Nagpur: Association of Physicians of India, Vidarbha Chapter & kokilaben Dhirubhai Ambani Hospital had organised a Continuing Medical Education (CME) on “ Organ Transplant: Liver, kidney & BMT” on 20th November in Hotel Raddison Blu, Wardha Road, Nagpur.
At the outset, President API (2016-2017) Dr S D Suryawanshi, Consultant Physician, welcomed the gathering and highlighted why this topic was chosen.
A Case Discussion was presented by Dr Prakash Khetan, Consultant Nephrologist, Shravan Kidney Hospital & Dialysis Centre, Nanadanvan, for which the Chairpersons were Dr. Sharad Seth, Dr. Shankar Khobragade. Dr. Praksh Khetan said, a recipient can lead an active self dependent near normal life. Longevity or half life of the transplanted kidney depends on many factors. He narrated a case of a childhood Nephrotic syndrome person who underwent a Kidney Transplant, 25 years back. He needed 2nd Transplant (SWAP) 4 years back and has normal kidney function for 25 years post first transplant.
Dr. Saurabh Kapoor , Consultant Liver Transplant Surgeon, KDAH, Mumbai, spoke on “Indications for Liver Transplantation & Living Donor Selection for Liver Transplant & its Outcome” It was chaired by Dr S. V. Mukewar, Dr. Abhiram Paranjpe, & Dr Amit Agrawal. Dr. Kapoor informed that after enforcing. of NOTA ( National Organ Transplant Act 1994) Brain Death is legally recognised. however it has stringent criteria for brain death Certification. Tamil Nadu and Maharashtra are leading states, M.P. , Telangana and Kerala started now.. All religions encouraged organ donations.. Need for Organ transplants in India is huge. e.g. 1.8 lakh kidney Transplants, 30,000 Liver Transplants, 30 lakhs corneally blind persons, more than 1000 Hearts, and 1000 Lungs, Pancreas >1000 and small;l Bowel >`100. One person can save lives of 8 people and save or heal more than 100 lives through tissue donation, said Dr. Kapoor. Liver transplant is indicated in Liver Cirrhosis + decompensation (Hep B, C, Alcohol, NASH etc) Acute Liver Failure, tumours, Biliary Atresia, Metabolic diseases and Budd Chiari syndrome etc. h According to Kings College criteria, there is 80 to 90 % mortality without transplant and 90 % survival with Liver Transplant. “Liver Transplant is the only option for liver cirrhosis with decompensation. /HCC/ALF. There is good hort and longterm outcome . Team approach with Primary care Physician is essential for long term success. added Dr. Kapoor.
Dr. Sharad Sheth, HOD, Dept. Of Nephrology, KDAH, Mumbai, highlighted “Renal Transplantation in CKD- A Better Option”. Dr. V. L. Gupta, Dr. Prakash Khetan & Dr. Amit Pasari, were the Chairpersons for this lecture. He argued, a General Practitioner (family physician) has a big role. He should detect early and take management of Chronic Kidney Disease.(CKD) which is a global epidemic, with referral to specialist only when necessary, assess and modify cardiovascular risk factors, to slow down or prevent Kidney failure, One should avoid nephrotoxic drugs. Number of studies have shown that Quality of life improves tremendously after kidney transplant. Life satisfaction, physical and emotional wellbeing and ability to return to work is higher in transplanted patients. Uremic complications are more fully reversed and fertility returns. There are socio economic benefits, Cost to society for haemodialysis is Rs.1,20,000 to Rs. 1,40,000 annually. But after transplant >1,50,000 but after first year Rs. 8000/- per month. Mean cumulative cost for dialysis and transplantation are equal for 1 to 2 years and thereafter the cost becomes cheaper. for transplantation. Blood Related Renal Transplantation is the best option in end stage renal disease. Dialysis is effective in removing excess fluid, and waste, but has to visit dialysis centres 2 – 3 times weekly, Co morbidities affect the quality of life. There is risk of acquiring blood borne diseases.
Dr Samir Tulpule, Consultanting Hematologist, KDAH, Mumbai, spoke on “Haematopoietic Stem cells Transplant” Dr. Dilip Gohokar, Haematologist was the Chairperson. He described the evolution of stem cell therapy. It was seen following Atomic bomb victims the bone marrow is most sensitive to radiation. Splenic shielding protected mice from radiation. and Bone marrow infusion rescued mice from radiation illness The grafts are either from the same person – Autologus or allogeneic from other person. He described the various protocols followed for BMT and described procedures undertaken. He concluded that Bone Marrow Transplant (BMT) is now standard care in number of haematological disorders, It is only hope in cure of leukaemia. The key to success is multidisciplinary approach.
Secretary API (2016-2017)- Dr Nirmal Jaiswal, conducted the proceedings and also proposed the vote of thanks.
The CME was largely attended by medical fraternity of the city and Members of API.