The Interview....

TRANSPLANT CO-ORDINATORS - DOCTORS WHO MAKE ALL THE DIFFERENCE

The Critical Care Unit - the scene of innumerable battles between life and death. Life triumphs at times, death at others. The doctors working there have to be ever prepared to deal with grieving families and never more so, than with families who have a critically injured or brain dead relative.

Brain death - the concept is new in India, the setting in which it generally happens in extremely traumatic to the family. There is always the question, "Why did it have to happen to my father or mother or son or daughter?". Feelings of inense grief, anger, despair and frustration run high in the family.

It is into such a situation that a TRANSPLANT CO-ORDINATOR steps in. The transplant co-ordinator needs to clearly explain to the family the meaning of brain death, the tests that are done, the specialists involved, details of what organs can be removed and the fact that something positive can come out of something so negative and tragic.

On the transplant co-ordinator lies the onus of convincing the family to give consent for donation. Without this all important foundation being laid, there is no question of the transplant being performed.

The brain death or cadaver transplantation programme is still in its infancy in India but here in Chennai the transplant co-ordinators in Apollo Hospitals, Sri Ramachandra Medical College & Research Institution and Madras Medical Mission have taken that all important step in convincing families to donate.

A pioneer in this is a doctor from Apollo Hospitals who has stepped in fearlessly where others have feared to tread. He is Dr. R.K. Hariharan. Dr. Hariharan single handedly started the transplant co-ordination programme in Apollo Hospital in 1995. He says not only is it absolutely essential that one is sensitive and compassionate but also clear in communicating every detail of the concept of brain death and organ donation. One also has to be determined in asking for consent. "Every thing has to be above board and transparent. Give every family the choice to donate or not to donate. You should ask them." he adds. The consent rate in Apollo Hospital has been 70-80%. Kidney, heart, liver and skin transplants have been performed there.

Dr. Hariharan is ably assisted by Dr. Venkatasalam. They are unanimous in syaing that the transplant co-ordination programme has taken off because of team effort - co-operation from the management, primary consultants and of course the critical care unit team.

Most importantly, it is the families who deserve the applause. Dr. Hariharan and Dr. Venkatasalam feel that an aggressive education campaign is the need of the day, not only for the general public bout also medical students and doctors. It would make the task of approaching families easier if they were already informed.