Organ Donation



Organ donation is the donation of biological tissue or an organ of the human body, from a living or dead person to a living recipient in need of a transplantation. Transplantable organs and tissues are removed in a surgical procedure following a determination, based on the donor's medical and social history, of which are suitable for transplantation.

Organ donation refers to donation of parts of human body by a living or dead individual to a patient with diseased organ that has failed to function permanently. Living donation is legal in India if the organ donor and organ recipient are closely related to each other. A living donor may donate organs like one of their kidneys or part of liver to their close relatives if they have kidney or liver failure. This write up deals with deceased donation, which refers to donation of organs by a brain dead donor.

To understand the concept of deceased donation, one must understand what brain death means. It means complete and irreversible loss of functioning of brain. These patients can have their cardiac and lung functions supported artificially for some time, but would have lost their brain function permanently. It has been universally accepted that brain death is also a form of death. There are criteria to define brain death. An adhoc committee of Harvard Medical School first formulated these criteria in 1968. Since that time, these criteria have been accepted universally. Brain death criteria are not used in the context of organ donation alone. It is used to define the outcome of any patient who has severe brain injury due to any cause to determine whether the loss of brain function has resulted in permanent inability to live. When somebody is brain dead, no further treatment is likely to help him or her come back alive. These are the reasons why brain death is accepted as a form of death. Once a patient is brain dead, the respiratory and circulatory functions may be supported for sometime artificially. These are the patients who can be deceased organ donors.

Once patients satisfying potential brain death criteria have been identified, there is a test called apnoea test to confirm brain death. Apnoea test refers to a series of medical measures to confirm brain death in bedside. Two apnoea tests have to be done, six hours apart by the neurology teams to test for brain death. If both tests are positive, a patient is defined to have brain death.

Anybody who is brain dead is legally dead and can become a potential organ donor. The treating team of doctors will declare brain death. Grief counselors and transplantation coordinators will generally speak to the family of brain dead patients and give information to them about organ donation. Deceased donors may donate organs of their body that are healthy. Organs that may be donated include liver, kidneys, heart, lungs and corneas of eyes. Sometimes, deceased donors also may donate skin. Each of the vital organs donated has the potential to save one patient with an affected organ. It is important for people to know about organ donation, be aware of who can be an organ donor and the immense benefit that organ donation by a deceased donor do to save several lives. If awareness about organ donation increases among the general public, it will be easy for people to make a decision on organ donation at a difficult time when their near and dear one is brain dead.

Organ donation rate in India is currently close to 0.1 per million population. Due to the general unawareness of organ donation in India, families of several thousand potential deceased donors don’t even know that their kith and kin can be an organ donor and potentially save several lives. On the other hand, several thousand patients with liver, kidney, heart and lung disease who can be saved by organ transplantation die without ever receiving transplantation in our country. It is a sad fact that 90% of patients who are listed for organ transplantation in India die without receiving transplantation.On the other hand, Spain is the country that has the highest number of organ donors per million population. Spain generates 35.3 organ donors per million population. If organ donation rate in India reaches this level, we will be able to meet the organ requirement of the whole world.

National Foundation for Liver Research (NFLR) aims to propagate awareness among general public about organ donation so that the general public are empowered with the necessary information to make an informed decision about organ donation

Life after death has been the stuff of mythology today it is possible to give life after death by donating organs to people who would die from organ failure. This is not easy for the family going through the bereavement of the loss of a loved one. But if they can be made aware that by donating organs they are giving life to others and enriching other lives this decision. Becomes easy for them even in their grief and sorrow. Our trust will promote this awareness through the print and electronic media as well as social networks. Apart from the public, medical personnel have to be made aware about the process involved in organ donation since they will be involved in counselling the families who come forward for organ donation. This would be achieved with teaching programs for nurses, doctors and health care workers.

India

India has a fairly well developed corneal donation programme however donation after brain death has been relatively slow to take off. Most of the transplants done in India are living related. To cub organ commerce and promote donation after brain death the government enacted a law called "The Transplantation of Human Organs Act" in 1994 that brought about a significant change in the organ donation and transplantation scene in India.

Tamilnadu

The Government of Tamil Nadu put together government orders laying down procedures and guidelines for deceased organ donation and transplantation in the state. These brought in almost thirty hospitals in the programme and has resulted in significant increase in the donation rate in the state. With an organ donation rate of 1.15 per million population, Tamil Nadu is the leader in deceased organ donation in the country. The small success of Tamil Nadu model has been possible due to the coming together of both government and private hospitals, NGOs and the State Health department. Most of the deceased donation programmes have been developed in southern states of India.