“Death’s Gift of Life”

First cadaver kidney donor in Karnataka was an alumnus of MMC&RI

The year 2024 is the centenary year of Mysore Medical College and Research Institute (MMC&RI). As part of the celebrations, MMC&RI Alumni Association  (MAA) hosted the Global Alumni Meet at the Platinum Jubilee Auditorium in JK Grounds, Mysuru, on Jan. 20. On the occasion, the Association felicitated Seetharam and Nethravathi, parents of Usha Gowri, the first cadaver kidney donor in Karnataka in 1998 & an alumnus of MMC&RI. —Ed

By Dr. Veena Bharathi

Of what use is a dead man to the living?” When Jeremy Bentham, an English philosopher and jurist, asked this question more than 180 years ago, he had not foreseen the amazing possibilities of ‘Cadaver transplant’ or ‘Transplant of organs from a brain dead person to a needy patient.’ In February 1998, Usha Gowri  became the first cadaver kidney donor in Karnataka under the “Human Organ and Tissue Transplant Act.”

Usha Gowri, a native of Shivamogga, was just 21 years of age, when she met with a road traffic accident in Bengaluru.She was then a third year student of MBBS in Mysore Medical College (MMC).

Born on 31st of Dec. 1976 in a small village near Thirthahalli in Shivamogga District, Usha Gowri was a topper in her class and used to swim fearlessly in the Tunga river when she was barely  eight years of age.  Her father Seetharam recalls, “When Usha was four years of age, she used to climb the Kodachadri hill with me.” When Usha was in the seventh standard, she had the honour of presiding over the “Akhila Karnataka Makkala Sammelana”  held at Shivamogga! When she joined the Kasturba National Girls’ High School, her academic excellence and exceptional achievements in the co-curricular activities always placed her ahead of many other students.

Says her mother Nethravathi Seetharam, “An in-born quality in my daughter was her tolerant and affectionate attitude.  We were in Mysuru on 31st of December to celebrate her 21st birthday during 1997, which turned out to be her last birthday. On that day, before we started back to Shivamogga she told me, ‘I will have to get 2 or 3 gold medals in my final MBBS examination.’ That academic ambition of hers, however remained unfulfilled.”

On 25th January 1998, Usha had come to Bengaluru to buy a few Medical books.  She had stayed at her cousin’s  place.  The next day, when Usha was riding pillion on the bike of her cousin, on her way to the Railway Station, a sudden brake by her cousin to avoid a head-on collision with another vehicle, resulted in Usha’s fall. She sustained extensive head injuries. Usha was admitted to NIMHANS in an unconscious state.  She had to be kept on a ventilator, along with other critical care measures.

Despite the best of critical care treatment, Usha Gowri was declared brain dead, when she showed no signs of improvement.

Says her father Seetharam, “I instinctly felt that Usha, who was an optimist to the core, would have coerced me to realise the positive side of our family’s irreversible personal tragedy. Thus, even in a heart-wrenching situation, I could discuss the probability of ‘organ donation’ with the concerned specialists.”

Though stricken by the ultimate truth that his daughter was saying an eternal ‘good bye’, Seetharam requested Dr. Thimmappa Hegde, at that time Neurosurgeon at NIMHANS, to retrieve Usha’s kidneys for the benefit of two other individuals.  But, then Usha had to be shifted to one of the “Donor recognised Hospitals” since NIMHANS had the provision to extract only corneas.

At Manipal Hospital, in Old Airport Road, Usha Gowri was declared brain dead by a team of Neuro-Physicians, when essential resuscitative measures for continuous ten hours went in vain, at the hospital’s critical care unit.

After Seetharam signed the consent form, Usha Gowri’s kidneys were retrieved, while she (the cadaver) was still on a ventilator, thus maintaining the viability of the organs. One of the kidneys was transplanted to an End Stage Renal Disease (ESRD) patient at the Manipal Hospital and the other kidney was sent to St. John’s Medical College and Hospital, to be transplanted to another needy patient.

As a gesture of acknowledging Usha’s undaunted spirit and her family’s gesture in providing the “Gift of Life” to two other persons, Dr. Sudharshan Ballal, Director of Nephrology Unit, Manipal Hospital, Bengaluru, had declared a day every month as “Usha’s Day.”  On that day every month, a kidney transplant used to be carried out at the Manipal Hospital, at a subsidised cost, which was operational for an entire decade from March, 1998.

(The Human Organ Transplant Act of 1994 in India clearly defines brain death and the preconditions necessary to declare a patient as brain dead.  All irreversible causes of coma are to be excluded, so also alcoholic intoxication, intake of depressant drugs and Neuro muscular blocking agents, to exclude or rule out endocrine and metabolic disorders.  A Certificate has to be signed by a Neurologist or a Neurosurgeon nominated from the panel of names approved by the appropriate authority of the Government “…dead on account of permanent and irreversible cessation of all functions of the brain stem”).