“The lack of organ donors is a national medical crisis with a simple cure.R32;The solution has nothing to do with money or legislation.R32;It has everything to do with people.”
Donating an organ after death is more than just the physical act of giving a part of your body that is of no use to you anymore. It is about celebrating your life! It shows that you value your life and you want it to continue. Many of us believe that we should make ourselves useful and help people who are less fortunate than we are. Organ donation gives us the opportunity to be of use and help people even after we are not around anymore. Organ donation is a very noble deed, indeed!
Facts about organ donation in India
Each brain dead donor has the opportunity to affect the lives of 50 others. There are 5-6 or even more brain dead people lying in hospitals in a city at any given time. In India every year, 1,50,000 people await a kidney transplant. Of which, only 5000 get a transplant whereby only 200 of these get kidneys by way of donations from the deceased. Two lakh people die of liver disease, 50,000 from heart disease and 10 lakh people suffer from Corneal blindness and await transplant.
In India, the organ donation rate is 0.34 per million in a country of 1.3 billion people. i.e. less than 1 in a million Indians are Organ donors.
Tamilnadu, Maharashtra, Kerala, Andhra Pradesh, Gujarat, Delhi and Karnataka are the most active states for organ donation. The statistics for the last few years are: 2012-196 donors (530organs), 2013- 313 donors (852 organs) and 2014-411 donors (1150 organs)
Signing the donor card will not affect your treatment, should you take ill or have an accident. The medical team that saves life is not connected to the organ transplant team.
HISTORY OF ORGAN TRANSPLANTATION IN INDIA.
The first organ transplant in India was the kidney, which happened at KEM Hospital, Mumbai in 1965, under the leadership of Dr.PK Sen. The organ functioned for a few days and failed. Around the same time, the first liver and heart transplant were also performed at the same hospital. However these transplanted organs barely worked for a few hours or days and shut down. While the technical skills were available, the immunology of transplantationwas poorly understood and drugs modifying immunology were yet to be discovered. Having recognized this shortcoming, new efforts in this field ground to a halt.
By the late 70’s and early 80’s, major breakthroughs happened in the understanding of transplant immunology and availability of drugs to control it, and living donor transplants commenced in India. However this was initially restricted to the kidney alone. All other organs, which could be sourced only from a brain-stem dead donor i.e heart, lung, liver and pancreas, could not be transplanted, as there was no law to facilitate this. Meanwhile, commerce in organ transplant began in this country in a very big way, with buying and selling of organs becoming commonplace. This opened up a vast spectrum of social problems, to the underprivileged. The Human Organ Transplantation Act, was passed in parliament in 1994, to rein in this kind of commerce as well as to facilitate an alternate solution for organ transplants in the form of cadaveric organs. The concept of brain stem death was defined and ground rules to source organs from brain-stem donors was laid. The first successful cadaveric kidney transplant was performed by Drs.Viswanath Billa and VatsalaTrivedi, at Sion Hospital in 1997. Since then, major strides have taken place in this field, in our state and others in the country. In Mumbai,; Sion, KEM Hospital and corporate hospitals like Jaslok, Bombay and Hinduja Hospital have been in forefront of kidney and liver transplant programs (both cadaveric and living donor programme). While these developments have opened another avenue for organ procurement, another challenge has emerged. There is an ever widening demand supply mismatch for organs. Continuous media coverage and public debates on this problem have now beginning to sensitise the common man. The concept of brain stem death, the idea that under certain circumstances, each one of us could be a potential organ donor, that our organs can save numerous lives is now taking root in public minds. With time, and continuous education, there is hope that organ donation will become commonplace, and the availability of transplantable organs will increase.
This brochure answers all questions that you may have on this topic. When you complete reading this, we hope you will be ready to become an organ donor.
What is organ donation?
Organ donation is a noble act, which gives us an opportunity to save many lives after our death. Organ donation takes healthy organs and tissues from one person for transplantation into another, in order to replace the diseased and non-functioning organs. An organ transplant can dramatically improve or save someone's life, but they depend entirely on the generosity of donors and their families.
Why organ donation is so important?
Organ donation saves lives and restores health. A kidney transplant is not a cure but represents the best possible improvement to health and quality of life for many people living with kidney failure. The only other life – sustaining treatment is dialysis to artificially clean the blood.
What is organ transplantation?
Human organ transplantation is an achievement of modern medical science where through surgical procedure, healthy organ from a living or dead person is transplanted on an individual suffering from end stage organ failure.
Which organs can be donated?
The vital organs like heart, liver, kidneys, pancreas, intestine, lungs etc. can be donated. However, cornea (eyes), skin and other tissues can be donated after cardiac death.
A living person can donate limited organs like kidneys (as we have two kidneys) or part of the liver and only to his/ her or close relative. The other vital organs can be retrieved only from brain dead individual.
When does organ donation take place?
Organ donation can take place in 2 situations.
Live Donation: This occurs when a person donates their kidney and/or a part of their liver whilst they are still alive. By Indian law, one can only make a live donation to someone within his or her immediate family.
Cadaver Donation: This takes place after death. This type of donation occurs only if the potential donor is on life support and has been declared brain dead. Brain death is the irreversible end of all brain activity (including involuntary activity necessary to sustain life). Unlike being in a coma or a persistent vegetative state, brain death is medically and legally recognized as death. Procedure mandates four doctors to carry a series of tests before certifying a patient as brain dead
Why kidney donations?
Once both the kidneys fail, the patient has only two options. Either he has to take dialysis or has to undergo transplantation. The quality of life is better in transplant patient compared to dialysis patients. So kidney donation must be done to improve and prolong the quality of life.
Who can donate organs?
Organ donations are not constrained by age limit. All adults and minors with consent of parents or legal guardians, regardless of age, race or gender can pledge to become an organ donor. Those suffering from life threatening diseases ( HIV/AIDS, cancer, bacterial or blood related disease) are not eligible organ donors and cannot take the pledge. The decision to pledge their organs must be made by a person in state of sound body and mind
What is brain death? How are organs retrieved?
Any individual whose brain stem, an important part of central nervous system is damaged irreparably is described brain dead. Brain stem dead individual cannot regain his consciousness and breathing as brain stem has the center for both consciousness and respiration. The heart can continue to function and respiration is maintained on ventilator and other support for a maximum time of 36 to 72 hours. As the blood supply to organs can be maintained for few hours. It is during this period the organs can be retrieved after obtaining consent from the close relative. This death can occur only in Intensive Care Unit.
How is brain death declared?
Brain death is declared by the brain death committee (team of four doctors recognized by the Govt. and who are not involved in performing the transplant surgery). The team has to perform the brain stem death tests twice at the gap of 6 hours. This death is declared in the hospitals recognized for transplantation. Brain death is accepted worldwide and the brain death certificate is issued to the relatives.
How does Brain Death occur?
When any of the above occurs, they cause swelling of the brain. Because the brain is enclosed in the skull, it does not have room to swell, thus pressure within the skull increases. This can stop blood flow to the brain killing brain cells.
Is there any chance of survival of a brain dead individual?
No. Brain dead individual is declared dead and cannot come back. There is no question of survival of the individual, as the set of tests done by experts’ have left no possible doubts of the diagnosis of brain death.
Brain death has nothing to do with mercy killing. The organs are taken only after the person is declared brain dead. There is a difference between comatose patients and brain dead individuals. The comatose patients are not dead whereas brain death is the stage beyond coma and individual is declared dead. Organs are never taken at the cost of donor’s life.
Does donor have to die only in hospital?
Yes, as brain death can occur only in ICU, one who becomes organ donor dies in ICU of the hospital. No vital organs can be retrieved if the death occurs at home. However, eyes can be retrieved up to 6 hours after the heart stops beating; hence this could be done even if the individual dies at home.
Is it legal?
Yes, in India. The Human Organ Transplantation Act was passed in 1994, which mainly covers three issues.
Can a person sell their organs for money in India?
No. The key word is donating. Organ donation is a gift. There is no monetary compensation. It is illegal to buy or sell organs in India.
Will my kidneys be taken away without any of my family members consent?
Even if you have consented to organ donation before your death, by law, the consent of the next-of-kin or relatives has to be taken before removal of any organ.
Is the donor’s body given back to the relatives?
Yes, the body is given back to the relatives to perform the last rites after the retrieval of organ. The organs are retrieved only for therapeutic purposes. This is different than body donation where the whole body is given to the anatomy department of the Medical College for research purpose.
Are the organs given to rich patient only?
No. As per the priority criteria like age, blood group, waiting period and clinical status of the recipient, organs are given to the most needy and suitable recipient. In Maharashtra the Government has given guidelines to give the priority score to all the waiting recipients to distribute the organs. Money, race, religion are not the criteria for distribution.
Will the donor family know the organs are given?
No, the name and address of the recipient is not given to the donor family and vice versa.
Is their any disfigurement after organ donation? Can there still be an open casket funeral?
No. Donation neither disfigures the body, nor rules out an open casket funeral. The organs are removed carefully by taking the donor to the operation theatre and there is no disfigurement. There is cut on the body that is sutured just like any other surgery performed on the living person.
Does our religion support organ donation?
Yes, all the religions in India approved organ and tissue donation and consider donation as the greatest gift.
Is any compensation or payment made to the donor family?
No, it is pure donation and hence it becomes the noble act. However, the family is not charged for the investigations after the consent for organ donation is given.
How can one become an organ donor?
Sign an organ donor card. Share the wish with the close relatives, as their consent is required before retrieving the organs even if the donor has signed a donor card. The donor card has to be kept with the person who has signed it.
Will my decision to become an organ and tissue donor affect the quality of my medical care?
No. Organ donation is not even considered until all possible efforts to save a patient’s life have failed. The criteria used to determine death are based on strict medical and legal standards. Organ and tissue recovery happens only after every effort has been made to save your life, and death has been legally declared.
What happens to my donated organs and tissues?
A national system ensures the fair distribution of organs in India. The patients who will receive your organs and tissues will be identified based on many factors, such as blood type, length of time on the waiting list, severity of illness, and other medical criteria. Factors such as race, gender, age, income and celebrity are NOT considered when determining who receives organ and tissue donations. Furthermore, the buying and selling of organs, tissues and eyes is illegal.
Kidney transplants are highly successful.
Kidney transplantation is a very successful and accepted treatment. The success rate for a transplant from a deceased donor is high: 85 – 90% of these kidneys are working well after one year and will last on average from 10 – 15 years. Success rate are improving every year with advances in medical research.
Where to go for more information?
About Apex Kidney Foundation - gift your organ initiative
AKF- “Gift Your Organ initiative” is a non-profit organization working towards creating awareness and educating on organ donation & transplantation. It promotes and educates the society about organ donation and also makes them aware of organ donation. It runs a swap transplant registry to promote the kidney transplantation in patients with kidney disease who are not having compatible donor in the family.
OBJECTIVES of the Apex Kidney Foundation: