PROPOSAL FOR MULTI ORGAN TRANSPLANT CENTRE

Appendix I
Unit description Unit cost Number of units Costs
approximation required
Each OT (OT Table 2 crores 6 12 crores
with
lights, anaesthesia
workstation, cautery/
harmonic unit, self-
retaining retractor,
Laparoscopy station 80 lakhs 2 1.6 crores
Instrument sets 10 lakhs 36 3.6 crores
C arm (CATH LAB) 7 crores 1 7 crores
Scrub station 5 lakhs 3 15 lakhs
Sterilization unit 50 lakhs 3 1.5 crores
Ultrasound for OT 25 lakhs 2 50 lakhs
ROBOT (Da Vinci) 20 crores 1 20 crores
TEG/SONOCLOT 5 lakhs 1 5 lakhs
Auto pulse CPR 25 Lakhs 1 25 lakhs

TOTAL
46.65CRORES
 Appendix II

Unit cost Number of units Costs

approximation required

Unit description
Pre-processing 1 crore 1 1 crore
equipment: centrifuge,
microscopes,
automated DNA/ RNA
isolators,
electrophoresis
Pathology laboratory: 50 lacs 3 1.5 crores
Microwave processing,
microscopy stations
Luminex platform 75 lacs 2 1.5 crores
Flow cytometer 1.5 crores 1 1.5 crores
HLA laboratory 1 crore 1 1 crore
RT-PCR 50 lacs 2 1 crore
LC-MS for therapeutic 1.5 crores 2 3 crores
drug monitoring
High throughput DNA 1.5 crores 1 1.5 crores
sequencer
TOTAL 12 CRORES
Unit description Unit cost Total required Costs
approximation
Beds with monitors 5 lakhs ICU: 12 2.2 crores
and furniture: HDU: 20
Cardiac table, side Isolation: 6
table, stools, IV Treatment rooms
stands, infusion and minor OTs: 6
pumps and fluid
warmer
General ward beds 2 lakhs General ward: 20 66 lakhs
Pvt room: 10
Recovery non
monitored beds: 3

Data management and computer systems

Unit description Unit cost Number of units Costs

approximation required
Computers 25,000 40 10 lacs
Storage: NAS 2 lacs 2 4 lacs
MANPOWER
Faculty
For 6 OT days and 3 OPD days and doubling of workload:
14 faculty members
10 fellows/ senior residents
8 junior residents

Faculty for essential services

Anaesthesiologists: 3
Pathologists: 2
Immunopathologists: 2
Radiologists: 2
Clinical pharmacologist:1
FACULTY

Post Annual costs Number of Total costs

personnel
Professors 22 lacs 2 44 lacs
Associate Professors 16 lacs 4 64 lacs
Assistant Professor 10 lacs 8 80 lacs
Demonstrator 3 lacs 2 60 lacs
Lecturer 8 lacs 2 16 lacs
RESIDENTS

Post Annual costs Number of Total costs

personnel
Senior 18 lacs 18 3.24 crores
Residents(academic/nonacademic)
Fellow

Nursing staff
Post Annual costs Number of personnel Total costs
Staff nurse 4 lacs 170 6.8 crores

Technical staff

Post Annual costs Number of Total costs

personnel
Technician 3.5 lacs 14 49 lacs

Clerical staff

Post Annual costs Number of personnel Total costs

Social worker/ Store 4 lacs 10 40 lacs
officer/ Computer
operator
Clerical 3 lacs 4 12 lacs

Other staff

Hospital attendants 1.8 lacs 32 57.6 lacs

 Safaiwala 1.5 lacs 34 51 lacs

Pathology services – Creating a dedicated centre would also require upgrading of

pathology services to run a successful transplant program. Graft Rejection is a common
problem in post-transplant patients which needs early diagnosis and specific treatment for
improving graft survival. Presently around 300 biopsies are being done annually. As we are
targeting around 500 transplants in a year, number of allograft biopsies may also increase
exponentially, which requires additional renal pathologists to make this transplant program
successful.

Drug monitoring: Kidney transplantation is considered the best treatment modality for
patients with kidney failure. Transplant recipients require lifelong immunosuppression.
Nowadays, most centres use triple immunosuppression, consisting of calcineurin inhibitor
(tacrolimus or cyclosporine), an antimetabolite (mycophenolate mofetil or azathioprine), and
corticosteroids. The calcineurin inhibitors form the backbone of present-day
immunosuppressive regimens and most centres worldwide have now shifted to tacrolimus-
based immunosuppression. For better graft and patient survival, it is essential to optimize
the degree of immunosuppression, as over-immunosuppression might lead to increase
adverse effects and under-immunosuppression predisposes to rejection. To achieve this
balance and to individualize drug dosing, therapeutic drug monitoring (TDM) of various
immunosuppressive drugs is required.

Radiology services: Comprehensive diagnostic and interventional radiology services are

required to support a robust solid organ transplantation service by providing imaging
diagnosis and interventional management of vascular and nonvascular conditions both
prior to and following transplantation. Diagnostic radiology services include continuous
availability of radiography, fluoroscopy, ultrasonography (including intraoperative
ultrasonography), computed tomography, magnetic resonance imaging, and nuclear
medicine imaging. Interventional radiology services must be available continuously for
elective and urgent minimally invasive procedures for bridging patients to transplantation
or managing postoperative complications.