The third Organ Procurement and Transplantation Course (OPAT) 2019 was conducted on March 29th and 30th, 2019 by the Department of Hepatobiliary and Pancreatic (HPB) Surgery & Multi-organ Transplantation, PSG Institute of Medical Sciences & Research (PSGIMSR), Coimbatore. The course was conducted in association with the Indian Society of Organ Transplantation (ISOT) and MOHAN Foundation. 13 participants from various parts of the country attended the hands-on liver and kidney procurement training on a live porcine model. Ms. Sujatha Suriyamoorthi, MIS & Programme Manager, MOHAN Foundation was invited as faculty and this was the second consecutive year that she was on the faculty for OPAT.
The course began with a welcome address by Dr.Swaminathan S, Consultant HPB Surgery & Multi-organ Transplantation, PSGIMSR and Dr.B. Joseph John, Consultant, HPB Surgery & Liver Transplantation,PSGIMSR. A series of didactic sessions were held to prepare the participants for hands-on work in the Animal Labs.Ms. Sujatha Suriyamoorthi gave an overview of Transplantation of Human Organs Act and its provisions. The legal framework in India for living and deceased donation and transplantation, regulatory bodies, qualifications and legal obligations of a transplant surgeon mentioned in the law were discussed. Following that was a session on ‘Coordinating deceased organ donation and family counselling’ by Ms. Rathi R, Transplant Coordinator and Clinical Nurse Specialist, PSGIMSR.
Dr.Anand Bharathan, Consultant Surgeon, HPB Surgery, Sri Ramakrishna Hospital, Coimbatore spoke on ‘General Principles of Organ Retrieval.’ He enlightened the participants with a step-by-step approach to achieve maximum utilisation of organs and thus honour the donor and the family for their gift of life to many. Dr. S. Vivekanandan, Managing Director, RPS Hospitals &Consultant, Liver Diseases &Transplantation, Kauvery Hospital, Chennai handled a session on ‘Liver Retrieval and Back Bench.’ His session also included a video on surgical procedures for procuring liver graft.
A guest lecture on ‘Donation after Cardiac Death (DCD) – The Indian Context’ was given by Dr. Mohamed Rela, Chairman & Managing Director, Dr. Rela Institute & Medical Centre. He talked about the key elements in setting up the DCD programme such as legislatures, guidelines and resources. He also emphasised the practical and ethical issues surrounding DCD - multi‐disciplinary approach, potential for perceived conflicts of interest, supporting and maintaining the trust of bereaved families.
Following this, was a session on ‘Kidney Retrieval and Back Bench’. Dr. N. Sezhian, Consultant Urologist & Kidney Transplantation, Apollo Hospitals, Chennai addressed the ‘Kidney Retrieval’ part in which he covered the surgical procedures in kidney recovery - access to the kidneys, mobilising the graft, cross clamping and graft perfusion. Dr.Ilango Sethu, Sr Consultant, Surgical Gastroenterologist, MIOT Hospital, Chennai spoke on ‘Back Bench in Kidney Retrieval’.
The participants were taken for hands-on organ procurement training at the PSGIMSR’s Animal Labs in the afternoon where they were mentored by eminent faculty.
Day 2 started with a didactic session on ‘Donor Optimisation’ by Dr. Senthil Kumar, Additional Professor, Institute of Liver & Biliary Sciences (ILBS), New Delhi. He stressed that optimal donor management is essential for increased number and functional quality of organs available for transplantation. The best practices to achieve these donor management goals were discussed during the session.
Dr. Gabriel C. Oniscu, Consultant, Multi-organ Transplantation, Royal Infirmary, Edinburgh, UK spoke about ‘Pancreas Retrieval’ as well as ‘Novel Approaches to Organ Preservation.’He mentioned that Pancreas was the organ most likely to be damaged during the retrieval surgery and the surgical skills of the surgeons were key for the success of pancreas transplantation. Dr. Srinivas Reddy, HPB Surgery and Liver Transplantation, Dr. Rela Institute & Medical Centre spoke on ‘Split Liver’. Though the split liver transplant would maximize the benefit of available donor organ, it is technically demanding and crucial evaluation of donor organs and effective logistics management are the key elements in this programme.
Dr. Frederick Vyas, Professor and Head, Department of HPB Surgery and Liver Transplantation, CMC Vellore spoke on ‘Small Bowel Retrieval’. He said that apart from being a complex surgical procedure, the risk of rejection of graft post-transplantation was very high in small bowel transplantation. Dr. Paari Vijayaragavan, Consultant HPB Surgery and Multi-organ Transplantation, Kovai Medical Center and Hospital made a presentation on ‘Complex Situations in Organ Retrieval’ and interesting case scenarios were discussed during his session.
Prof. Ramalingam M, Consultant Urologist and Kidney Transplantation, Coimbatore, Dr. Rajasekhar Perumalla, Consultant HPB Surgery and Liver Transplantation, Kauvery Hospital, Chennai, Dr. N. Anand Vijai, Consultant, HPB Surgery and Liver Transplantation, GEM Hospitals, Coimbatore, Dr. Maheswaran. P, Kovai Medical Center and Hospital, Coimbatore Mr. C B Chandrasekaran, Manager – Multi Organ Transplantation and Medical Tourism, PSGIMSR, Coimbatore were the other faculty present at the training and moderated various sessions.
The participants were awarded the course completion certificate at the end. They appreciated the course design and the hands-on learning experience that they received on the live porcine model.