Information on Organ Transplant

• Approximately 5 lakh people die every year due to unavailability of organs!

• There is only one hospital per 43 lakh people in India to handle organ donation and transplantation. It is almost impossible for one hospital to handle the requirements of the staggering number of people it has to cater to.

• Only 2-3% of the demand for organs is met and many people die of organ failure while waiting for a transplant on the waiting list.

• Every year, following number of people need organ/tissue transplant as per organ specified:  

            1)   Kidney – 2,50,000                  2) Liver – 50,000

            3)   Heart – 50,000                       4) Cornea- 1,00,000

• 90% of people in the transplantation waiting list die without getting an organ!
  

• According to the World Health Organization (WHO), only about 0.01 percent in India donate their organs after death, while in Western countries around 70-80 percent of people pledge their organs.
  When compared to other countries, India still has a long way to go.

• Lack of understanding of concept of brain stem death: when a person is declared brain dead, it is challenging for the family to accept the death as the body is warm and the heart is beating while the patient is kept on the ventilator. Brain death is often confused with a comatose state and the family harbours optimism of the patient recovering. Hence it becomes difficult to explain to the family and organ donation requires family consent, therefore, the donation is not able to occur.

• Several myths revolve around organ donation, a major one being that if one donates organs, they may be born without that organ in the next life.
• Lack of education and awareness among the relatives of the brain-dead patient, lack of awareness among the public about organ donation, organ donor cards and procedure of organ donation add to the misconceptions associated with organ donation in our country and makes it a difficult task.

• Living Donor: Any person above 18 years of age, who voluntarily allows the removal of any of their organ and/or tissue, during their lifetime, as per current medical practices and conditions for therapeutic purposes. 
  

• Deceased Donor: Anyone, regardless of age, race or gender can become an organ and tissue donor after their Death (Brainstem/Cardiac). Consent of a near relative or a person in lawful possession of the dead body is essential. If the deceased donor is under the age of 18 years, then the consent required from one of the parents or any near relative authorized by the parents is important. Medical suitability for donation is determined by the clinician at the time of death.

1. LIVING ORGAN DONATION PROCESS:

• The living donor needs to undergo certain medical tests to check their compatibility with the recipient. Once this is established and proper approval from the hospital committee is acquired, the donation and transplantation can take place.

• The donor’s organ (one kidney or a part of the liver) is surgically procured by the doctors and transplanted into the recipient.

• The living donor needs to remain under medical observation for a few days after the organ retrieval process to be declared fit to leave. This duration varies from person to person.

2. DECEASED ORGAN DONATION PROCESS:
   

• A deceased organ donor is someone who donates organs after death. Organs are retrieved from the person who has had a brain stem death, causing cessation of all activities of the brain stem.

• In order to support the vital functions of the brainstem dead patient, they are put on a ventilator. Artificial external support allows for organs to remain viable till procurement. Organs can be retrieved for the process of organ donation, only after consent is given by the family members.

• Brain stem death is irreversible with no possibility of recovery.
• A person who dies due to a cardiac cause cannot donate vital organs as they die within minutes which causes a lack of circulation leading to lack of oxygen to these organs. Only the tissues can be donated in these cases like corneas, bones, skin, bone marrow, tendons, ligaments, cartilage, etc.

• This is where a person no longer has activity in the brainstem due to a severe brain injury.

• They have permanently lost the potential for consciousness and the capacity to breathe.

• This may happen even when a ventilator is keeping the person’s heart beating and allowing oxygen to be circulated throughout their body.
• It is possible to donate all organs in case of brainstem death.

Common causes of brain stem death include: severe head injury, primary brain tumors, homicide/suicide, cerebral insults (Subarachnoid hemorrhage, Subdural hemorrhage, Cerebrovascular accidents), metabolic disorders like Diabetic ketoacidosis, cerebral anoxia (near drowning, drug overdoses).

The approximate amount of time between recovering the tissues/organs and transplanting them is:

• Lung – 4 to 6 hours

• Heart – 4 hours

• Liver – 10-12 hours

• Pancreas – 12-18 hours

• Kidney – up to 72 hours

• Cornea – 14 days

• Bones – 5 years

• Skin – 5 year

• Heart Valves – 10 years

• Everyone can take the pledge to be an organ donor. Even people living with chronic diseases or those who have a history of cancer or other serious diseases are encouraged to join the donor registry. If a person meets with a brain stem death, their medical condition is evaluated by a trained clinician to determine which organs and tissues are viable for donation.

• Organ procurement organizations treat each donor with absolute respect and dignity and do not lead to any disfigurement.

• Costs associated with recovering and processing organs and tissues for transplant are never charged on to the donor family. The family may be expected to only pay for medical expenses incurred before the consent is given to donate organs by family members.

• The first priority of a medical professional is to save lives when a sick or injured person comes to the hospital. Organ and tissue donation is not discussed until after brain stem death is declared.
  

• Doctors and nurses involved in a person’s care before death are not involved in the retrieval or transplantation of donated corneas, organs, or tissues.

• When you are on transplant waiting list for a donor organ, what matters is the severity of illness, the time spent waiting, blood type and other important medical information.