Advanced transplant coordinators’ Workshop 3rd Consultative Meeting to Improve Organ and Tissue Donation 29th & 30th January 2016 - The Radha Regent, Chennai RESOURCE MANUAL Organised by Multi Organ Harvesting Aid Network Supported by Sir Ratan Tata Trust & Navajbai Ratan Tata Trust MOHAN Foundation Advanced Transplant Coordinators’ Workshop – Chennai – January 2016 Cover Design: Ms. Gieetha Priyadharshini MOHAN Foundation Advanced Transplant Coordinators’ Workshop – Chennai – January 2016 The 3rd Consultative Workshop is dedicated to our Trustee who Always Kept us Inspired. Her Indomitable Spirit Continues to Guide us Malathi Venkatesan (15/09/1946 – 02/11/2015) MOHAN Foundation Advanced Transplant Coordinators’ Workshop – Chennai – January 2016 MOHAN Foundation Advanced Transplant Coordinators’ Workshop – Chennai – January 2016 Foreword The 3rd Consultative meeting to improve organ and tissue donation in India has been planned with a focus towards promoting donation after circulatory death or DCD & tissue banking in the country. DCD has helped increase the donation rate in many countries in the west and revolutionised lung donation and many countries are even contemplating a heart transplant after DCD. The Transplant law in India does not have any clause against such a practice, but we do require guidelines from the „Ministry of Health‟ before hospitals are comfortable with this type of donation process. The international faculty – Dr. Sanjay Deshpande & Ms. Michelle Hunter from NHSBT, UK and Dr. Vijayanand Palaniswamy from Australia will share their experience. Captain Malvinder Singh Sahi will talk about “Ethical issues in end of life care”. We hope to come out with guidelines that can be sent to the Ministry on this subject. Tissue banking is still in its infancy in India with a few scattered hospitals doing various types of tissue collections. We have invited International faculty, Dr. Alvin Chua from Singapore, to give us a perspective on some of the key issues in moving forward with such banking process that depends so much on quality. We also have Dr. Sunil Keswani, Dr. Ajoy S M, and Dr. R. R. Sudhir who will give us the Indian perspective. These meetings in the past have come out with the proceedings that are made available on our website and we encourage you to look at last year‟s recommendations - http://www.mohanfoundation.org/proceedings/index.asp Organ and Tissue Donation and Transplantation overall is a large programme in India. Currently, we are doing over 58,000 corneal transplantations annually, approximately 10,000 live kidney and liver transplantations and another 2000 organs and tissue transplantations from deceased donations. To run such a large programme effectively that has multiple requirements, the government has formalised NOTTO (National Organ and Tissue Transplant Organisation), ROTTO (Regional Organ and Tissue Transplant Organisation), and SOTTO (State Organ and Tissue Transplant Organisation), in 2011-12. However, the need of the hour is to have more clarity on the role of regional bodies in promoting good practices in the field of organ and tissue donation besides formalising all the administrative requirements. It is felt that to be effective NOTTO needs to be an independent body within the directorate of health services almost similar to bodies such as NACO (National AIDS Control Organisation) and NPCB (National Programme for Control of Blindness). The current consultative meeting will see many stakeholders and experts gathering in Chennai and we hope to have a discussion on various aspects and come out with recommendations from the meeting. Dr. Sunil Shroff Managing Trustee MOHAN Foundation Advanced Transplant Coordinators’ Workshop – Chennai – January 2016 MOHAN Foundation Advanced Transplant Coordinators’ Workshop – Chennai – January 2016 Programme Schedule Friday - 29th January 2016 Time Session Speaker Chair person Dr. Sunil Shroff, 9.30am - 9.35am Welcome Address Managing Trustee, MOHAN Foundation Dr. Sanjay Deshpande 9.35am - 10.30am DCD process NHSBT, UK Dr. Rajasekhar Perumalla Specialist Nurse for Organ Michelle Hunter 10.30am - 11.15am Donation (SNOD) – NHSBT, UK Dr. Rajasekhar Perumalla Perspective on DCD 11.15am - 11.30am Tea break Mrs. Lalitha Raghuram 11.30am - 12noon Consent process video NHSBT, UK Dr. Sumana Navin Dr. Sanjay Deshpande Mrs. Lalitha Raghuram 12noon - 12.30pm Organ Donation UK 2020 NHSBT, UK Dr. Sumana Navin Dr. Anand Khakhar, Apollo Dr. Sunil Shroff 12. 30pm - 1.00pm DCD in India Hospitals, Chennai Dr. Sanjay Deshpande Dr. Sanjay Deshpande, 1.00pm - 1.30pm Q & A Michelle Hunter & Dr. Anand Khakhar 1.30m - 2.15pm Lunch Current scenario in skin banking in India; Dr. Sunil Keswani 2.15pm - 3.15pm Challenges in establishing National Burns centre Dr. V. B. Narayana Murthy and running a skin bank Dr. Ajoy S M Department Of Quality management in Orthopaedics, MSRMC & H 3.15 pm - 4.00pm Dr. R. Krishnamoorthy tissue banking QCO Mr. C. E. Karunakaran M S R Tissue Bank, Bengaluru Dr. K. R. Balakrishnan, Ex-vivo cardiac care system Ms. Pallavi Kumar 4.00pm - 4.15pm Fortis Malar Hospital, – an experiment into future Dr. Hemal Kanvinde Chennai 4.15pm - 4.30pm Tea Dr. K.R. Balakrishnan Dr. Akila Rajakumar Panel Discussion – Unusual Dr. P. Magesh Moderator – Dr. Sunil 4.30pm - 5.30pm case studies Dr. R. Radhakrishnan Shroff Dr. Arulraj Dr. R. Kanimozhi Mr. K. Prakash MOHAN Foundation Advanced Transplant Coordinators’ Workshop – Chennai – January 2016 MOHAN Foundation Advanced Transplant Coordinators’ Workshop – Chennai – January 2016 Saturday - 30th January 2016 Chair person Time Session Speaker Dr. M. Ananda Babu Chief Cornea Surgeon, Current trends in eye Dr. R. R. Sudhir Regional Institute of banking in India; 9.30am - 10.10am Sankara Nethralaya, Ophthalmology and Challenges in establishing Chennai Government Ophthalmic and running an eye bank Hospital, Chennai, Chennai Dr. Alvin Chua Assistant Director, Transplant Tissue Centre, Singhealth Dr. Sunil Shroff Towards a multi-tissue Clinical Scientist & Deputy Mrs. Lalitha Raghuram 10.10am - 11.00am bank facility - The Head, Skin Bank Unit, Singapore experience Department of Plastic, Reconstructive & Aesthetic Surgery, Singapore General Hospital 11.00am - 11.15am Tea break Surgeon Captain Malvinder Singh Sahi, Senior Consultant, Dr. B. Subba Rao Ethical issues in end of Critical Care & Head, Pain Dr. N. Sridhar 11.15am - 12noon life care Management Rajiv Gandhi Cancer Institute & Research Centre, New Delhi Dr. Sumana Navin Procurement and 12.noon – 1.00pm Dr. Alvin Chua Ms. Pallavi Kumar sterilization of tissues 1.00pm - 2.00pm Lunch Dr. Vijayanand Palaniswamy, Intensive Dr. Sunil Shroff Australian perspective on 2.00pm - 2.30pm care consultant, Royal Dr. N. Sridhar DCD Darwin Hospital, Darwin, Australia Kerala Network for Organ Dr. Thomas Mathew, Dr. J. Amalorpavanathan 2.30pm – 3.00pm Sharing (KNOS) – Convenor, KNOS Dr. Georgi Abraham Forging ahead Getting financial help for Ms. Aneka Paul 3.00pm – 3.15 pm Dr. Noble Gracious Transplant surgery Sir Ratan Tata Trust Dr. Georgi Abraham 3.15pm – 3.45pm Valedictory function Dr. J. Amalorpavanathan Dr. Thomas Mathew MOHAN Foundation Advanced Transplant Coordinators’ Workshop – Chennai – January 2016 MOHAN Foundation Advanced Transplant Coordinators’ Workshop – Chennai – January 2016 Contents S. No Topic Page No 1 Donation after circulatory death (DCD) process 1 Specialist Nurse for Organ Donation (SNOD) – Perspective on 2 2 DCD 3 DCD in India 3 Current scenario in skin banking in India; Challenges in 4 7 establishing and running a skin bank 5 Quality management in tissue banking 11 6 Ex-vivo cardiac care system – an experiment into future 13 Current trends in eye banking in India; Challenges in establishing 7 15 and running an eye bank 8 The requirements for establishing a state-of-the-art Tissue Bank 17 9 Ethical issues in end of life care 20 10 Australian perspective on DCD 22 11 Kerala Network for Organ Sharing (KNOS) – Forging ahead 23 12 Getting financial help for Transplant surgery 29 13 Deceased Organ Donation in India - 2015 30 MOHAN Foundation Advanced Transplant Coordinators’ Workshop – Chennai – January 2016 MOHAN Foundation Advanced Transplant Coordinators’ Workshop – Chennai – January 2016 Dr. Sanjay Deshpande FRCA, FCA (Ireland), FICM, DA, MD, MBBS Consultant in Anaesthesia and Intensive Care South Tyneside NHS Trust, HartonLane, South Shields, U.K. Dr. Sanjay Deshpande passed his MBBS and MD (Anaesthesia) from Government Medical College, Aurangabad. He worked in Mumbai for 2 years and then opted to work for the Ministry of Health, Saudi Arabia. He got his Part 1 FRCA and later moved to the UK. He completed the Registrar training and during this period passed the Part 2 and Part 3 examinations in Anaesthesia. He did a fellowship in Obstetrics Anaesthesiology in Oregon, USA for 15 months and following this experience moved to the UK. He completed the Higher Specialist Training and got a Consultant job in Anaesthesia and Intensive Care in 2000 at the above hospital. Since 2010, he has been a Clinical Lead for Organ Donation with 1-2 donations regularly since then; he has been a Resuscitation Instructor for over five years. Other interests include travelling, reading, playing badminton and table tennis. Synopsis Donation after circulatory death Donation after circulatory death (DCD) has been re-introduced and contributes to donor numbers in many countries. DCD is increasing in response to a lack of organs available for transplant. DCD differs in many aspects