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

Organ donation – Current Indian scenario


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

Date of Web Publication11-Jan-2019

Correspondence Address:
Dr. Senthilkumar Nallusamy
Rana Hospital, A-10/156, Salai Road, Thillai Nagar, Tiruchirappalli, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jpcs.jpcs_59_18

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  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.

Keywords: Brain death, create awareness about organ donation, donors, guinness record, organ donation, organ donation in India, recipients


How to cite this article:
Nallusamy S, Shyamalapriya, Balaji, Ranjan, Yogendran. Organ donation – Current Indian scenario. J Pract Cardiovasc Sci 2018;4:177-9

How to cite this URL:
Nallusamy S, Shyamalapriya, Balaji, Ranjan, Yogendran. Organ donation – Current Indian scenario. J Pract Cardiovasc Sci [serial online] 2018 [cited 2019 Mar 19];4:177-9. Available from: http://www.j-pcs.org/text.asp?2018/4/3/177/249941


  Introduction Top


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,

  1. Community-based awareness
  2. Public/patient-based awareness
  3. Hospital-based awareness
  4. Government-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? Top


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 organs
  • At 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 donations
  • There 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 Top


There are three kinds of organ donors:

  • Live donors
  • Cadaveric or brain death donors
  • Natural 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 Top


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: Public attitude survey.

Click here to view



  How Long can a Donated Organ Last Outside the Body? Top


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]

  1. 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 numbers
  2. There 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 organs
  3. The 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 Top


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:

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



  Process of Pledging Organs by A Living Person Top


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]

  1. This is a voluntary act
  2. The donor may also approach a transplant center or other organ
  3. Donation organizations for a donor card
  4. The decision to donate organs could also be done by the lawful custodian
  5. Of 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 Top


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 Top


  • There is a lack of awareness among people with regard to deceased organ donation, the concept of brain death, and the process of organ transplantation
  • More nongovernment organizations should take significant steps to create awareness
  • There is a lack of clarity within the medical fraternity with regard to the rules and procedures related to organ transplantation
  • The 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 allocation
  • Strong 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:

  1. Social media
  2. Celebrity involvement
  3. Organizing awareness camps
  4. Involving the government and public hospitals.



  How can you Help? Top


  • By spreading awareness in the society about organ donation
  • By pledging your organs
  • By 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 Top

1.
Shroff S. Legal and ethical aspects of organ donation and transplantation. Indian J Urol 2009;25:348-55.  Back to cited text no. 1
[PUBMED]  [Full text]  
2.
Hashraj S. Patient's kin hesitant of organ donation. Hindustan Times (Print Edition) 2013.  Back to cited text no. 2
    
3.
Times View, India's rate of organ donation compares poorly with other countries. Time India (Online Edition) 2013.  Back to cited text no. 3
    
4.
Jagga R. Organ donation still not popular in city. Indian Express (Online Edition) 2013.  Back to cited text no. 4
    
5.
Narayan Pushpa TN. Hearts meant for transplant end up in trash. Times India (Online Edition) 2013.  Back to cited text no. 5
    
6.
Bill 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.  Back to cited text no. 6
    
7.
TNN, procedure for organ donation. Times India Goa (Online Edition) 2012.  Back to cited text no. 7
    
8.
Valayapathy R. Tiruchy Doc in Guinness for Largest Awareness Meet. Deccan Chronicle Coimbatore Edition; 03 October, 2017. p. 3.  Back to cited text no. 8
    
9.
Express News Service. Cardiologist Earns Guinness Entry with Lecture. India Express Tiruchy Edition; 03 October, 2017. p. 2.  Back to cited text no. 9
    


    Figures

  [Figure 1]



 

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  In this article
   Abstract
  Introduction
   Different Kinds ...
   How to Ask for O...
   Legal Aspects of...
   Process of Pledg...
   Guinness World R...
   Future Outlook A...
  How can you Help?
   Organ Donation a...
   How Long can a D...
   References
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