Dileep V Kumar By Express News Service THIRUVANANTHAPURAM: As Covid-19 cases spiral, organ transplantation programme has come to a grinding halt in the state. According to officials, the organ donation from both live and deceased, has taken a severe hit since the Covid-19 outbreak. Considering the possibility of in-hospital transmission of the virus, the state health department has directed organ transplant centres to carry out only emergency liver transplantation. But that too by following the guidelines of the Liver Transplant Society of India (LTSI). At the same time, as countrywide lockdown progresses, the state might fall into an unprecedented crisis due to shortage of post-transplant medications, sources said. “Organ transplant programmes have been temporarily suspended in the state. Such a decision has been taken based on the instructions from the health ministry. Immunosuppressant drugs have to be administered after a transplant, which is the main reason for suspending the programme. The other reasons are shortage of blood and blood components, transportation difficulties and others,” said an officer of the health department. According to the officer, the problem with immunosuppressant drugs is that it is a double-edged one. On one side its administration suppresses or reduces the strength of the body’s immune system making it susceptible to infections and viral attacks. On the other side, the unavailability of immunosuppressant drugs will create problems as the absence of the same will prompt the body to attack the new organ and destroy it. “For example if one undergoes a kidney transplant, immunosuppressant drugs is provided. It is for lowering the body’s ability to reject a transplanted organ. If it is not consumed, the body will try to reject the new kidney and damage or destroy it as it is a foreign element. Almost everyone who has had a transplant will have to take it, most probably on a daily basis,” added the officer. Meanwhile, even if kidney transplant expectant could manage the renal functions through dialysis, the erythropoiesis injection that has to be provided to them for increasing haemoglobin level is also said to be facing a shortage. At the same time, a senior officer at the Directorate of Health Services said that only liver transplantations will be performed till further notice and the guidelines issued by LTSI have been shared with both deceased donor liver transplant (DDLT) centres and living donor liver transplant (LDLT) centres. As per the guidelines, elective DDLT should be done only if the donor tests negative for Covid-19 in both RT-PCR and serologic tests. At the same time, LDLT could only be done in urgent cases after thorough counselling as LDLT poses a risk to the healthy donor with hospital admission and contact risks. Moreover, the guidelines mandate that all donors (deceased and living) and recipients should be tested for Covid-19 (both tests) at the time of urgent transplant. Considering the possibility of in-hospital transmission of the virus, the state health department has directed organ transplant centres to carry out only emergency liver transplantation.

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