|LETTER TO EDITOR
|Year : 2022 | Volume
| Issue : 1 | Page : 142-143
The aeroplane takes off against the wind
Ganapathy Krishnan Subramaniam1, Dhruva Sharma2, Neha Sharma3
1 Department of Paediatric Cardiac Surgery, Institute of Heart and Lung Transplant and Mechanical Circulatory Support, MGM Healthcare, Chennai, Tamil Nadu, India
2 Department of Cardiothoracic and Vascular Surgery, SMS Medical College and Attached Hospitals, Jaipur, Rajasthan, India
3 Department of Pharmacology, SMS Medical College and Attached Hospitals, Jaipur, Rajasthan, India
|Date of Submission||03-May-2021|
|Date of Acceptance||20-Dec-2021|
|Date of Web Publication||31-Mar-2022|
Dr. Dhruva Sharma
Department of Cardiothoracic and Vascular Surgery, SMS Medical College and Attached Hospitals, J L N Marg, Jaipur - 302 001, Rajasthan
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Subramaniam GK, Sharma D, Sharma N. The aeroplane takes off against the wind. Indian J Transplant 2022;16:142-3
The current 2nd wave, nay the tsunami of the coronavirus disease (COVID-19) pandemic, has caught the entire nation off guards. No doubt this could be one of the greatest challenges that the country has ever faced previously, and how will we handle this, could well define our Nation's character. Are we going to see this adversity, as a roadblock or an opportunity? is up to us. Adversity is the fertile ground on which the rich seeds of character, creativity, and conviction germinate.
If we go back and look into history, 2nd World War seems to be the deadliest military conflict human race has ever faced and probably, the current situation is no different than a war, it is a war between humanity and the virus. Charles Darwin's theory: “Survival of the fittest” is aptly remembered at this time. Despite the devastation, it acted like a great catalyst bringing forth many innovations and inventions and changed the direction of human history. Many of our everyday comforts which we now take for granted owe their origin to this period. The war acted as a powerful accelerator. The computer and artificial intelligence owe their origin to the need to break down the German encrypted communication system. From a position, where it was thought to be unbreakable, the Allies under the leadership of Alan Turing developed the “Bombe” which was deciphering up to 3000 messages a day. Many of the central concepts of artificial intelligence were developed during this period. From automated teller machine, antibiotics, ballpoint pen, satellite communications to pressurized flight cabins and canisters all owe their existence to the technology which was either introduced or developed during this period. Even the ultrasound was first invented to detect cracks in the armor by tank engineers. The blood banking system and the emergency ambulance system were all War aftermaths.
Throughout history, great strides in Medicine have been made during the war. There is no doubt that the same technology and materials designed to devastate and destroy can save lives if put to appropriate use. The polytetrafluoroethylene or Teflon which is so commonly used in cardiac surgery was first used to store the reactive Uranium Hexafluoride for the erstwhile Manhattan project. Dr APJ Abdul Kalam, firmly believed that the research in the defense sector should have spin off benefits for humanity, the Kalam Raju stent, Kalam Raju Tablet for health-care administration, and the Light Calliper Project for Polio afflicted patients is testimony to his conviction. Rustom II, the Medium Altitude Long Endurance Unmanned Aerial Vehicle (UAV), a military drone, which is being developed by Defence Research and Development Organization, capable of automatic takeoff and landing on rough terrains, designed to carry a payload of up to 350 kg in the day and night lighting conditions and can execute missions autonomously or under manual control. The UAV can fly at a maximum speed of 225 km/h and can endure for up to 24 h.
The transplant program in the country is in nascency. Unofficially anywhere between 40% and 50% of the organs from potential donors are not utilized because of transport logistic reasons. In a country where the donation is only 0.53 per million population (2019) compared to 36.07 per million in the USA, we can ill afford to waste the potentially lifesaving organs. The donation-transplant network is significantly affected by the mode of transport of the donor organ, especially for longer distances. Ground transport was affordable for local sharing of organ, but when it comes to broader sharing, air transport is preferred. Since the viable donor organ should reach the recipient in shortest possible time, thus air logistics are preferred over road transport to cover long distances. By enhancing the efficiency of transportation of donor organ, we can improve the success of transplant. Both expeditious and virtuous transportation is imperative to establish safe outcome of transplant.
Fast mobilization of transplant team including cardiothoracic surgeons, perfusionists, transplant coordinators, and even trainees for organ procurement is a big task, especially amid this COVID-19 pandemic and lockdowns. Cost of air logistics is one of the major factor in hindering the procurement of organ. It is another difficult job to organize private flights to transport organs. Immediate access to charter planes is very difficult due to limited availability of pilots as well as planes. The safety and cost of air travel of organ and transplant team pose a big challenge for transplant program. A recent technological discovery was reined by implementation of drone transportation of organs.
The COVID-19 pandemic has drastically disrupted organ-supply chain. 49.4% of transportation failures were reported in a safety study by the Organ Procurement and Transplantation Network because of either cancellation or delay in flights.
Despite all the ravaging caused by COVID-19, it has led to a variety of new additions in solid organ transplant field like use of drones to transport organs, use of artificial intelligence, liquid biopsies, and remote monitoring devices like CardioMEMS are few to be named. The ability to haul organ safely and quickly decides the success of transplantation., Transplant outcome as well as volume can be drastically improved by ameliorating organ transportation. New allocation plans according to the upgraded system are need of the hour for smooth functioning of organ transport. Although advances in immunology and surgery are witnessed, the problem of organ transportation needs to be addressed.
There is an urgent need to tackle the problem of air transport of organs, medical supplies, and sick patients. The time to act is now. We must accept the adverse circumstances that we all are in as a nation, but it is time to use the adversity to our advantage and learn from our mistakes. Let us use this situation to build our nation's character, resilience and draw out on our inner strength of frugal innovation. Let us embrace the challenges and grow from overcoming them: “The aeroplane takes off against the wind, not with it.”
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
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Strauss AT, Cartier D, Gunning BA, Boyarsky BJ, Snyder J, Segev DL, et al
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Pour-Ghaz I, Hana D, Raja J, Ibebuogu UN, Khouzam RN. CardioMEMS: Where we are and where can we go? Ann Transl Med 2019;7:418.