The patient referral guideline 2008 will be amended to include them as well

Health: In a move that would help many patients, the national referral hospital in Thimphu will refer patients for bone marrow transplant, by amending the patient referral guideline of 2008.

Today, the hospital supports only kidney transplant through its referral system.

The medical superintendent of the apex hospital, Dr Gosar Pemba, said a board meeting of the hospital would be held soon to take a final decission.

The hospital has already held some discussions on the issue, and hopes the revised guideline will benefit patients with bone marrow failures in two to three months.

“We feel that bone marrow transplant should be included in the list of cases eligible for referral,” Dr Gosar Pemba said. “Bone marrow transplant is a one-time and life-saving treatment, which can give patients a new lease of life.”

The doctor explained that bone marrow failure happens in young children, who have a long life ahead of them. “We don’t recommend organ transplants in old patients,” he said.

The need to revise the referral guideline was felt in the light of an increased success rate and affordability in India.  Some five years ago, a bone marrow transplant would cost about Rs 3M (million) in India.  Now it cost roughly Rs 1M.

Dr Gosar Pemba said there were currently two patients admitted in a Kolkata hospital requiring bone marrow transplants. One of the patients is a nine-year-old boy admitted in Tata Medical Centre.

Unwell since January, the patient was referred to the hospital about a month ago.  The hospital in Kolkata suggested transplant.  According to the hospital, eight of 10 patients can be cured, if a tissue matched brother or sister donates bone marrow to the affected sibling.

The boy received kidu for a transplant yesterday.

The country’s health policy states that the state should provide free access to basic public health services in both modern and traditional medicines, as enshrined in the Constitution.  In 2012-13, the government referred 988 patients outside the country for treatment at a cost of Nu 168M.

The medical superintendent, however, said the hospital would not be able to consider other common cases, such as heart and liver transplants, at least any time soon.  He said the success rates of heart and liver transplants are not so high in India, while the government cannot afford to refer patients to Western countries.

A liver transplant today costs Nu 1.5M to 2M in India.  Comparatively, a kidney transplant costs Rs 400,000 to 600,000. “If one day, transplants become cheaper, and the success rates improve in India, we might refer liver and heart transplant cases as well,” Dr Gosar Pemba said.

However, he feels that only those patients whose liver fails due to reasons other than alcohol consumption should be eligible for government-sponsored transplants. “The government will not sponsor somebody’s liver transplant if it’s because of alcohol.”

Cornea transplant is the only organ transplant Bhutan can perform at home. “However, it hasn’t been able to gain pace due to lack of donors.”

Meanwhile, the father of the boy waiting for bone marrow transplant in Kolkata, Sonam, said he would remain grateful to His Majesty the King for granting him the kidu and a chance to save his son.  Sonam believes that bone marrow patients should be referred for transplant, as it was too expensive for common people to afford.

By MB Subba