Journal of the Practice of Cardiovascular Sciences

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Year
: 2018  |  Volume : 4  |  Issue : 3  |  Page : 177--179

Organ donation – Current Indian scenario


Senthilkumar Nallusamy1, Shyamalapriya2, Balaji2, Ranjan2, Yogendran2,  
1 Chief Interventional Cardiologist, Department of Cardiology, Apollo Speciality Hospitals, Trichy and RANA Hospitals, Tiruchirappalli, Tamil Nadu, India
2 Department of Cardiology, Apollo Speciality Hospitals, Tiruchirappalli, Tamil Nadu, India

Correspondence Address:
Dr. Senthilkumar Nallusamy
Rana Hospital, A-10/156, Salai Road, Thillai Nagar, Tiruchirappalli, Tamil Nadu
India

Abstract

Organ donation is one of the greatest medical marvels of the twentieth century which has saved the lives of several patients. The disparity between the huge demands for the organs and their poor supply is the main issue. The total organ donation shortage in our country can be met even if only few victims involved in fatal accidents serve as organ donors. Organ donation and successful retrieval of life saving organs is a complex process involving co-ordination of multiple transplant teams. This article reviews the different kinds of organ donors, evolution and present status of organ donation program in India, legal aspects of organ donation, process of pledging organs by a living person and the efforts taken to promote awareness about organ donation.



How to cite this article:
Nallusamy S, Shyamalapriya, Balaji, Ranjan, Yogendran. Organ donation – Current Indian scenario.J Pract Cardiovasc Sci 2018;4:177-179


How to cite this URL:
Nallusamy S, Shyamalapriya, Balaji, Ranjan, Yogendran. Organ donation – Current Indian scenario. J Pract Cardiovasc Sci [serial online] 2018 [cited 2023 Feb 9 ];4:177-179
Available from: https://www.j-pcs.org/text.asp?2018/4/3/177/249941


Full Text

 Introduction



Organ donation is the process of retrieving or procuring an organ from a live or deceased person. The process of recovering organs is called harvesting. The organ is transplanted into the recipient who is in need of that organ.

Organ donation in India is slowly rising to take off. The main reason behind this slow take off is lack of awareness. Awareness should increase in all levels, namely,

Community-based awarenessPublic/patient-based awarenessHospital-based awarenessGovernment-initiated awareness.

The main aim of this article is to create awareness so that it will motivate as well as inspire the reader to pledge his or her organs and through whom more awareness about organ donation will spread in our country.

 Organ Donation and Transplantation in India–Where we are?



India'sfirst organ transplant was conducted in the 1970s (it was a kidney transplant).[1] India has made a few strides forward since then, but a lot more needs to be done.

The number of transplants done annually has been gradually rising. Around 5000 kidneys, 1000 livers, and around 50 hearts are transplanted annually in India[2]There is a poor organ donation rate – 0.26 per million in India, compared to some of the better performing countries such as Croatia's 36.5, Spain's 35.3, and America's 26 per million, respectively[3]With 1 per million-donation rate, India would have 1100 organ donors or 2200 eyes, 2200 kidneys, 1100 livers, 1100 pancreas, and 1000 hearts. This should take care of almost all current demands for organsAt a 2 per million-donation rate, there would be 2200 organ donors and the above figures would double. Then, there would be no necessity to undertake living kidney donationsThere is a need of roughly 2,00,000 kidneys, 50,000 hearts, and 50,000 livers for transplantation each year.[2]

 Different Kinds of Organ Donors



There are three kinds of organ donors:

Live donorsCadaveric or brain death donorsNatural death donors.

Live donors

This occurs when a living person decides to donate his or her organ(s) to someone in need of a transplant. Living donors are usually family members or close friends of that person who require a transplant. They must fulfill certain medical criteria and undergo comprehensive medical testing as required by the particular circumstance before being accepted as suitable donors.

Cadaveric or brain death donors

This is when organs from a brain-dead individual are transplanted into the body of a living recipient. The deceased individual in this scenario can only be a victim of brain death. This kind of transplant initially requires the recipient to wait on a list until a suitable organ is available based on the recipient medical profile. The following organs can be donated by a brain death patient: kidney, liver, heart, lungs, pancreas, intestine, tissues, cornea, bones, skin, and veins.

Natural death donors

A person after his or her natural death can donate their eyes.

 How to Ask for Organs in the Event of “Brain Death” from that Patient's Relatives



In the event of brain death, we follow the sequence by asking for eye donationfirst and see the response of the relatives as shown in the flow chart in [Figure 1].{Figure 1}

 How Long can a Donated Organ Last Outside the Body?



If kept chilled in preservation solution, donated organs can remain viable for transplantation for a duration ranging from a few to many hours, although it is best if they are transplanted as quickly as possible after the donation surgery. Typical storage times are 30 h or less for a kidney, <12 h for a pancreas or liver, and <6 h for a heart or for lungs. These times vary because of the relative speed at which deterioration begins in the organ's tissues.

Organ Wastage in India

Due to the prevalence of myths surrounding brain death and the lack of awareness in India, the majority of people do not take up this noble cause for the benefit of others.

The following statistics are alarming in the Indian context:[4]

The total number of brain deaths due to accidents is nearly 1.5 lakhs annually. Other causes of brain death such as IC bleed and brain tumors would potentially add more numbersThere is a need of two lakh kidneys, 50,000 hearts and 50,000 livers for transplantation every year. Even if 5%–10% of all brain deaths are harvested properly for organ donation, technically, there would be no requirement for a living person to donate organsThe situation of organ wastage is the most severe in cases of hearts. Due to various issues such as cost and availability of expertise in different cities, hearts are often wasted in India.[5] In the past 6 months, with the active involvement of National Organ and Tissue Transplant Organization, the organ utilization has improved dramatically, and the distribution Pan India is much better with much less wastage.

 Legal Aspects of Organ Donation



Transplantation of Human Organs Act was passed in 1994. It defines about the regulation of removal of human organs and its storage. It also arrived at the regulation of transplantation of human organs for therapeutic purpose and for the prevention of commercial dealings in human organs.[6]

The main provisions of the act (including the amendments and the rules of 2014) are as follows:

Brain death identified as a form of death process and criteria for brain death for brain death certification definedAllows transplantation of human organs and tissues from living donors and cadavers (after cardiac or brain death)Regulatory and advisory bodies for the monitoring transplantation activity and their constitution definedThe government shall maintain a registry of the donors and recipients of human organs and tissues.

 Process of Pledging Organs by A Living Person



Any person willing to donate his/her organs can do so by filling out the donor consent form available on the Ministry of Health and Family Welfare, Government of India website.[7]

This is a voluntary actThe donor may also approach a transplant center or other organDonation organizations for a donor cardThe decision to donate organs could also be done by the lawful custodianOf the body after the death of the patient.

Note: The organ donor card is not a legal document. It is only an expression of a person's willingness to be a donor. In India, at the time of organ donation, the family of the patient will make the final decision on whether to donate organs or not.

 Guinness World Record on Organ Donation Awareness



The world's largest awareness lecture for general public on organ donation was delivered recently by us on behalf of Senthilprabha Trust in Trichy, Tamil Nadu.[8],[9] The purpose of this rare feat was not aimed to create a world record but to promote awareness about organ donation among the general public.

 Future Outlook About Creating Awareness About Organ Donation



There is a lack of awareness among people with regard to deceased organ donation, the concept of brain death, and the process of organ transplantationMore nongovernment organizations should take significant steps to create awarenessThere is a lack of clarity within the medical fraternity with regard to the rules and procedures related to organ transplantationThe absence of a centralized agency to maintain a registry of donors as well as recipients and ensure maximum utilization of organs, as well as their fair and equitable allocationStrong need for developing a centralized organ-sharing network among hospitals for better coordination, timely utilization, and avoiding organ wastage.

More organ donation awareness should be done in the following ways:

Social mediaCelebrity involvementOrganizing awareness campsInvolving the government and public hospitals.

 How can you Help?



By spreading awareness in the society about organ donationBy pledging your organsBy motivating your near and dear ones to pledge their organs.

“Thanks a ton to the donors of live transplant”

“Homage and prayers to the natural death and brain-dead donors”

“In my end, there is a beginning”

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1Shroff S. Legal and ethical aspects of organ donation and transplantation. Indian J Urol 2009;25:348-55.
2Hashraj S. Patient's kin hesitant of organ donation. Hindustan Times (Print Edition) 2013.
3Times View, India's rate of organ donation compares poorly with other countries. Time India (Online Edition) 2013.
4Jagga R. Organ donation still not popular in city. Indian Express (Online Edition) 2013.
5Narayan Pushpa TN. Hearts meant for transplant end up in trash. Times India (Online Edition) 2013.
6Bill No: 136 – F of 2009. The Transplantation of Human Organs (Amendment) Bill, 2011. Passed by Lok Sabha, 12 August, 2011. Passed by Rajya Sabha; 26 August, 2011.
7TNN, procedure for organ donation. Times India Goa (Online Edition) 2012.
8Valayapathy R. Tiruchy Doc in Guinness for Largest Awareness Meet. Deccan Chronicle Coimbatore Edition; 03 October, 2017. p. 3.
9Express News Service. Cardiologist Earns Guinness Entry with Lecture. India Express Tiruchy Edition; 03 October, 2017. p. 2.