India has established a registry for the first time for patients in need of hand transplants. According to officials, it will facilitate the allocation of the donated organ in a transparent manner and on a priority basis. The National Organ and Tissue Transplant Organisation (NOTTO), which is governed by the Union Health Ministry, will accept the registration in its national registry.
In a letter, NOTTO Director Anil Kumar informed all states and union territories about the registry and instructed them to share the information with all hospitals and hand transplant centres to ensure compliance. According to Dr. Kumar, the number of hand transplants performed has been rising, with more and more facilities carrying out the transplants.
The letter claims that the registration for hand transplant is not available under ‘Subject Demography Management’ in the national registry on the NOTTO website. “Therefore, it has now been decided by the competent authority that all the hand transplant centres/hospitals should register such patients/recipients requiring hands for transplants under the category ‘bone’ of the tissue section in subject demography management,” the letter said.
There are currently nine hospitals in the nation authorised to perform hand transplants. Based on information gathered by NOTTO, 36 patients have had hand transplants to date, totalling 67 hand transplants.
What do the doctors say?
Dr Subramania Iyer, who led the team that conducted India’s first hand transplant in 2015 is professor and chairman of plastic and reconstructive surgery and head and neck surgery of Amrita Hospitals and School of Medicine in Kochi. Dr Iyer said that the establishment of a registry and pan-India allocation of hands on a priority basis will give a boost to the donation as well as the proper utilisation of the donated hands.
According to Dr Iyer, hands can be donated both after cardiac and brain death, however, organs are typically donated after brain death. Doctor further explained that in the case of a cardiac death, hands should have to be donated within 30 minutes of the heart stoppage, and this should happen in a hospital’s controlled environment.
With increasing awareness more and more patients are seeking hand transplants and more donations are happening so the registration process is being initiated, Dr Iyer said.
Meanwhile, NOTTO’s Dr Kumar said that this step will further help NOTTO in smoothening the national allocation process and data management for hand transplant of donors and recipients. He stated that now with awareness, the number of hospitals performing hand transplant in the country is also increasing.
As per Dr Iyer, hand transplants in India started in 2015 when a 29-year-old man underwent bilateral hand transplants. Since then the utility of the procedure in rehabilitating patients with hand amputation especially when both hands are lost was appreciated and several centers took it up. “Hands at various levels of amputation, that is forearm, upper arm and even at shoulder level, have been carried out successfully,” he added.
Dr Iyer further said that the lack of available hands for donation and the distribution of donated organs across the nation are the main factors deterring its extensive use, besides the technical and organisational challenges. “Hand donation process being an externally mutiliating one is not perceived favourably by many when organ donation is considered. Hence the establishment of a registry and pan Indian allocation of the hands on a priority basis will give a boost to the donation as well as the proper utilisation of the donated hands,” he stated.
(with PTI inputs)
