Organ transplantation has been one of the greatest advances of modern science that has resulted in many patients getting a renewed lease of life. Transplantation would not be possible without organ donation from living and deceased organ donors. However, in India, our organ failure patients have not greatly benefited from this advancement. This is not because we do not have well equipped hospitals or doctors, but due to shortage of organs and lack of awareness that organ donation is possible not only from living people but also after brain death.

Organ transplantation has been one of the greatest advances of modern science that has resulted in many patients getting a renewed lease of life. Transplantation would not be possible without organ donation from living and deceased organ donors. However, in India, our organ failure patients have not greatly benefited from this advancement. This is not because we do not have well equipped hospitals or doctors, but due to shortage of organs and lack of awareness that organ donation is possible not only from living people but also after brain death.

In India, currently 95% of transplants come from living donations (related donors and unrelated donors) and the small 5% come from deceased donors or cadaver donors.  However, abroad 90% donations came from brain dead donors and only 10 % happen from living donors.

The need for organs is rising rapidly in India. As diabetes and hypertension are on the rise in the nation, the demand for organs is huge as it is estimated that at least 3000 patients die in India with kidney failure due to non-availability of kidneys. There are over 100,000 patients annually who are diagnosed to have terminal kidney failure. Similar figures are quoted for liver and heart transplants. Undoubtedly, the need is higher than the availability of organs.

Today our mission is to ensure:

• 1) That no Indian dies due to shortage of an organ.
• 2) To ensure that every Indian who is suffering from terminal organ failure be provided with the gift of a “New lease of Life” through a lifesaving organ transplant.
• 3) To promote public education programs so that a cross section of our population is aware about the need to donate one’s organs.
• 4) To liaise with the Government of India and State Government to pass favourable legislations that will augment organ donations.
• 5) To network with organ donation agencies so that no organ is ever wasted

From the realms of mythology to the futuristic pages of sci-fi books, transplantation from one human being to another has always been written, talked and debated about intensely. But, what is happening today in the world of organ donation and transplantation?

Transplantation over the past few decades has become an accepted form of treatment for a number of conditions where organs like the kidneys, heart and liver have irreversibly failed. For a patient with kidney failure, an alternative such as dialysis is available till an organ becomes available, but for a patient with liver or heart failure; the only hope of living may be a transplant. Are we doing enough to help these critically ill patients whose numbers seemed to constantly increase? What is the current status of different transplants in India and what are we doing to help these patients?

Organ donation is a gracious act that reaffirms our faith in humanity. However, over the last 10 to 15 years, the organ donation process is marred in India due to the stigma around kidney donation. The law of the land prohibits any commercial dealing in organs – such as purchase of kidney from a donor from economically weaker section, but because the demand is so high, the law is difficult to implement and kidney scandals continue to haunt the country where a donor is not adequately compensated.

Parallel to these problems there has been a very interesting advancement in the field of transplantation in India in the last 12 years and this is seldom discussed or talked about.  For the first time in our country organs have been donated and transplanted from patients who are brain dead, the so called cadaver or deceased organ donation.

India’s deceased organ donation rate was only 0.67 per million populations (pmp) with 875 deceased donors in 2018 and Spain had the highest deceased organ donation rate in the world at 48.3 per million populations in 2018 according to the WHO-ONT Global Observatory on Donation and Transplantation.

 

Most Important facts which we all must know about organ donation are given below :-

1.  What is an organ?

An organ is a part of the body that performs a specific function like your heart, lungs, kidneys, liver etc.

2. What are the Organs that can be donated?

The organs that can be donated are the liver, kidneys, pancreas, heart, lungs and intestines.

3. What is Tissue?

Tissue means a group of cells performing a particular function in the human body. Examples would be bone, skin, cornea of the eye, heart valve, blood vessels, nerves and tendon etc.

4. What are the tissues that can be donated?

The tissues that can be donated are the Cornea, Bone, Skin, Heart Valve, blood vessels, nerves and tendon etc.

5. What is Organ Donation?

Organ Donation is the gift of an organ to a person with end stage organ disease and who needs a transplant.

6. What are the different types of Organ Donation?

There are two types of organ donation:-

1. i) Living Donor Organ Donation: A person during his life can donate one kidney (the other kidney is capable of maintaining the body functions adequately for the donor), a portion of pancreas (half of the pancreas is adequate for sustaining pancreatic functions) and a part of the liver (the segments of liver will regenerate after a period of time in both recipient and donor).

ii)Deceased Donor Organ Donation: A person can donate multiple organs and tissues after (brain-stem/cardiac) death. His/her organ continues to live in another person’s body.

7. Is there any age limit for Organ Donation?

Age limit for Organ Donation varies depending upon whether it is living donation or cadaver donation; for example in living donation, person should be above 18 years of age, and for most of the organs deciding factor is the person’s physical condition and not the age. Specialist healthcare professionals decide which organs are suitable from case to case. Organs and tissues from people in their 70s and 80s have been transplanted successfully all over the world. In the case of tissues and eyes, age usually does not matter. A deceased donor can generally donate the Organs & Tissues with the age limit of:

• Kidneys, liver: up – to 70 years
• Heart, lungs: up – to 50 years
• Pancreas, Intestine: up – to 60-65 years
• Corneas, skin: up – to 100 years
• Heart valves: up-to 50 years
• Bone: up – to 70 years

8. Who can be a Donor?

Living Donor: Any person not less than 18 years of age, who voluntarily authorizes the removal of any of his organs and/or tissue, during his or her lifetime, as per prevalent medical practices for therapeutic purposes.

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

9. How can I be a Donor, What is the process to take donor pledge?

You can be a donor by expressing your wish in the authorized organ and tissue donation form (Form-7 As per THOA). You may pledge to donate your organs by signing up with our website https://willingdonlions.in and register yourself as donor.

10. Do I need to carry my donor card always?

Yes, it will be helpful for the health professionals and your family.

11. Do I need to register my pledge with more than one Organisation?

No, if you have already pledged with one Organisation & received a Donor Card, you need not register with any other organisation.

12. Can a person, without a family, register for pledge?

Yes, you can pledge, but you need to preferably inform the person closest to you in life, a friend of long standing or a close colleague, about your decision of pledging. To fulfill your donation wishes, healthcare professionals will need to speak to someone else at the time of your death for the consent.

13. What is the benefit to my family or me after donation of organs?

Donation of an organ or tissue provides an unparalleled opportunity to give someone a second chance of life. Your donation is not only giving impact to the life of one person or family, but it is of overall help for the society as a whole.

14. Are there any religious objections to donate Organs and Tissues?

No, none of our major religions object to donate organs and tissues, rather they all are promoting and supporting this noble cause. If you have any doubts, you may discuss with your spiritual or religious leader or advisor.

15. Time frame to harvest organ from a brain dead/ normal dead Person.

This refers to the amount of time that an organ is chilled or cold and not receiving a blood supply. This varies widely by organ, but in general, the sooner an organ can be transplanted, the better. The cold ischemia time is as follows:

• Heart – 4 hours
• Lungs – 4 hours
• Liver – 12 hours
• Pancreas – 24 hours
• Kidneys – 48 hours

16. The people who have pledged for Organ donation in life, will they definitely become organ donors?

No, only few people die in the circumstances where they are able to donate their organs. That is the reason we need people to take pledge for Organ Donation and registered them self as potential Donor.

17. Are donors screened to identify if they have a transmissible disease?

Yes, Blood is taken from all potential donors and tested to rule out transmissible diseases and viruses such as HIV and hepatitis. The family of the potential donor is made aware that this procedure is required.

18. Can I be a donor if I have an existing medical condition?

Yes, in most circumstances you can be a donor. Having a medical condition does not necessarily prevent a person from becoming an organ or tissue donor. The decision about whether some or all organs or tissue are suitable for transplant is made by a healthcare professional, taking into account your medical history.

In very rare cases, the organs of donors with HIV or hepatitis-C have been used to help others with the same conditions. This is only ever carried out when both parties have the condition. All donors have rigorous checks to guard against infection.

19. Can I be an organ donor, if I have been rejected to donate blood?

Yes, The decision about whether some or all organs or tissue are suitable for transplant is always made by a specialist, taking into account your medical history. There may be specific reasons why it has not been possible to donate blood, such as having anaemia or had a blood transfusion or had hepatitis in the past or there may be reasons why you could not donate blood because of your health at the time – sometimes a simple thing like a cold or medication that you are taking can prevent you from donating blood.

20. How does whole body donation differ from organ donation?

Organ donation for therapeutic purposes is covered under the Transplantation of Human Organs Act (THOA 1994).Whole body donation is covered by the Anatomy Act 1984.

Organ and Tissue donation is defined as the act of giving life to others, after death by donating his/her organs to the needy suffering from end stage organ failure.

Body donation is defined as the act of giving oneӳ body after death for medical research and education. Those donated cadavers remain a principal teaching tool for anatomists and medical educators teaching gross anatomy.

21. Can a dead body be left for medical education or research after the organs have been retrieved for donation?

No, Bodies are not accepted for teaching purposes if organs have been donated or if there has been a post-mortem examination. However, if only the corneas are to be donated, a body can be left for research.

22. How can I help in increasing organ donation?

You can help by:

1. Becoming a donor and talking to your family about your decision of saving lives of others.
2. Promoting donation by motivating people at work place, in your community, at your place of worship, and in your civic organizations.

23. Can I sell my organs?

No. The Transplantation of Human Organs Act makes it ILLEGAL to buy or sell human organs and tissues. Violators are subject to fines and imprisonment.

You may feel that selling an organ is your only option and that after selling your organ yours debts will be settled and you can start afresh. But studies have shown that those who have sold their organs in exchange of money to lessen their debt have not done well at all.

24. Is it possible to jump the waiting list if you are rich, well connected and influential?

No. In India, the allocation of organs to recipients on the waiting list is based on predetermined criteria which include date of registration and medical criteria.

The wealth, race, or gender of a person on the waiting list has no effect on when and whether a person will receive a donated organ. The Transplantation of Human Organs Act of 1994 makes it illegal to buy or sell human organs in India.