| | MARCH 20209IN RESPECT OF MAKING THE ORGAN DONATION PROGRAM A SUCCESS, THE EARLY IDENTIFICATION, CERTIFICATION AND MAINTENANCE OF POTENTIAL DONORS IN THE INTENSIVE CARE UNITS IS IMPORTANTlike hypertension and diabetes. Ter-tiary prevention is to manage the kidney disease in order to control its progression. India's Position at Kidney Transplant in the WorldThe wait for new and right kidney can be very long sometime in India. Generally, the transplanted kidneys come from the dead donors and some come from family members. About two lakh patients In India are waiting for organs, with mere 15000 donors available. The minis-try of health calculation says that the annual requirement for kidneys could range between 2-3 lakh with a mere 6,000 transplants occurring in reality.The variance between demand for and supply of kidneys has led the government to push deceased donor or cadaver donations. The old statistics from the Indian Trans-plant Registry, a non-governmental initiative by the Indian Society of Organ Transplantation, says that out of the 21,395 kidneys trans-planted in India between 1971 and 2015, only 783 were from cadaver or deceased donors.Also, the lack of awareness and hesitation from the family is some of the main reasons for lower cases of deceased donors in India. Well post 2012, there is significant in-crease in the organ donations. The live kidney transplant programme in India has evolved from the past 50 years and is currently the second largest program in numbers after the US. The better immuno suppres-sive drugs and induction agents stop early rejection events and also there has been a various changes regarding using high dose steroids to prevent graft rejection, and this has resulted in lower incidence of post-operative complications after transplant surgery. There have been vast changes in the methods also of transplant. Now, there are minimal invasive methods for managing transplant surgery complications.Since 2011, there has been a rule in Indian law and amendments that there is a provision of `required request' to the intensive care doc-tors to ask for organ donation in the event of brain death. As it also makes it mandatory to register it nationally and counsel relatives for organ donation, this has also im-proved the rate of donation in India. The responsibility of making do-nations happen is with hospitals. So in respect of making this program a success, the early identification, certification and maintenance of potential donors in the intensive care units is important. The states that have relatively better are from south India such as Tamil Nadu, Puducherry, Kerala, and Andhra Pradesh. In north, Chandigarh has done well in terms of donors as per million population. As of now, the kidney transplant costs between Rs. 5-6 lakh in private hospitals in the country. And post treatment, the monthly cost is around Rs. 15,000 and life-long medicines that cost Rs. 10,000 per month.The records in Indian Transplant Registry reported that hat between 1971 and 2015, a total of 21,395 kid-neys were transplanted in India, out of which a mere number of 783 kid-neys belonged to deceased or cadav-er donors. This is mainly due to lack of knowledge of the process and ap-prehension among Indian families, thereby decreasing the number of deceased donors in the country. The report also says that more than 2.5 lakh people suffer from last stage kidney diseases every year. In that, seven out of 10 patients go for dial-ysis, and nearly six out of those 10 can't continue due to heavy treat-ment fees. There are dialysis cen-tres, but majorly based in cities. India is the diabetic capital of the world, and increase in the dia-betes also leads to proportionate in-crease in the chronic kidney disease. For patients suffering from kidney disease and come-up at end stage, dialysis and kidney transplant is the only option. Post the transplant, one of the major challenges is to sensitize the patient about the im-portance of the post-transplant care and due to any negligence which can worsen the condition further and can be fatal.Kidney transplants and dialysis are two meaningful replacement therapies available which can pro-vide good quality of life or longev-ity to the patients suffering from kidney failure at affordable costs. Never let any kidney patient feel helpless, or as if `the end of life' is knocking at the doors.
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