The committee, which includes senior doctors like Dr Vinay Agarwal, Dr S C L Gupta, and Dr Dharam Prakash, has been given two weeks to submit its report.

Condemning the “proliferating black market in organ transplants in the country,” the IMA has sought a proper inquiry before assigning guilt.

“The government should hand the matter over to the CBI at the earliest and ensure that the guilty are severely punished,” said Dr M Abbas, the national president of the IMA.

“The IMA will ensure that names of the guilty, if they are members of our association, will be struck off our list. Relevant authorities will also be informed of the move,” Dr Abbas said.

To keep a check on similar rackets, the IMA has recommended that the Transplantation of Human Organ Act 1994 be amended to make it more lenient.

It has also urged the government to set up organ banks “as an affirmative way to curb the black market trade in human organs”.

“If kidneys were made easily available, there would not be any shady or clandestine deals. The act should be both donor and recipient-friendly,” Dr Abbas said.

According to the IMA, nearly two lakh patients are affected with end-stage kidney failure each year in the country; 60-70% of them need kidney transplants to survive. However, on an average, only 4,000 patients avail themselves of the transplant.

Addressing the need for promoting organ donation, the IMA announced that it would soon launch a nation-wide awareness campaign and urge the government to set up well-equipped cadaveric organ retrieval centres.

EXPLAINED
Kidney Transplant
From The Surgery Table
Who needs a kidney transplant?
Patients with kidney failure — caused by hypertension, infections, diabetes, congenital abnormalities of the kidneys and other diseases that cause renal failure, such as autoimmune diseases.

Who can be excluded from transplants?
Kidney transplant requirements vary from programme to programme and country to country. Many programmes place age limit at 69 years or less and require that one must be in good health. Significant cardiovascular disease, incurable terminal infectious diseases and cancer often are transplant exclusion criteria. In addition, candidates are typically screened to determine if they will be compliant with their medications, essential for survival of the transplant. People with mental illness and/or significant ongoing substance abuse issues may be excluded.

Where can one find kidney donors?
From either brain-dead organ donors, or living relatives or friends of the recipient, as per government laws.

What is the procedure of transplant?
After patient is put on general anaesthesia an incision is made in lower-right quadrant of the abdomen — donor kidney is transplanted into the right lower pelvis. Vessels of new kidney are connected to vessels leading to the right leg, called iliac vessels; the ureter is sutured to the bladder.

In most cases, barely-functioning existing kidneys are not removed because this has been shown to increase rates of surgical morbidities. So the kidney is usually placed in a location different from the original one.

The transplant surgery takes 2-3 hours.

What happens post-transplant?
Living donor kidneys normally require 3-5 days to reach normal functioning levels; cadaveric donations stretch that interval to 7-15 days. Hospital stay is typically for 4-7 days. Transplant recipients are required to take immunosuppressive medications for the rest of their lives, to prevent rejection of the transplanted organ. The most common medication regimen now is: tacrolimus, mycophenolate, and prednisone. Some patients may, instead, take cyclosporine, rapamycin, or azathioprine.

In most cases, the kidney starts producing urine soon after the transplant.

What are the possible complications?
* Transplant rejection (hyperacute, acute or chronic)
* Infections and sepsis due to immunosuppressant drugs that are required to decrease risk of rejection
* Post-transplant lymphoproliferative disorder (a form of lymphoma due to immune suppressants)
* Imbalances in electrolytes, including calcium and phosphate, which can lead to bone problems among others
* Other side-effects of medications including gastrointestinal inflammation and ulceration of stomach and esophagus, excessive hair growth in a male-pattern distribution, hair loss, obesity, acne, diabetes mellitus (type 2), hypercholesterolemia, and others.

What is the success rate?
The average lifetime for a donor kidney is 10 to 15 years. When a transplant fails, a patient may opt for a second transplant, and may have to return to dialysis for some intermediary time. Dr Sanjay Agarwal of AIIMS says the success rate is 99 per cent “in surgeries involving living donors for the first one year after the surgery. After five years of surgery, the success rate is 80 per cent. Ten years on, the success rate is 60 per cent.”

Acute rejection occurs in 10-25 per cent cases after transplant during the first 60 days. Rejection does not necessarily mean loss of the organ, but may require additional treatment.

SOME COMEBACKS
Professional athletes who have made a comeback after

transplant: