Times of India
16 April 2010
Chennai, India

After having successfully set up a liver transplant centre, Apollo Hospitals will soon establish a facility to transplant pancreas and islet cells, a first in the country. With the centre, Apollo hopes to help improve quality of life for patients who undergo renal transplants following diabetic nephropathy, transplant surgeon Dr Anand K Khakar said here on Thursday.

A successful pancreatic transplant, he said, has proven to be an effective cure for most severe forms of diabetes. In most cases, it may reverse the diabetic condition, or halt further complications but it does not cure the ones already caused. “But such a major operation is rarely offered to diabetics unless they also have renal failure and require a kidney transplant,” said Dr Khakar.

At the function organised to celebrate 40 liver cadaver liver transplants and 11 live donor transplants, Dr Khakar also said that a combined pancreas and kidney transplant increases 10-year survival from 30% to 80%, and unlike other transplants, failure will not kill a patient.

The pancreatic transplant may cost Rs 2.5 crore in addition to the kidney transplant and in some cases, patients may be given just islet cells, instead of the whole organ to improve condition. But doctors added that the pancreas transplant is not a substitute or option for those who merely want to avoid insulin pricks. “This is not a surgery to avoid needle pricks. Unless there is a complication, it’s not recommended,” he said. Statistics show that 16% of the city’s population is diabetic and of them, at least 20% develop complications of the kidney and some may require transplants.

The hospital will soon be setting up a centre that would deal with transplant of all abdominal organs. “In six months, we plan to start bowel transplants. They are more complicated and done only in few centres across the globe,” he added.

Apollo Hospital chairman Dr Prathap C Reddy said the hospital’s results had also been good. “We have an average of 70% survival rate for up to ten years among patients who have hd a liver transplant and up to 85% survival rate for up to five years. It qualifies us to be one among the best in the world. We will strive to achieve this in all organ transplants,” he said.

Anatomy Of Organ Donation

• Liver transplants are the most expensive of organ transplants. Cost: Rs 18-20 lakh at most corporate hospitals
• A kidney transplant costs Rs 3 lakh, Heart transplant costs Rs 9-12 lakh
• Apollo has completed 50 liver transplants at Chennai centre, largest in country with cadaveric organs

The Break-Up
Liver Preservative
Solution used to preserve organ after harvesting from donor cost Rs 7,500 a litre. Doctors require nearly 12-13 litres of this solution, called custodial solution, to keep the organ viable. COST – Rs 10,000

Blood
Patient undergoing surgery has low immunity. Blood undergoes series of tests like nucleic acid test (NAT test), where virus or a bacterium is detected. White blood cells are removed to avoid transfusion reaction, blood irradiated to kill virus. A patient would need six units of red blood cells, 10-12 units of fresh frozen plasma, and at least three units of platelets. A unit of platelet costs Rs 16,000. COST – Rs 7 lakh (depends on unit of blood used)

Icu care
A patient might take up to 5 days in ICU. Cost of keeping a patient on ventilation, syringe pumps and monitoring would be at least Rs 50,000 a day. COST – Rs 2,50,000 (depending on the no. of days)

Hospital stay
Rooms patients are moved into after transplant can cost Rs 5,000. The stay is for a minimum of 10 days. COST – Rs 50,000 (it may increase)

Cost of drugs
Medicines during post-surgical care includes immunosuppressant, antibacterial, antiviral and antifungal for 10 days. Cost - Rs 10,000

Theatre cost
Hospitals charge Rs 7,500 for transplant theatres. Surgical time, including harvest time from recipient, is up to 18 hours. COST – Rs 1,35,000

Surgeons fee
Three to four surgeons share a fee of Rs 4 lakh for the 18-hr process