Fact Files

Making transplants safer in the Covid-19 era

As the pandemic maturates comfortably and announces its unpleasant extended stay in the neighbourhood, the community is learning to shake hands with it and return to work. Kidney failure and transplant professionals remain the most cautious community to restart after the storm due to various intellectual extrapolations never experienced before. The current pandemic has made us rethink how to reinvent the art and science of transplantation, especially the kidney.

For many high landing professionals across the country or may be globally, kidney transplant is counted as an elective surgery as an alternative treatment in form of dialysis, is available, or at least that is what is being communicated to the patients. However from a patient's perspective I strongly believe, kidney transplant is mostly a semi urgent rather many times, a certain medical emergency. It's seldom an elective procedure, for the simple reason that the patient has already made up his mind and chosen a certain more invasive, presumably more expensive but life saving treatment in form of a transplant. If a timely organ transplant is denied, most of the patients end up losing their lives, mostly on dialysis, leaving the family members in a lurch. The urgency in kidney transplantation is not only medical but also ethical, social, financial and many a times circumstantial. Usually the patients would travel thousands of miles to chose a transplant center for their surgery, make repetitive visits for the legal formalities, which unfortunately are too extrapolated in our country, and there is a dire need to make them simpler. It's high time the government should realise that stricter doesn't mean more complicated, rather should be simple and attainable by the patients, who are already on deathbed. Dying during completion of papers is a common story, which transplant surgeons are accustomed to listening. while the government committees take their own sweet time to clear them, when they finally land to their actual treating doctor. Given the high death rate in dialysis ( almost close to ninety percent will not see through ten years on dialysis, whereas close to eighty percent would be alive, even after ten years, if they received a timely kidney transplant), we have always tried to make a transplant more simpler, meaningful and timely so that we don't deprive them of the right to stay alive. We are gearing up now to make these transplants still safer in the covid era and trining our minds to be prepared for the theoretical unseen. Thankfully, in a devastated state like New York where the pandemic showed its fulminant wrath, kidney transplants are still carried on.

Transplants not only need to be continued but also the shield needs to be strengthened further, and be accessible to all who need it. Globally the transplant surgeons have continued/ restarted the kidney transplant programme so as not to see more number of unfortunate souls dying waiting for a transplant rather than covid. These testing times have already brought out the best in the surgical community.

As we step up to hold hands for the sick and restart the kidney transplant programme, we have mollified the efforts to satiate several concerns raised about the transplant surgery as well as the immunosupression which these patients are going to receive. The primary motive is to safeguard ourselves and our own healthcare workers, apart from protecting our patients from contacting the coronavirus infection due to suppressed immunity. Addressing these concerns required thorough brainstorming and now we have devised methods to plug in all the gaps. The hospitals entry gates, reception, billing counters, Outpatient practices and Operating room modifications, telemedicine consultations and so many other methods are being devised to attain the next level of safety.

We have already stepped up all measures to get used to the new normal. Covid is going to stay here and we have to modify ourselves to shield everyone. It's a tough challenge but the pandemic has taught all of us so much more than just the disease biology. We are determined to give the best to our patients and are already on war-footing to give them every chance and hope of staying alive.

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