Opportunities and challenges for thoracic organ transplantation in government institutions
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REVIEW ARTICLE
Opportunities and challenges for thoracic organ transplantation in government institutions Sarvesh Pal Singh 1
&
Milind Padmakar Hote 1
Received: 17 December 2018 / Revised: 4 February 2019 / Accepted: 7 February 2019 # Indian Association of Cardiovascular-Thoracic Surgeons 2019
Abstract The first successful heart transplant in India was performed by Panangipalli Venugopal on 3 August 1994 at the All India Institute of Medical Sciences, New Delhi. Twenty-five years later, only seven government institutions are performing heart transplants and only one government hospital has an established heart transplant program in India. Only one lung transplant has been performed in a government institution all over the country. This article reviews the history and current status of thoracic organ transplant in India. The authors discuss the factors responsible for the dismal progress of thoracic organ transplant in government hospitals, opportunities available in government institutions for widening the scope of transplant program, and the steps taken by the Government of India to improve healthcare in the country. Keywords Opportunities . Challenges . Thoracic
Panangipalli Venugopal performed the first successful heart transplant in India on 3 August 1994 at the All India Institute of Medical Sciences, New Delhi [1]. This first patient survived for 14 years. The longest surviving recipient of heart in India is now 18 years post surgery and doing well. Even though the first heart transplant in India occurred in a government institution, Kotturathu Mammen Cherian performed the first successful sequential bilateral lung transplant and first successful heart–lung transplant at Madras Medical Mission in Tamil Nadu [2]. The first lung transplant in a government hospital was performed by Rana Sandip Singh at Post Graduate Institute of Medical Education and Research, Chandigarh, on 11 July 2018 [3]. The patient died of infection 15 days later. The exact statistics for thoracic organs harvested and transplanted in India is not available because of an absent proper, transparent, and regulated nationwide registry. One publication quotes, Btill 2016 the number of heart transplants done in India is 250^ [4]. The data collected by Society for Heart Failure and Transplantation (SFHFT) in 2016 reveals * Sarvesh Pal Singh [email protected] 1
Department of Cardio-Thoracic and Vascular Surgery, Cardio-Thoracic Sciences Center, C N Center, All India Institute of Medical Sciences, New Delhi 110029, India
that 400 heart transplants and 24 heart–lung transplants were done in India until 2016 [5]. The state of Tamil Nadu leads in the number of thoracic organ transplants done annually, because the rate of organ donation in Tamil Nadu is about ten times the national average [6]. India spends only 1.1–1.2% of GDP on healthcare in a country of more than 1.2 billion people [7]. The existing government hospitals provide healthcare with miniscule charges or free of cost. Although donated heart and lungs come for free and in
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