Southern States - Kerala-Thiruvananthapuram   

Pregnancy aborted before kidney extraction

By P. Venugopal

THIRUVANANTHAPURAM Nov. 5. The kidney transplantation issue acquires a bigger dimension as more details pour in about the manner in which one of the hospitals involved in the controversy had been doing this business.

A Kozhikode hospital even went to the extent of terminating the pregnancy of an uneducated, impoverished woman, before extracting her kidney for the benefit of a rich patient willing to pay for the organ.

The details of this illegal and unethical transaction are with the committee appointed by the Indian Medical Association (IMA) to investigate the issue.

The woman donor involved in the incident, one Rajani, was said to be breast-feeding a six-month-old child when she was brought to the National Hospital in Kozhikode in February, 1999.

Medical opinion gathered by the committee says that lactating woman should not be cleared for kidney donation.

She was not only lactating, but was also pregnant, when she was cleared by the Authorisation Committee (which sanctions requests for kidney transplantations from unrelated donors). The fact that she was lactating was not reported to the Authorisation Committee.

Her pregnancy condition came to the notice of the National Hospital after the Authorisation Committee had cleared the request for allowing her to donate her kidney. She was found to be pregnant when she was put through a renal angiogram prior to the transplantation surgery. Urine test reconfirmed it.

According to the chairman of the three-member IMA committee which went into the issue, M. Mohammed Ali, the nephrologist at the hospital should have straightaway refused to accept her as a donor. Instead, he referred her to the hospital's gynaecologist.

The gynaecologist concluded that since Rajani was already having two children, the third pregnancy had occurred due to the failure of contraceptives. On April 16, 1999 she was put through medical termination of pregnancy (MTP) and on April 21, was discharged after the MTP.

The very same day, or, to be precise, just five days after the MTP, Rajani was cleared by the gynaecologist as `gynaecologically fit' for kidney extraction. According her casesheet, she was running a temperature after her pregnancy was aborted. The actual transplantation exercise took place on May 18, 1999. According to an expert whose opinion was sought by the inquiry committee, the latest such a woman could be accepted as a kidney donor was six months after the MTP.

The nephrologist at the hospital, however, was of the view it could be done one month after the MTP. ``The question whether the MTP was done with the consent of the woman concerned was also to be investigated. No such consent letter was attached to the casesheet in the labour room. The gynaecologist said the practice at this hospital was to record the consent in a register.

Two sheets of paper were shown to the committee as being copy of the consent as recorded in the register,'' Dr. Mohammed Ali said. He said that, as a person with no expertise in judging signatures, he could not say that the signature on these pages tallied with the signature of Rajani elsewhere in the hospital records.

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