Monthly Archives: December 2020

Liver transplant gives a new lease of life to 36-year-old Kolhapur man who was waitlisted since July 2019

On new year’s eve, doctors at Fortis Hospital in Mulund, Mumbai, conducted fourth cadaveric liver transplant of 2020; the donor was a 60-year-old woman from Pune who had suffered a fatal Acute Subarachnoid Hemorrhage.

Mumbai, December 31, 2020: On the new year’s eve, doctors at Fortis Hospital, Mulund, Mumbai, gave a new lease of life to a 36-year-old man, who runs a small store in Kolhapur. The recipient was waitlisted for a liver transplant in July 2019 after being diagnosed with Alcoholic Liver Disease; a liver transplant was his only option.

The donor, a 60-year old female from Pune, was rushed to a local hospital; she had suffered a fatal Acute Subarachnoid Hemorrhage; she was subsequently declared brain dead. Doctors and Medical Social Workers counselled her family, who readily consented to donate her liver, kidneys, heart, lungs, intestines and corneas. With immense effort and astute time management, the retrieval procedure was initiated.

A green corridor was meticulously laid out between Pune and Mumbai so the harvested liver could be transported to Fortis Hospital, Mulund. The donor is survived by her husband, son, and a daughter, who breathed a new life into a young recipient from Kolhapur.

Dr Gaurav Gupta, Sr. Consultant & Chief Surgeon – Liver Transplant & HPB Surgery, Fortis Hospital, Mulund, said, “We are happy to have been able to give our young recipient a new chance at life, and we are extremely humbled by the donor family’s gesture that enabled this life-saving surgery. It is heartening to see that families are continuing to respond warmly to the cause of organ donation even during the pandemic. While the fear of virus looms large, such stories continue to ignite hope within all of us.”

Thanking the donor, Dr S. Narayani, Zonal Director, Fortis Hospitals, Mumbai, said, “I extremely thankful of the donor family who made this courageous decision in the time of profound grief. I must thank the medical teams, nurses, Medical Social Workers, Mumbai Zonal Transplant Coordination Centre, Traffic Police, and Transplant Coordinators who enabled this feat. Each successful donation is one progressive step towards building a better and robust organ donation system in India.”

‘Post-COVID recovery may take longer than expected’

A patient should speak to doctor using tele-medicine option/over a call so that post-COVID recovery is assessed regularly and properly. The doctor will also be able to indicate if a patient needs to undergo any tests, make any lifestyle changes or recalibrate medication. So a patient shouldn’t miss on doctor appointments, eat healthy, take prescribed medication, and stay positive.

Dr Rahul Pandit

It was in December 2019 that the first human cases of COVID-19, the disease caused by the novel coronavirus causing COVID-19, subsequently named SARS-CoV-2, were first reported by officials in Wuhan City, China. As we come close to completing a year since the outbreak of COVID19, let’s understand the repercussions of this infection that has impacted the lives of 9.74 million Indians over the past 12 months and its impact, that may extend to not just a few weeks or months, but a year or more. This phenomenon is called ‘Long COVID’, which has had debilitating effect on patient’s lives.

Across the globe so far, the focus has been on saving and enriching lives during the COVID-19 pandemic, but the infection’s long term consequences are now gaining attention, and people continue to reel under its incapacitating impact. While more research is required to understand why certain patients bear the brunt of ‘Long COVID’, a more crucial question that needs to be answered is ‘is complete recovery on the horizon?’

While there is no textbook definition of ‘Long COVID’, patients who experience post-COVID symptoms lasting over six months are known to be suffering from this condition. These patients are not just those who have had lengthy stay in the Intensive Care Unit, but also those who have had mild symptoms and may or may not have needed hospitalization. Most common symptoms of ‘Long COVID’ include fatigue, breathlessness on least amount of exertion, persistent cough, muscular & joint pain, drop/ inaccuracy in hearing and sight, persistent loss of smell and taste. Many patients with ‘Long COVID’ are also noted to have mental health problems, including anxiety and depression.

The Journal of the American Medical Association recently published a study (on 143 patients) conducted by the Fondazione Policlinico Universitario Agostino Gemelli IRCCS in Rome, Italy, which assessed post-COVID patients who came into the hospital’s OPD. Analysis revealed that of the patients who had recovered from COVID-19, 87.4% reported at least one symptom, nearly 2-3 months post recovery.

‘Will there be 100% recovery?’ is a question asked by many, but there is no clear answer for this question. Studies are being conducted worldwide to understand the long-term impact of COVID19, however there are increasing concerns that even after making complete recovery, a section of patients may face lifelong implication.

Most of the symptoms of Long COVID fortunately need symptomatic care, and rehabilitation forms an important aspect of care. The respiratory rehab and cardiac rehab programs aimed at gradually building the exercise capacity back, and also allowing time for gradual improvement are important. Mental health assessment and stability forms a large aspect of recovery and need a lot of attention.

To conclude, it is important to remember that you must speak to your doctor (using tele-medicine option/ over a call) periodically so they can assess you post-COVID recovery. Your doctor will also be able to indicate if you need to undergo any tests, make any lifestyle changes or recalibrate medication. So don’t miss on your doctor appointments, eat healthy, take prescribed medication, and stay positive.

(The author is Director-Critical Care, Fortis Hospital, Mulund)

(Featured Image by Gerd Altmann from Pixabay)

World Patient Safety Day: All that a patient needs to know about haemodialysis

Dr Suresh Sankar 

Patient safety is the core aspect of patient care and dialysis care is no exception. It rests on the core ethical principle of “First do no harm”. It is doubly important because haemodialysis is among the most advanced technology used in outpatient settings. Though there are safety checks and controls built in the technology used, the processes of care, the capability of the health care worker delivering the service and an engaged and informed patient are key to achieve the desirable results at a dialysis centre.

Patient safety events in dialysis can occur in the following aspects of care:

  1. Initiation and ending of dialysis session
  2. Type of dialyzer used and whether the appropriate labelled dialyzer was used
  3. Amount of blood thinner used
  4. Medications
  5. Fluid removal on dialysis
  6. Infections

What you can do to make your treatments safer?

  1. It starts with knowing where safety matters and doing the right action.
  2. Give time to your technician and nurse the time for process of care when starting and ending your dialysis session.
  3. Know about the kind of kidney filter used and if it is to be reused, the identity has been verified. You could gently ask your care provider to recheck it especially if there is another patient with the same or similar name in your centre.
  4. Ask your doctor about the amount of blood thinner you will need and know the same recommendations are followed.
  5. Ensure your prescription is updated every few months every few weeks and insist on a copy of your medication prescription is maintained in your dialysis chart.
  6. Limit your fluid intake to what is appropriate for you and do no insist on “maximal fluid removal” during a dialysis session. Based on each individual’s body weight, duration of the session, there is a limit to how much fluid can be removed.
  7. Clean your fistula site with soap and water before every dialysis treatment.
  8. Clean your hands with soap and water or waterless alcohol-based sanitizer before you start your dialysis session and after you leave.
  9. If you have a catheter, wear a mask and request your care provider to wear a mask when starting and ending dialysis. Know the signs when a catheter could be infected.
  10. If you don’t have a permanent fistula, but will need dialysis for your lifetime, discuss the early placement of a fistula with your doctor, before the need for dialysis.
  11. Ensure you have taken the vaccines recommended for you at the right dose and frequency.

(The author is Nephrologist & Senior VP, Clinical Affairs, NephroPlus)

Mumbai’s 29th cadaveric donation by 56-year-old woman helps save 4 lives

It was the first to be conducted at Fortis Hospital in Mulund after the lockdown was announced on March 22, 2020; the harvested lungs, liver and kidneys were sent to four hospitals across Mumbai and the corneas were sent to a local Eye Bank.

Mumbai, December 7, 2020: Mumbai witnessed its 29th cadaveric donation at Fortis Hospital, Mulund on December 2, 2020, when the family of a 56-year-old brain dead patient consented to donate their kin’s lungs, liver, corneas and kidneys. The family’s noble act of giving helped give a new lease of life to four patients with end-stage organ failure; and would enable two people to receive the gift of eyesight. The harvested organs were sent to four hospitals across Mumbai. This donation marked Mumbai’s 29th and Fortis Hospital, Mulund’s first since the lockdown was first implemented in March 2020.
The female donor was declared brain dead at Fortis Hospital, Mulund on December 2, 2020, following a Subarachnoid Hemorrhage. The patient, from Badlapur, Thane, had sustained a fall at home, after which she was rushed to Fortis Hospital, Mulund. The family was counselled and informed consent was sought. The donor is survived by her husband, a son and three daughters.
Speaking about this feat, Dr S. Narayani, Zonal Director, Fortis Hospitals, Mumbai, says, “It is heartening to see that families are continuing to respond warmly to the cause of organ donation, even during the pandemic, as the fear of the virus looms large. This is a gigantic leap towards helping patients with organ failure, who have had longer time on the waitlist, owing to the pandemic. We express our heartfelt gratitude to the donor family, and to our doctors, nurses, Medical Social Workers and administrative staff who enabled the donation, and subsequent transplants”.
According to Dr Bharat Shah, general secretary, Zonal Transplant Coordination Centre (ZTCC), Mumbai, the medical team and transplant coordinator of Fortis team must be congratulated for diagnosing brain-stem death and counselling the family. “All the donated organs were successfully transplanted in four patients with end stage organ failure. This goes on to show that even the recipients are now coming out of fear of COVID pandemic and are willing to go for transplant during this pandemic. There is no need for potential recipients to fear COVID,” he says. The ZTCC has made robust guidelines which are strictly followed by all medical teams. With this, the risk of recipients contracting COVID infection is negligible.
Appreciating the kindness of the the family of deceased donor who came forward to save lives of four patients unknown to them, Dr S.K. Mathur, President, ZTCC, Mumbai, says, “If more people start following their example, then slowly the current dependence on live organ donations can be reduced.”

(Featured Image by Gerd Altmann from Pixabay)