Business of Kidneys: Kerala priest facilitates domino transplants for over fifty patients

A priest in Kerala is demonstrating how an alternate model may offer a solution to kidney patients who wait endlessly for donors, and often end up paying lakhs to scrupulous elements in the hope of finding a willing donor. DNA in its reports dated October 15 and 16 brought out the ugly face of Delhi's kidney rackets where patients were duped into getting their kidneys removed.

Nephrologists at New Delhi's All India Institute of Medical Sciences estimate that five lakh people live with failed kidneys in India at a time. A Lancet study revealed that just 10 per cent of patients suffering from kidney failure have access to dialysis, and 70 per cent of those starting dialysis die or discontinue treatment within the first three months due to the high cost of the treatment.

The Catholic priest in Kerala's Thrissur district mooted a chain of kidney exchanges with a voluntary donor offering a kidney to a needy person, and a relative of this recipient in turn donating his/her kidney to another person, and so on. This system is known as 'Domino Transplant'. In the last five years, 56 people have been part of such kidney exchange chains, linking disparate people from industrialists to truck drivers in a chain. Two hundred others have pledged to join the chains when compatible donor-recipient pairings are established. Fr Davis Chiramel says the numbers could have been higher but for the poor medical infrastructure it could not.

"Thousands of patients are in need of kidneys in Kerala alone. I am turning my attention to improving access to dialysis," says Fr Chiramel. "Clinics and hospitals pay hefty commissions to doctors to refer dialysis patients to them. There are good doctors, but the scale of profiteering in health services scares me."

It's not just infrastructure and a willing donor that start the work. Government hospitals are known to drive away voluntary donors to private hospitals and insist on relatives-as-donors. "They should be willing to accept unrelated donor-recipients who are recommended by eminent citizens," says Fr Chiramel.

For instance in 2011, a chance meeting with Fr Chiramel prompted Reetha Cherian, a 60-year-old widow, to offer to donate a kidney."My daughters were livid that I was neglecting my health for another person. But I had read about the surgery and knew there was nothing to worry about," says Cherian. By January 2012, Fr Chiramel had arranged a kidney chain of six people. "We had done all the paper work and the medical tests but the recipient, Ansamma, suddenly passed away. When she died, her husband, who was to donate his kidney to another person, lost interest. Ultimately, nobody in that chain benefitted."

Ansamma's loss was AV Prasad's gain. The 35-year-old daily wage labourer had been on dialysis for nine years. Prasad met Fr Chiramel who roped in Cherian as his donor in 2013. The surgery took place in January 2014 after several medical tests had been conducted and consent forms were signed in front of executive and judicial officers. Today, Prasad sells lottery tickets for a living. "I can't do hard work but I am relieved to be off dialysis," he says.

(This is the last in the three-part series which explored the vulnerability of patients desperate to receive kidney)