Railway Medical Attendance Rules/RELHS: Guidelines and ceiling limit for Liver Transplant Surgery - Railway Board Order

SHARE:

GOVERNMENT OF INDIA MINISTRY OF RAILWAYS (RAILWAY BOARD) No. 2010/H/6-1/POLICY (Liver Transplant) New Delhi, dated :- 28.06.20l3 ...

GOVERNMENT OF INDIA
MINISTRY OF RAILWAYS
(RAILWAY BOARD)

No. 2010/H/6-1/POLICY (Liver Transplant)
New Delhi, dated :- 28.06.20l3
General Managers
All Indian Railways
(Including PUs).

Sub :- Guidelines and ceiling limit for Liver Transplant Surgery in respect of beneficiaries of Railway Medical Attendance Rules / RELHS.

The issue of laying down uniform guidelines to be adopted for Liver Transplant Surgery of Railway Health beneficiaries has been engaging attention of Ministry of Railways for sometime. After careful consideration of the matter, it has been decided to stipulate the under mentioned guidelines for adoption in all cases of Liver
Transplantation :-




1. Selection Criteria
A. Indications
(i). Adult Liver diseases

Acute liver failure Non-Paracetamol (Viral, drug, induced, Wilson’s, Autoimmune hepatitis etc.) Prothrombin time >100 sec or 3 of 5:
Interval jaundice-encephalopathy > 7 days
Age < 10 or > 40 Years
Prothrombin time > 50 sec. / INR > 3.5 Bilirubin > 30 umol/1
Cause non-viral or unknown.
Paracetamol induced Arterial Ph <7.30 or all 3 criteria Encephalopathy grade III or IV
Prothrombin time >100 sec./INR > 6.5 Creatinine >300 umol/I
Chronic Liver disease Cirrhosis (Non- Cholestatic) Child-Pugh score >or equal 10 or
Meld Score > 14
Cholestatic with or without Cirrhosis According to American criteria based on MELD scoring
Miscellaneous case to case basis
Liver Tumors Hepatocellular
Carcinoma
Single Tumor <6.5 cm or Two Tumors < or equal 4.5 cm
No Vascular invasion
No distant Metastasis
Other types Case to case basis

2. Pediatric Liver diseases: - EHBA and Metabolic Liver Disease to be decided on case to case basis. 

B. CONTRAINDICATIONS

Absolute Systemic extra hepatic infections
Extra hepatic malignancy (if not definitely cured)
Irreversible brain damage
Irreversible multi-organ failure
Substance abusc ( if not abstinent for > 6 months)
Relative HIV seropositivity
Age > 65 years
Mental incapacity
Extra hepatic disease limiting the chance of survival
Residency outside India (unless emergency)

2. Type of Transplant: permitted for reimbursement.
(a) Cadaveric donor
(b) Live donor
      i.Related 
      ii. Unrelated 

3. Centres Approved for Liver Transplantation Surgery 
Liver Transplant Surgery shall be allowed only in Government Hospitals/ Pvt. Hospitals, which are registered under the Transplantation of Human Organs Act, 1994, as amended from time to time.

4. Documents required to be submitted for consideration of permission for liver transplant surgery
(i) Recommendation by Govt. / RIy. Gastroenterolgist/GI Surgeon.
(ii) CT/ MRI Liver report.
(iii) Etiology evaluation report.
(iv) Histopathological report, wherever available.
(v) Current Child Pugh/MELD score report.
(vi) Other relevant document.

5. Package Charges for Liver Transplantation Surgery
a) Package rate for Liver Transplantation Surgery involving live Liver donor shall be - Rs. 14,00,000/- (Rupees Fourteen Lakhs only). This would include Rs.2,50,000/- (Rupees Two Lakhs Fifty Thousand only) for pre-transplant evaluation of the donor and the recipient and Rs. 11,50,000/- (Rupees Eleven Lakhs Fifty Thousand only) for transplant surgery.

b) Package rate for Liver Transplant Surgery involving deceased donor shall be Rs.11,00,000/- (Rupees Eleven Lakhs only).

The above package includes the cost of consumables during the organ retrieval and the cost of preservative solution etc. The package charges also include the following:

(i) 30 days stay of the recipient and 15 days for the donor starting one day prior to the transplant surgery.

(ii) Charges for Medical and Surgical Consumables, surgical and procedure charges, Operation theatre charges, Anaesthesia Charges, Pharmacy charges etc.

(iii) Investigations and in-house doctor consultation for both donor and recipient during the above period of stay.

(iv) All post operative investigations and procedures during the above mentioned period.

C) The package shall exclude the following :-
Charges for drugs like Basiliximab/Daclizumab, HBIG, and peg interferon.Cross Matching charges for Blood and Blood products.

d) (i) The extra stay if any may be sanctioned/reimbursed after justification by the trcating specialists for the reason of additional stay and only as per Railway RMA/RELHS guidelines.

(ii) The drugs mentioned above would be reimbursed as per CGHS rates or actual whichever is lower.

6. Reimbursement Criteria:
As Liver Transplant Surgery is a planned surgery and, therefore, prior permission has to be obtained before the surgery is undertaken. However, if for some reason it is done in emergency to save the life of the patient, the medical board shall consider the case referred to it for recommending grant of ex-post-facto permission on a case to case basis.

7. Procedure for Sanction:
CMD of the zone shall nominate Medical Board comprising of a CMS/MD as the Chairman and two specialists each from Gastroenterology and GI Surgery as members which will recommend for Liver Transplantation. The proposal for financial sanction would be considered in consultation with finance of the zone and approval of General Manager before forwarding the same to Railway Board for sanction.

8. Other terms & conditions for payment of advance as per instructions laid down by this office from time to time will remain unchanged.

9. This issues with the concurrence of the Finance Dte. of Ministry of Railways.

10. These guidelines shall come into effect from the date of issue of this letter.

sd/-
(Dr.S.K. Sabharwal)
Executive Director, Health (G)
Railway Board

Source : www.nfirindia.org


Stay connected with us via Facebook, Google+ or Email Subscription.

Subscribe to Central Government Employee News & Tools by Email [Click Here]
Follow us: Twitter [click here] | Facebook [click here] Google+ [click here]
Admin

COMMENTS

BLOGGER
Name

100 percent da,17,10th Bipartite Settlement,45,6 CPC Order,4,7th CPC Charter of Demands,79,7th cpc interim report,8,7th CPC Meeting,126,7th CPC Notification,202,7th CPC Projected Pay,171,7th CPC Questionnaire,16,7th CPC Recommendation,361,7th CPC Report,113,7th CPC Terms of Reference,40,Absorption,30,Ad-hoc Bonus,19,Additional Pension,2,Administrative Reforms,17,Advance Increment,4,Adventure Sports,8,Age Relaxation,16,AGIF,5,AIIMS,10,Air Travel,44,AIRF memorandum to 7th CPC,4,Airport Employees,7,All India Service,56,Allowances,161,Alteration of Date of Birth,6,Anubhav,12,APAR,27,Area Welfare Officer,5,Armed Forces Tribunal,16,Artisan Staff,11,Ashok Kumar Mathur,9,Atal Pension Yojna,9,Autonomous Bodies,41,awards,12,Bank,155,Bariatric Surgery,2,Benevolent Fund,2,bhavishya,10,Bhutan Compensatory Allowance,7,Bio-metric Attendance,36,Bonus,113,Bonus Order 2014,9,Bonus Order 2015,13,Bonus Order 2016,7,BRO,15,BSNL,65,BSNL IDA Pensioner,16,Budget 2014,12,budget 2015,22,Budget 2016,1,Budget 2017,22,cadre management,11,Cadre Restructuring,145,Cancer Treatment,8,Cantonment Board Employees,3,Cash Handling Allowance,5,cashless treatment,12,Casual Leave,3,CAT jurisdiction,1,CAT Order,60,CBDT Order,25,CBEC,13,CBEC CR,9,CBSE,22,CCS (CCA) Rules,46,CCS (Conduct) Rules,48,CCS (Joining Time) Rules,6,CCS (Leave) Rules,43,CCS (RP) Rules 2008,35,CCS (RP) Rules 2016,35,CEA,30,CEA Form,4,Central Administrative Tribunal,2,Central Government Employee Calendar,22,central government employee news,39,Central Pension Accounting Office,83,Central Secretariat Service,5,Central Universities,15,CG Counsel,1,cgda,85,CGEGIS,14,CGEGIS TABLE,8,CGEWHO,64,CGEWHO Noida,17,Cghs,339,CGHS AHMEDABAD,5,CGHS ALLAHABAD,2,cghs BENGALURU,3,cghs bhopal,2,CGHS BHUBANESWAR,2,CGHS CHANDIGARH,4,cghs CHENNAI,2,CGHS Clarification,53,cghs dehradun,3,Cghs Delhi,65,cghs empanelment,117,CGHS GUWAHATI,3,CGHS HOSPITAL LIST,29,CGHS HYDERABAD,4,cghs jabalpur,3,cghs jaipur,5,cghs kanpur,2,cghs kolkata,2,cghs lucknow,2,CGHS MEERUT,4,cghs mumbai,4,cghs nagpur,2,cghs patna,1,CGHS plastic cards,7,cghs pune,1,cghs ranchi,2,cghs rates,40,cghs trivendrum,2,CGWB,3,Child Care Leave,28,Children Education Allowance,26,CIP(IW),1,Citizen Charter,2,Civil Accounts Organisation,33,Civil Services Examination,15,cleanliness pledge,2,cmss,1,Coal Pilot Allownace,2,Collection of Order,1,Commercial Duty Allowance,2,Commercial Employment after Retirement,9,Commutation of Pension,24,commuted Leave,6,compassionate appointment,50,Compensatory allowance,2,Compensatory Leave,2,Composition of 7th CPC,9,Compulsory Retirement,9,computer advance,3,computer help,7,Confederation 7th cpc memorandum,3,confirmation,3,Constant Attendant Allowance,5,Consumer Price Index,4,Contingent Employee,3,Contract Labour,74,Conveyance Allowance,1,Court Order,67,CPAY,1,CPF Pensioner,20,CPGRAMS,9,CPMA,2,CPMF,81,CPSE,96,cpse ida,37,CS(MA) Rules,58,cscs,10,CSD,32,CSS,32,CSSS,11,cvc,54,Cycle Maintenance Allowance,3,DA from 01-07-2011,3,DA from Jan 2012,5,DA from Jan 2013,16,DA from Jan 2014,22,DA from Jan 2015,16,da from Jan 2016,10,da from Jul 2012,13,DA from Jul 2013,16,da from jul 2014,11,DA from Jul 2015,9,DA from Jul 2016,12,Daily Allowance,11,Damage Rate,1,DAPWA,1,Data Entry Operator,5,Database of Employees,2,date of next increment,22,DCMAF,4,DCRG,4,Dearness Allowance,134,Dearness Pay,2,Dearness Relief,62,Debt Recovery Tribunals,2,Defence Civilian Employees,72,Defence personnel,395,Dental Clinics,1,Department Canteen,18,Deputation,51,dgqa,1,Dictionary,3,Digital Signature Certificates,1,Direct Tax Code,2,Directorate of Estates,71,Disability Pension,39,Disciplinary Authority,17,DIT,9,Divorced Daughter,1,DNI falls Feb-Jun,7,doppw,3,DOPT,39,DoPT Order,274,Double HRA,5,Double Tpt Allowance,1,dpc,20,Draftsmen,3,DRDO,5,e-awas,6,e-filing,25,E-Governance,11,e-IPO,1,E-office,11,e-payment,19,E-Revision,13,e-samarth,2,Earned Leave,6,ECHS,68,ECI,1,EDLI 1995,4,edp allowance,1,EDP Cadre,7,Education,83,Ekta Diwas,2,Election,21,Eligibility of Teacher,10,email Policy,1,emergency treatment,4,Empanelment under CSMA Rules,21,Employee Pension Scheme,18,Employees Deposit Linked Scheme,1,Engineering Cadre,16,eNPS,3,Entry Pay on Promotion,20,EPFO,112,EPFS 1952,38,ERS,3,ESIC,21,eTDS return,15,EVC,5,ex-gratia,22,Ex-India Leave,4,Ex-Indian Coast Guards,1,EX-SERVICEMAN,497,Excel Tips,5,Exemption from Return Filing,8,Expected DA,70,Extension in Service,3,extraordinary pension,15,Facilitation Fee,1,Family Pension,166,Family Planning Allowance,6,FAQ,70,Festival Offer,6,Fin Min Order,56,Finance Act 2013,1,Financial year 2012-13,2,Firefighting Staff,1,Fitment Formula,38,fixed medical allowance,34,Flexible Complementing Scheme,2,Flying Training,1,Foreign Allowance,2,Foreign Visit,8,form 14,1,Form 16,3,Form 16A,2,Form 25,3,Form 26AS,2,Forms,53,Forwarding of Application,2,FR 15(a),1,FR 22,3,FR 26,1,FR 29,1,FR 35,1,FR 46B,1,FR 49,1,FR 56,15,Freedom Fighter Pension,17,Fundamental Rules,2,GAMS,1,Gandhi Jayanti,10,GAR-23,1,GDS,50,General Pool,56,Geological Survey of India,4,GFR,20,Government Holiday Calendar,35,Govt accommodation,100,Govt Tour,32,gpf,31,Grade pay of SO,41,Grameen Bank,2,Grant-in-aid,1,Gratuity,24,Gratuity Limit for Income Tax,3,greetings,4,group A,78,Group D,54,Guest House,15,Hard Area Allowance,5,Hard Station,2,Headquarter Allowance,1,health insurance scheme,15,hearing aid,2,Hierarchy,40,High Court Order,55,Higher Education,30,Hindi Incentive,5,Holiday Homes,37,Honorarium,19,Hostel Facility in Universities,1,Hota Committee,1,House Rent Allowance,9,HRA,25,IBA,27,Immovable Property Return,57,Implementation of 7th CPC,411,incentive for higher qualifications,1,Incentive for NER,3,Incentive to Sportsperson,9,Income Tax Exemption Limit,96,INCOME TAX,252,Income tax calculation,16,Indemnity Bond,1,Independence Day,2,India Water Week,1,INDU,4,Industrial Trades,16,Inquiry Officer,8,insurance scheme,9,Intelligence Agencies,3,Interest of EPF,22,Interest of GPF,11,interest rate,22,Interim Relief,60,Internet facility to officer,1,Invalid Pension,3,Investment,2,IPv6,2,IRCTC,35,IRTSA,27,IT Cadre Restructuring,23,IT Return,43,Jawahar Navodaya Vidyalaya,11,JCM,281,Jeevan Pramaan,40,Joining Time,6,Kashmir Valley Special Concession,6,KBC,2,kendriya bhandar,2,Kendriya Vidyalaya Sangathan,150,Kilometreage Allowance,2,Kisan Vikas Patra,3,KV Admission Guidelines,18,KV Uniform,7,KYC,1,Lab Technician,10,Labour Bureau,4,Labour Laws,16,lactating mother allowance,1,LARGESS,3,LDC-UDC,77,LDCE/GDCE,24,Leave Encashment,10,leave management system,2,Legal Fee,1,Librarian,2,LIC,1,Licence Fee,12,Lien,3,Life Certificate,51,List of Holidays for year 2012,2,List of Holidays for year 2013,8,List of Holidays for year 2014,10,List of Holidays for year 2015,17,List of Holidays for year 2016,11,List of Holidays for year 2017,1,List of Posts,4,Liver Transplant Surgery,1,Liveries,1,loan advances,27,Loans and advances by Central Government,3,lodge complaints,2,Lok Sabha QA,42,lokpal,58,LTC,101,ltc to AN,8,LTC to JK,29,ltc to NE,22,LTC-80 Fare,17,MACP,148,Major Penalty,8,Married Accommodation Project,2,Maternity Leave,4,Medical Charges Reimbursement Bill Form,15,medical decategorization,2,Medical Examination of Group A Officers,3,Medical Professional,35,Memorandum to 7th cpc,82,merger of da,125,merger of grade pay,25,merger of post,9,Min HIPE,1,minimum wages,72,Ministerial Staff,31,Minor Penalty,5,Minority Community,1,Missing Family Member,6,Model School Organization,1,modified parity in pension,38,MOHALI HOUSING COLONY,2,Movable Property Return,48,MTNL,7,Multi Tasking Staff,13,NAC,61,national council meeting,7,National Holiday Allowance,4,National Level Monitors,1,National Mascot Design,1,National Pension System,84,NC JCM Memorandum to 7th CPC,29,NCH,1,NDG ESM Pensioner,1,new pension scheme,179,New Pension System,32,News,135,NFIR,3,NFSG,16,Night Duty Allowance,19,Nivaran,1,NLM,1,No Demand Certificate,1,Nomination Forms,4,Non-functional Upgradation,10,Notice for Pensioners,29,NPA,11,NSC,6,NSSF,3,Nursing Allowance,8,Nursing Institutions,5,nutritious dietary allowance,2,obc,31,office procedure,9,office space,4,Office Timing,41,Official Directory,1,Official Language Cadre,5,Official Secret Act,1,Officiating Pay,3,One Rank One Pension,349,Online Survey,1,ordnance factory,68,OROP Order,29,OTA,16,Outsourcing,6,Overpayment,6,PAC Recommendation,1,PAINTING,2,PAN,10,Paramilitary Allowance,3,Parangat,2,Passport,17,Paternity Leave,3,Patient Care Allowance,11,pay,8,Pay Anomaly,30,Pay Fixation,105,Payroll,4,PCDA Order,53,Pension,511,Pension Adalat,14,Pension Disbursement,48,Pension Form,6,Pension Revision,173,Pensioner Grievances,53,Pensioner I-Card,10,Pensioner Portal,108,Pensioners associations,122,pensioners retired prior to 1.1.2006,144,Permanently disabled children,15,person with disability,74,Personal Pay,3,Personal Staff to Minister,5,PF Scheme,3,PFRDA Bill 2011,18,pgportal,2,pharmacist,2,Physical Training Instructor,1,PIB,4,Piece work calculation,3,Piece work incentive,5,Piece Work Profit,2,Piece Work Rates,3,Piece Work System,3,PLB,40,Pledge,7,PLR Scheme,1,post office,137,PPF,13,PPF Scheme,8,PPO,48,Pragati,5,Pre-1996,4,Pre-2006,55,Pre-2016 Pensioners,27,pre-retirement counselling,17,Presenting Officer,1,Principal CAT,2,PRIS,19,probation,6,Project Dantak Bhutan,3,Promotions,106,Provisional Pension,4,public grievances,7,Public Provident Fund,8,punctuality,1,Qualification Pay,4,qualifying service,30,Railway Concession Form,3,Railway Servants (Pass) Rules,12,Railways,656,Railways Training Centre,6,Rajbhasha,34,Rajya Sabha QA,38,Rank Pay,22,Ration Money Allowance,4,RBI Circular,12,Re-employed ex-serviceman,45,Receipt Payment Rules,12,Recovery,9,Recruitment,160,Recruitment rules,153,Refreshment Rates,1,RELHS,7,Reply to 7th CPC,12,requisition to SSC,3,reservation,122,residency period,3,Resignation,7,Rest Allowance,1,Retired Employee,46,Retired officers as Consultant,13,Retirement Adviser,1,retirement age,77,Retirement Road Map,52,review of records,2,revised pay rules,29,Right to Information Act 2012,3,Right to Public Service Act,1,Risk Allowance,17,roster,2,Rotational Transfer Policy,12,Rounding Off,2,RTI,65,RTI Call Centre,4,rti online certificate course,2,Rule 10,1,Rule 16(3),1,running staff,18,Safai Karamcharies,1,Sainik School,1,Salary Disbursement,20,Sankalp,27,Sanskriti Schools,3,SAS Examination,7,Saving Bank Allowance,2,sc,22,scholarship Scheme,3,Schools,8,Scientific and Technical Posts,12,Scouts-Guides,2,SCOVA,62,Self attestation,7,Self-certification,7,Senior Citizens,19,Seniority,16,Sensitive Posts,2,Service Book,14,Service Verification,6,Seventh Pay Commission,1151,Seventh Pay Commission Report,110,Sexual Harassment,23,Shramev Jayate,1,shunting duty allowance,2,Sitting Fee Allowance,1,small saving scheme,40,social Media,15,Sparrow,1,Special Allowance,5,Special Casual Leave,5,Special Disturbance Allowance,1,Special Duty Allowance,2,sports-person,29,SSC,11,st,18,Staff Benefit Fund,3,Staff Car Driver,6,Staff Selection Commission,1,Stagnation,5,State Govt Employees,1,Station Leave Permission,4,Stenographer,1,Stents,2,Stepping up of Pay,21,Stiching Charges,2,Stipend,5,Storekeeping Staff,2,Strike,207,Study Leave,6,Substitute Employee,1,summer vacation,2,Sumptuary Allowance,2,Superannuation,6,surplus employee,3,suspension,11,Swantah Sukhaya,2,Swavalamban,29,TA Rules,5,Tatkal Tickets,25,tax,2,Tax Free Bonds,1,TDS,35,TDS Rates,11,technical resignation,5,telephone facility,1,temporary employee,6,Terms and condition,1,Toll Free Number,1,Touring Officer Hostel,14,Trade Apprentices,10,train,113,Training Allowance,6,training policy,34,Transfer Policy,63,Transport Allowance,20,Travelling Allowance,35,tribal area allowance,2,Trip Allowance,2,Uniform Allowance,2,Unit Run Canteen,23,Upgradation of Post,37,UPSC,18,vacancies,27,Veteran Commission,2,Vigilance Clearance,11,Voluntary Retirement,19,Wages,13,Washing Allowance,5,whistle-blowers,7,Widowed Daughter,2,Women Employees,39,Yoga,7,Youth Hostel,3,Zila Saink Board,5,वेतन आयोग,145,
ltr
item
Central Government Employee News and Tools: Railway Medical Attendance Rules/RELHS: Guidelines and ceiling limit for Liver Transplant Surgery - Railway Board Order
Railway Medical Attendance Rules/RELHS: Guidelines and ceiling limit for Liver Transplant Surgery - Railway Board Order
Central Government Employee News and Tools
http://www.staffnews.in/2013/07/railway-medical-attendance-rulesrelhs.html
http://www.staffnews.in/
http://www.staffnews.in/
http://www.staffnews.in/2013/07/railway-medical-attendance-rulesrelhs.html
true
3718188640253144573
UTF-8
Loaded All Posts Not found any posts VIEW ALL Readmore Reply Cancel reply Delete By Home PAGES POSTS View All RECOMMENDED FOR YOU LABEL ARCHIVE SEARCH ALL POSTS Not found any post match with your request Back Home Sunday Monday Tuesday Wednesday Thursday Friday Saturday Sun Mon Tue Wed Thu Fri Sat January February March April May June July August September October November December Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec just now 1 minute ago $$1$$ minutes ago 1 hour ago $$1$$ hours ago Yesterday $$1$$ days ago $$1$$ weeks ago more than 5 weeks ago Followers Follow THIS CONTENT IS PREMIUM Please share to unlock Copy All Code Select All Code All codes were copied to your clipboard Can not copy the codes / texts, please press [CTRL]+[C] (or CMD+C with Mac) to copy