The Woman Leader in Transplantation Award 2022 was conferred on Dr. Gomathy Narasimhan, India's first woman multi-organ transplant surgeon. The award was presented at The Transplant Society (TTS) Congress held in Argentina in September 2022. 

Dr. Gomathy Narasimhan is presently Consultant, HPB Surgery and Liver & Renal Transplantation at the Dr. Rela Institute & Medical Centre, Chennai. She pursued her MBBS at Chennai's Kilpauk Medical College and surgical postgraduate degree at the Madras Medical College. She completed her fellowship in abdominal organ transplantation (liver, kidney and pancreas) with the American Society of Transplant Surgery (ASTS) at Baylor University Medical Center, Dallas, USA. She then went to Kumamoto University in Japan to learn more about living donor liver transplant program.

Making history in the operating room as a woman transplant surgeon - Your experience

Being the first or the only female transplant surgeon for a while, it made no difference. It never made me feel less alone, whether I was training for general surgery or in the transplant program. However, the other womenfolk might not have experienced it the same way. Regardless of gender, the transplant program as a whole seeks contribution from different specialities and the fact that more and more women are entering this field in recent times is impressive.

As a female doctor, have you ever faced resistance from the patients?

If at all, it was only an advantage. The transplant process itself necessitates life long association between the doctor and patient and being the female doctor, often it helps the patients feel warmth and comfort.

Gender and transplant - Global perspective and your views

The TTS 2022 seminar on 'Impact of gender on equity and access to transplantation worldwide' helped grasping the global picture. The delegations showed that the number of female patients diagnosed with kidney diseases is more when compared to male patients, whereas the number of females receiving a kidney transplant is lesser than male recipients.  It was also found that female donors accounted for the majority of the living donor transplants across the world. This indicates that gender disparity is prevalent in every aspect of the transplant program. It was interesting to note that when we retrospectively reviewed living donor liver transplant data at our centre, it was found that the number of female versus male donors was almost the same.

Have we made progress in transplant surgery training in India? Do we still need to look overseas for training?

There was no liver transplant program back then in India. Those who desired to become a liver transplant surgeons had no choice but to travel abroad to pursue their training. It's no longer necessary to do that. The volume of liver transplants performed in India is huge and over the years the living donor liver transplant program has been well-established in our country. Although it isn't uniform throughout the country, the deceased donor transplant has also seen a huge leap in some parts, especially in the South. With the current scenario, there is no need to look overseas for transplant training per se. In fact, professionals from the East and the West now consider India for training, particularly for liver transplant training.

Nevertheless, travelling is always beneficial as it offers a new perspective on everything. It is all the more important when it comes to disciplines like transplant, because there are many other factors involved besides medical and surgical aspects.

How professional bodies like Indian Society of Organ Transplantation can contribute for transplant training activities?

The best course of action going forward will be establishing an international exchange program. Just as important as learning what other programs have to offer their patients, the world needs to know about our program as well. Rather than limiting ourselves with technical training, bodies like ISOT shall facilitate platforms for exchange program. This would help the young professionals to learn best practises as well as global perspectives.

Views on possible new areas that we need to focus

Metabolic syndrome is becoming an aetiology more common in both liver and renal transplantation. The number of liver transplants performed in people with non-alcoholic steatohepatitis (NASH) is on a huge rise not only in our country, but worldwide. It is crucial that these individuals receive holistic post-transplant rehabilitation. There should be more focus on making these individuals to  understand the importance of maintaining healthy lifestyle after a transplant, including balanced diet and physical activity. Failing to this, chances are that these recipients will develop fatty liver disease  in a few years time, defeating the purpose of transplant.

Message to those who aspire to become transplant surgeons

What makes the difference between a good surgeon and a great surgeon is attention to detail. It is important that we work as a team as good healthcare is always a teamwork, it is more so in fields like transplant.