Daijiworld Media Network - Mangaluru
Mangaluru, Apr 15: When the family members of Jeevan Vijay Fernandes (24) who was brain dead following an accident came forward to donate his organs, they did not know that it would be the first live organ harvest done in Mangaluru and that they would create medical history in Mangaluru and set a precedent. Though the family was in complete shock and in distress having lost a young and bubbling life tragically, it did not prevent them from coming forward to donate his organs. Though Jeevan is dead he lives through his heart valves donated to Narayana Hrudayalaya and Liver to BGS Global Hospital Bengaluru which have already been transplanted to patients there. True to his name Jeevan (life) lives and Vijay (victory) is victorious in the true sense of the term.
This entire exercise was possible through the Rapid Multi Organ Retrieval Programme done at AJ Hospital in association with a team of doctors from Zonal Coordination Committee of Karnataka for Transplantation. The procedure was carried out in a matter of 12 hours after the family came forward to donate till the organ was transported to Bengaluru by a special chartered flight. The AJ Hospital worked in coordination with the Mangalore traffic police, who had created a zero traffic corridor to enable its smooth transport from AJ Hospital to Mangalore International Airport at late night on Monday, April 13.
Why Bengaluru and not Mangaluru?
It is true that donating organs gives a new lease of life for those who can survive with donor organs no matter where they live. But a natural question arises: why take the circuitous route of transporting the organs all the way to Bengaluru? Don’t we have kidney transplantation facility in Mangaluru if not liver transplantation? Why not donate them to recipients waiting for Kidney or liver transplantation in Mangaluru instead of taking the risk and adopting the cumbersome procedure of sending them to Bengaluru?
Dr Sudhesh Rao, Chief Intensivist, Department of Critical Care at AJ Hospital, who was part of this first of its kind of procedure in Mangalore, said the time constraint was the major hurdle as far as Kidney transplantation is concerned. “We don’t have a cross matching process which is vital for organ transplantation. Cross matching process is done only in Manipal Hospital but the time constraint was the major factor. If we had a ready team working on cross matching procedure we could have done it immediately. But Jeevan’s condition was precarious as his heart beat was falling and we could not take chances. Otherwise the entire exercise would be futile. Finally Jeevan cardiac arrest and we had to revive it to keep him alive before the procedure. Though Mangalore has facilities for planned kidney transplantation we could not do the emergency case. Moreover we don’t have liver transplant facility in Mangaluru”, Dr Sudhesh pointed out.
Dr Sudheesh Rao
“It is not just the retrieval of organs that matter. We must have proper arrangement to transplant them and that calls for tremendous coordination and working in tandem, which is not there as of now here in Mangaluru”, he said. The recipient patient has to be kept ready in the shortest possible time to transplant the organ simultaneously. Moreover, except for private hospitals there is no comprehensive list of patients waiting for donors on the lines of Zonal Cooordination Committee of Karnataka for Transplantation, (ZCCKT) a government body in Bengaluru. Whenever there is a donor the organs are provided to the patients as per the waiting list order.
But Dr Sudhesh feels that it is high time for Mangaluru to have this kind of facility now that Jeevan’s family has set a precedent through their noble gesture. “The time has come to make this facility available even to the common people in Mangaluru. Jeevan Vijay in fact gave us an opportunity to show that can do it”.
Time management after crucial decision
For Dr Sudhesh Rao and his team it was more of time management to follow the protocol before they could successfully carry out this extraordinary feat of organ harvest. The idea donating the organs was mooted by Jennifer, the elder sister of Jeevan who works in AJ Hospital. Jennifer had resigned from AJ as her marriage is scheduled for May 4, 2015. April 14 was her last working day at the hospital. The doctors told the family that Jeevan was brain dead but the family decided to keep him on ventilation as his sister Gloria who was in Bahrain wanted to see him alive.
To continue the ventilation support at the behest of his sister proved to be the most vital decision as it gave time for Jennifer to reminisce that Jeevan often used to talked about donating parts of his body. When she got this brainwave she lost no time in suggesting it to her family and soon the family was in touch with the doctors of the hospital. Jennifer also took the responsibility of convincing her mother and her sick father. “My father was initially hesitant but I succeeded in convincing him”, says Jennifer. The hospital, though was not adequately equipped to handle the situation, swung into action to follow the protocol.
Talking to Daijiworld.com Jennifer said that she suddenly remembered that Jeevan used to express his desire to donate his body parts. “I often used to talk about my hospital experience with my family. Naturally there was also talk about organ donation and that is when Jeevan used to tell he wants to donate his body organs. I never used to give a serious thought to this until this day when I was actually faced with this reality. He also used to tell that he wanted instant death and did not want to suffer and that is what happened to him, Jennifer recalls.
The first step as far as organ donation is concerned is that the patient had to be declared brain dead and this has to be declared by three doctors - a Neurologist, an Intensivist and a Physician. They have to test and cross check and they have to declare it two times in a gap of six hours. Doctors can go ahead with organ harvest procedure only after this declaration is done. In the meantime Jeevan’s cousin Melwyn Saldanha who is associated with various activities of Lions club, got in touch with a NGO and through that contacted ZCCKT. Once ZCCKT was involved the entire responsibility was taken over by them including coordinating with airport authorities and AJ hospital. ZCCKT doctors were constantly in touch with the team of doctors from AJ Hospital and by 7.30 pm the chartered flight had arrived in Mangaluru. After two hour long operation the organs were transported through zero hour traffic to Mangalore Airport and from there to Bengaluru. “We wanted to donate the lungs and the pancreas also but could not due to time constraint”, Jennifer said.
For AJ hospital also it was the experience in handling live organ harvest and there was not much time as they had to follow the protocol. The hospital administration got in touch with District administration for providing and the zero traffic corridors for the safe transport of the organs. Assistant Commissioner of Police (Traffic) Uday Nayak said “though zero traffic corridors has been provided earlier during the visit of VVIP’s it was for the first time this facility is provided for transporting human organs. Since it was night vehicles had difficulty to know the presence of traffic police to ensure zero traffic. We had to use torch lights to stop flow of traffic during that period. But the general public was were aware of the incident and they cooperated with us”.
Dr Sudhesh terms the family’s decision to donate organs as “a splendid gesture which calls for tremendous courage, conviction and selflessness. It has really taken us by surprise considering that Jeevan’s father also suffers from cancer. We must really appreciate the family’s decision to be so brave especially when faced with the cataclysm they have been facing. It is no joke to be benevolent in such situations”.
Helmet could have saved Jeevan?
Jeevan had met with an accident at Adyar on April 10 while riding in his Yamah FZ bike towards Mangaluru to attend a Mehndi programme in Jeppu along with his friend. He had applied brakes to avoid hitting a pedestrian who had suddenly crossed the road. Both Jeevan and his friend, who is now recuperating in hospital with fractures were thrown to the road. Jeevan had severe head injuries and was almost brain dead when brought to hospital. There was no other injury on Jeevan’s body except the head injury. If he was wearing the helmet at the time he would have been alive and would have witnessed his sister’s wedding scheduled for May 4, 2015.
Jeevan's uncles Sylvester Noronha and Naveen Saldanha
In fact, Jeevan was wearing the helmet in the wrong place - on his hand like a bangle, a scene familiar in the streets of Mangaluru among youngsters. Jeevan who was working in his uncle Naveen Saldanha’s Mangalore Auto Body Parts at Padil was a very hard working and jovial fellow with no bad habits. The only habit he had and which ultimately proved to be his undoing, was rash riding and riding without helmet. The monstrous Yamaha FZ was bigger than his 5.3” frame and it is said that even the showroom people had advised him against buying it. Uncles Hibert Saldanha and Sylvester Noronha say that they always used to caution him against his rash driving and for not wearing helmet.
"He used to listen in one ear and leave it in the other," says Hibert who had lost his son four years back in a bike accident, though in different circumstances.
Naveen who is completely shaken by the loss of his nephew and faithful employee for the last 4 years opines that Jeevan had tremendous zest for life. "He was a good drummer and never used to miss playing for brass bands whenever he got an opportunity. If only he had heeded to our requests...."
Jeevan has been a part of the medical history of Mangaluru. Let us hope his death serves as a timely reminder for all those youngsters who fail to protect themselves in their appetite for momentary pleasures.