Low govt package rate for BPL patients hits organ transplant

Many patients in Karnataka are unable to avail of organ transplants as private hospitals are not accepting low package rates under the government’s organ transplant scheme.

Of the 70 transplant centres in Karnataka, 66 are in the private sector. Only BPL patients get transplant coverage under the government scheme, introduced in 2019. The package rates are Rs 2 lakh for kidney transplant, Rs 10 lakh for heart transplant, and Rs 11 lakh for liver transplant. A sum of Rs one lakh is fixed for immunosuppressive medicines to be taken after transplant.

Data from the State Organ and Tissue Transplant Organisation (SOTTO) shows that in 2022-23, only 38 patients received transplants from private hospitals under scheme coverage.

In 2021-22, the scheme covered only nine patients in private hospitals. The numbers are quite low, considering that 635 patients received kidney, heart and liver transplants from brain dead donors across these two years, and several others from live donors.

A majority of the scheme coverage is happening in government hospitals, with a total of 91 patients covered over the two financial years. But most transplants, especially complex ones like liver transplants, are happening in the private sector.

Dr Prashant G Kedlaya, who heads the nephrology department at St John’s Medical College, says 70% of eligible patients in Karnataka are estimated to be unable to get kidney transplant due to the cost. This is the case even in St John’s which has a lower cost of around Rs 5 lakh, compared to around Rs 8 lakh in corporate hospitals. “Even if the patient bears the surgery costs, they have to take lifelong medication, which would cost Rs 16,000-18,000 per month,” he says.

Dr Veerabhadra Gupta of Bangalore Kidney Foundation says that patients who can’t afford transplant often opt for dialysis. But they too are unable to afford the high frequency and quality needed for dialysis to be effective.

Cadaveric liver transplant costs at least Rs 25 lakh in corporate hospitals, says multiorgan surgeon Dr Sunil D Shenvi. “In Tamil Nadu, the government gives Rs 18 lakh for liver transplant. We had asked the government to increase costs, but there has been no response.”

Dr Yatheesh G, President of the Private Hospitals and Nursing Homes Association (PHANA), says that liver transplant involves a large team with 6-8 surgeons alone, and takes 8-12 hours. “With the current scheme rates, hospitals will have to put in money for the surgeries.”