It was last year, some days in March 2020 everyone was happy because we started New Year with 10+ Organ donations, We started New Year hoping that year 2020 will bring new development by reaching donations in three digits. As I remember I visited Nashik, Kolhapur and Satara to find out the need and appointment of a new coordinator to start work under ZTCC Pune, but on 23rd march 1st lockdown was announced for 21 days. I was hoping that after 21 days everything will be fine and the process will restore, but lockdown was continued with that wearing mask social distancing and somatization became a new normal.
All hospitals were working but inactive in Organ donations. April went silently, with zero donation. By the time online meetings started setting up guidelines for allocation and distribution at NOTTO ROTTO level. Finally in May we all received COVID-19 guidelines by NOTTO followed by DHS. The guidelines were really challenging to implement for hospitals as well as ZTCC.
The most difficult and challenging task was to update yourself with new COVID-19 guidelines and make a strategy to implement it practically in allocations. How donation is possible, when you are unable to call Pt. from outside the state and your city. That time there were restrictions on traveling. Public and private transportation collapsed. So the 1st challenge was we have to find recipient at local level not from the intercity or intrastate even he or she is up on the city waiting list (CWL) If we look from the that Pt, Point of view his/her no is up on the CWL but he can’t get a chance /call it is disappointing for them, but the other hand the local Pt. got the chance for what they were really hoping, to save their life and avail this unexpected golden moment in his life.
Whenever there is a donor at any centre and when you’re doing multi organ and tissue donation you have to do many organ wise investigations to insure safety and quality of organ. Due to COVID-19 so much paperwork and investigation’s was added into the process like all COVID 19 investigations, COVID consent from, COVID screening from for health care workers. Including ambulance driver nursing staff doctor’s surgeons and all. All of this increases the remarkable time of the organ donation process and that was a different challenge altogether.
We want to do multi organ donations, we don’t want to lose any organ because of delay, we have to implement the guidelines, we have to find out the local recipient, we have to do all investigations, in limited time, we have to do all the documentation. All this process required so much time and that we don’t have. Hospital Coordinators were finding difficulty to cope up and do all the new things. They can’t go out of the box as well, so many things going on simultaneously. Everything was challenging but everyone was ready to play their role to save someone’s life. And I feel that was the key point to achieve 41 donations in COVID era. It started when COVID was on pic.
As I said earlier donations stop in March and no donation in April infect no BSD identification or certification was done. I was thinking how it is possible in 40+ centres not to signal BSD identifications has been done. It’s often that Hospitals Identify and certify donors but consent not done because of family refusal or medically unfit for donation. But no BSD identification and certification was not acceptable for me, especially when 2 month back we did 10 donations within a month and No. of identifications was more than that. So I took interest to find out the reasons behind this there was no reason as such but COVID impact was there & some of the hospitals became COVID centres and it was obvious all the focus got shifted on COVID. From our side a little bit of push was required to resume the same.
In the month of May 2020, we received guidelines from NOTTO and DHS and hospitals got the idea how they can go with the donation in pandemic. Simultaneously online awareness program, webinar interactive sessions with coordinators all was going on through an online platform. All the coordinators from Pune zone were charged up for donation and May 2020 Ruby hall clinic did the 1st donation in COVID Pandemic and 1st liver Transplant done by Sahiyadri hospital. From that donation we started with the full swing and all energy we have. At the end of 2020, 41 donations have been done by ZTCC Pune and that was the highest No. of donation in India. We share 7 organs including heart, lungs, kidney, liver to all over India through ROTTO/NOTTO in 2020.
I feel proud for all coordinators of ZTCC Pune who took the challenges at every level in the process and delivered for the Nobel coz in this difficult situation. And the most important I would like to salute all the donor family members for giving consent to save many lives.
Central Coordinator, ZTCC Pune
(This article was first published in the Indian Transplant Newsletter, Vol.20 Issue No.61, November 2020 – February 2021)