade were in a fix as organs could either come from hospitals (from a brain dead patient) or first degree relatives (sister, brother, parents, children or spouse).

Dr Kishore Phadke, who along with Dr Elizabeth Zachariah and Mrs Rebecca Thomas founded the organisation, said, "Initially it was difficult. Families of brain dead patients needed a lot of convincing. The hospital administrators and counsellors had a crucial role to play here.''

The Cadaver Transplant Programme started off in Bangalore amidst a lot of scepticism. Public debates were held about how developing countries lacked the infrastructure required for such a programme. Critics said, "It requires high tech equipment, helicopters, advanced computers and software which India cannot afford.''

According to Ms Swami, "When we started this programme, there were plenty of sceptics who said it would take at least a decade before something like this could happen in India, but within one year of inaugurating the waiting list, we had out first donor."

FORTE has so far organised transplant of 31 kidneys, two livers and one heart.

The process of the transplant works like this: FORTE maintains a waiting list of patients awaiting transplantation. On receiving information from the hospital about a potential donor, FORTE will look for suitability based on blood group and the recipients are selected. A team of surgeons retrieve the organ from the donor and it is immediately implanted in the donee.

Ms Swami said, "The receiving patients will only get the organs according to the waiting list and there's no way anyone can jump the queue, unless of course, the donee patient's blood group does not match with that of the donor patient."

According to Dr Phadke, what FORTE needs at present is counselling services.

"The families of the donors have to be educated and counselled on all aspects of this process. Making them accept the idea is a difficult job and we need experienced counsellors in this field.''

He says the hospital administrators too play a crucial role as they have to inform organisations like FORTE at the right time.

He says though awareness has increased in Bangalore, Chennai still leads the way followed by Mumbai and Delhi.

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