Under the aegis of National Organ & Tissue Transplant Organisation (NOTTO), Directorate General of Health Services, Ministry of Health and Family Welfare, Government of India and ROTTO-SOTTO Mumbai, MOHAN Foundation in collaboration with Zonal Transplant Coordination Centre (ZTCC) - Pune conducted a one-week Transplant Coordinators’ Training Programme from 19th to 23rdFebruary 2018 at ISCCM Pune Office, Off Karve Road, Pune, Maharashtra. There were 51 participants not only from different places in Maharashtra, but also Tamil Nadu, Karnataka, Rajasthan,West Bengal and Delhi. This was the 52nd training programme conducted by MOHAN Foundation and the 18th in partnership with NOTTO. The training programme was supported by the Tata Trusts.
Dr. Kapil Zirpe, National President ISCCM, Dr. Subhal Dixit, Chairman, ISCCM Pune Branch, Dr. A. G. Huprikar, Secretary, ZTCC-Pune and Mrs. Arati Gokhale, Central Coordinator ZTCC-Pune were present at the inauguration. MOHAN Foundation was represented by Mrs. Lalitha Raghuram, Country Director, Dr. Sumana Navin, Course Director, Ms. Pallavi Kumar, Executive Director, Delhi-NCR, and Mr. Amit Shenoy, Project Manager – Hospital Outreach Program, Mumbai. One of the participants, Ms. Yamini Choudhary, spoke about why she had joined the training. Her father-in-law received a heart transplant in Chennai in 2017 and she said that she was inspired by the work of the doctors and the transplant coordinators. She wanted to learn more and contribute in a meaningful manner to the deceased donation and transplantation programme.
The MOHAN Foundation team and Mrs. Arati Gokhale anchored the training over the five days. Mrs. Arati Gokhale in her session on ‘ZTCC Pune – role and activities’ highlighted the fact that there were 56 deceased organ donors in 2017 from the Pune region. Two hospitals contributed to this in a big way – Ruby Hall Clinic with 21 deceased donors and Sahyadri Hospital with 20 deceased donors. She also outlined how organs were allocated in her session on ‘Role of Central Coordinator, ZTCC-Pune. ’She said that through the unique mobile app (GridSense Health) that had been created for ZTCC-Pune the method of organ allocation had become very efficient. Her session on ‘Green Corridor’ was an eye-opener for the participants.
The MOHAN Foundation team took sessions on various topics ranging from concepts of organ donation and transplantation, the legal framework, history of transplantation, successful organ donation and transplant programmes in the world, grief counselling and approaching a family for organ donation, role and qualities of a transplant coordinator, public awareness, setting up a deceased donation programme in a hospital, organisations (state based and NGOs) working in the field of organ donation and transplantation, timeline of successful transplants and status of deceased donation in India, and ethics in organ donation and transplantation. The team also kept the participants engaged with group activities, interactive sessions, role play and a number of films.
Ms. Rohini Sahasrabudhe, one of the senior-most transplant coordinators in the country spoke about some of her experiences with patients in her career of almost 40 years. She called it ‘Of Patients & Stories.’ Some of the take-home messages that she highlighted were - accept that you could be wrong, you learn from your patients, involve your patients in the counselling process and decision making - no matter how young they are, working as a team is crucial. She also suggested that starting a Renal fund in one’s unit would be a good way to help recipients. Dr. Vaishaly Bharambe’s session on Whole Body Donation clearly outlined the process and the importance of getting family consent as required by the law in voluntary body donation.
Dr. Urvi Shukla from Aditya Birla Memorial Hospital and Dr. Kayanoosh J Kadapatti, from Jehangir Hospital gave lucid presentations on the diagnosis and certification of brainstem death, and maintenance of a potential deceased organ donor, respectively. Films on the topic were also screened. This was followed by intensive sessions on counselling families including a film in Hindi showing both good and poor approaches (adapted from the film by NHS Blood and Transplant, UK).
The focus was on tissue donation, banking and transplant. Mrs. Meera Suresh of Snehbandhan Trust, Mumbai made an interesting and clear presentation on skin donation with a number of anecdotes. This was followed by two other interesting sessions – Corneal donation, eye banking and corneal transplantation including lamellar corneal transplant surgery by Dr. Chitra Sambare, Ophthalmologist, Shashwat Hospital, and bone donation and bone banking by Dr. Yogesh Panchwagh, Orthopaedic Oncologist,Deenanath Mangeshkar Hospital. Mrs. Surekha Joshi, Senior Transplant Coordinator, Ruby Hall Clinic spoke on the procedures to be followed in organ donation in medicolegal cases. She illustrated some of the difficulties that could be encountered through a case study. She also spoke about her first counselling experience for hand donation. ‘Phir Zindagi’ a film produced by ZTCC-Pune was screened. It was a very moving experience for the participants.
Dr. Manish Mali, Nephrologist, Aditya Birla Memorial Hospital spoke about kidney diseases and renal replacement therapy and provided the participants with key details in an easy-to-understand manner. Dr. Shriniwas Ambike, Nephrologist, Jehangir Hospital gave a detailed talk about pre- and post-operative care of a patient receiving a kidney transplant. Dr. C. N. Makhale, Cardiologist, Ruby Hall Clinic took the participants through the causes of heart failure, NYHA classification and INTERMACS score, LVAD and the indications for heart transplantation. Dr. Bipin Vibhute, Liver transplant surgeon, called his talk ‘Love your liver’ where he first outlined the diverse and vital functions of the liver. He then went on to brief the participants about liver diseases and liver transplantation, and the role of transplant coordinators in the entire process.Col. (Dr) Gopi Renganathan, Plastic surgeon, Command Hospital, Pune spoke about life-modifying hand transplants. He said that he drew inspiration from Mr. Matthew Scott, USA who received a hand transplant in 1999 and had gone back to working as a paramedic, even intubating patients! Heart valve (homograft) donation and banking was covered in detail by Dr. Ashish Khanijo, Cardiothoracic surgeon. Mrs. Vrinda Pusalkar, Senior Transplant Coordinator, Jehangir Hospital spoke about the documentation in live transplants – the forms and additional requirements.
Dr. Suresh Badhan, Consultant-Coordination, NOTTO, New Delhi outlined the role, responsibilities and activities of NOTTO and Ms. Urmila Mahajan explained the role and activities of ROTTO-SOTTO, Mumbai. A local NGO Rebirth Foundation (www.rebirthtrust.org) that works along with ZTCC-Pune made a presentation on the work they have done so far. They have initiated the Green Corridor Short Film Competitionwith very attractive prizes. At the valedictory function, two of the participants, Dr. Madhavi Salunke and Dr. Sagar Bedkihal recited poems on organ donation that they had felt inspired to write. Mr. Shrikant Patwardhan, volunteer with ZTCC-Mumbai shared his thoughts on saving lives through organ donation. Dr. Atul Mulay, Committee member, ZTCC-Pune and Dr. Suresh Badhan, congratulated the participants on finishing the training programme and presented the completion certificates to them. The highlight on the last day was the display from MOHAN Foundation of ‘Karma - Life before Ashes’ - human organ installations made from a mix of real human ashes and mud from graves. This idea stems from the insight that people are ready to allow their organs to be burnt and wasted, but they are not willing to let their organs give a new life to someone. The installations are meant to make people reflect and commit to pledging to be organ donors.