MOHAN Foundation was invited to a Deceased Donor Organ Transplantation Workshop organised on 11th February 2018 by the Organ Transplant Unit at Sri Jayewardenepura General Hospital, Sri Lanka. Dr. Sunil Shroff, Managing Trustee, Mrs. Lalitha Raghuram, Country Director and Dr. Sumana Navin, Course Director were the resource persons from MOHAN Foundation. Dr.Arun Kumar, Professor & Head, Department of Critical Care Medicine, Saveetha Medical College & Hospital, Chennai was also a resource person. The invitation came from Dr.Niroshan Seneviratne, Consultant Urologist & Transplant Surgeon on behalf of the Steering Committee.
The workshop began with an ‘Overview of organ transplantation in Sri Lanka’ by Dr. Lakshmi C. Somatunga, Deputy Director General of Health Services, Ministry of Health, Nutrition and Indigenous Medicine, Sri Lanka. She elaborated on the national transplant programme. It was aimed at streamlining deceased donor organ transplantation through clarifying the legal process, appointing and training donor coordinators, and developing infrastructure. There was a plan to divide the country into four zones (Northern, Central, Western, Southern) for the purpose of organ allocation. She said that the way forward was to have an allocation protocol and central allocation system in place as well as a regional ethics committee. It was important to do transplants within a legal framework keeping ethical norms, and social and cultural acceptance in mind.
Dr.Sunil Shroff then spoke about the deceased donation programme in the South Asian Association for Regional Cooperation (SAARC) countries – Bangladesh and Nepal are doing living kidney transplants. Sri Lanka and India perform both living and deceased donor organ transplantations. (Thereafter Dr. Shroff participated in a parallel discussion with senior medical professionals and law makers from Sri Lanka regarding what was required to give an impetus to the deceased organ donation programme in the country. He gave his inputs for creating an organ sharing registry and laying down procedures)
Dr. Sumana Navin gave an overview of the law in India – the Transplantation of Human Organs Act, 1994 and the subsequent amendment in 2011 and the new Rules in 2014. She highlighted some of the ambiguities and challenges that were encountered in the Indian law. She also touched upon the law in Sri Lanka - The Transplantation of Human Tissues Act 48 of 1987, as well as the Code of Criminal Procedure Act No. 15 of 1979.
Dr. Manoj Edirisooriya, Consultant Intensivist from Sri Lanka spoke on ‘Brain death certification in Sri Lanka’ and outlined some aspects in the law that needed clarifying – brain stem death versus whole brain death, the role of ancillary tests, time of death (first or second test), and hierarchy of next of kin. He also highlighted the concerns of the Judicial Medical Officer, Inquirer into Sudden Deaths and Magistrate.
Dr.Arun Kumar, Professor & Head, Department of Critical Care Medicine, Saveetha Medical College & Hospital, Chennai spoke in detail about ‘Certification of brain death – Early identification and caveats in certification’ and ‘Maintenance of a potential brain-dead organ donor. ’Mrs. Lalitha Raghuram started her session on counselling families by sharing a donor story. She went on to explain the role of a transplant coordinator, approaching a family and broaching the topic of organ donation.
Dr. Sumana Navin then spoke about training programmes for transplant coordinators. MOHAN Foundation’s E-learning programme could be made available to South Asian countries. The advantages would be that the same socio-cultural milieu exists in all of these countries, the participant could learn at his/her own pace, and it would be cost effective.
Dr. Amal Vadysinghe, Consultant Judicial Medical Officer & Senior Lecturer, University of Peradeniya elaborated on the ‘Post-mortem formalities in Sri Lanka in a medico-legal case. ’He also focused on the issues encountered in deceased donation in medico-legal cases – issuing death certificate, insurance issues, arranging final religious rites among others. The workshop ended with an activity - ‘Organ Donation Pathway – How to proceed when there is a deceased donor in the hospital,’ that was moderated by Dr. Sunil Shroff and Dr. Sumana Navin.
MOHAN Foundation acknowledges the support of the Steering Committee members – Dr. Chula Herath, Consultant Nephrologist, Prof.Rezvi Sheriff, Consultant Nephrologist, Dr.Chinthana Galahitiyawa, Consultant Nephrologist, Dr.Chamila Pilimatalawwe, Consultant Anaesthetist & Intensivist, Dr.Rajitha De Silva, Consultant Cardiothoracic Surgeon, and Dr.Niroshan Seneviratne, Consultant Urologist & Transplant Surgeon.