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Organ Donation

Organ Donation in India

Statistics suggest that about 150,000 people in India are waiting for a kidney transplant; however, only 3000 of them receive of them are able to receive a transplant. Only 1 out of 30 people who need a kidney receives one. 90% of people in the waiting list die without getting an organ.

Fifteen years after India passed the Transplantation of Human Organs Act, allowing organ retrieval from the brain-dead patients, kidney donations by live donors remain very much in vogue and, according to a recent study, the country sees more such transplants than any other country in the world barring the US.

India, however, slips to the 40th rank in the study of 69 countries in terms of number of transplants per million population, with only three in a million getting the kidney in case of a renal failure. According to a report in the Kidney International—the journal of the International Society of Nephrology—about 27,000 related and unrelated living kidney donor (LKD) transplants occur worldwide every year, of which 6,435 take place in the US and 1,768 in Brazil with India figuring in between with about 3,200 transplants, a number which the authors said, doesn’t represent “reliable national data”.

The number of transplants per year to be in the range of 3,000-3,500, with barely 5% coming from the brain-dead. The annual requirement is about 150,000.

Cadaver organ donation in India

Spain has the highest number of organ donation rate from brain dead patients in the world at 33 per one million population. In India our current organ donation rate is 0.05 per million (about 50 Cadaver donors per year). However if we can improve it even to 1 per million donation - we could take care of some of the organ shortages in India and this is how the arithmetic's would work:

  • At 1 per million donation rate we would have 1100 organ donors which would take care of almost all current demands for organs in India.
  • At 2 per million donation rate there would be 2200 organ donors and there would be no necessity to undertake living kidney donations.
  • If we reach 3 per million, we could take care of demand for organs for all SAARC countries.
  • At 5 per million we would have 10,000 kidneys, 5000 hearts and 5000 livers and we could start looking at the problem of organ shortage in rest of Asia and other parts of the world.

Organ Donations: The Statistics

  • Spain has 35 organ donors per million people
  • Britain has 27
  • US has 26
  • Canada has 14
  • Australia has 11
  • India's count of organ donors stands at 0.16 per million population

People waiting for transplant:

  • In Mumbai: Kidney: 2955 & Liver: 187 (ZTCC) & Corneas: 500
  • In Maharashtra, 10,000 for corneas approximately (as there is no common waiting list)

Cadaver donations in Mumbai:

  • 32 hospitals are ZTCC Members & out of that 10-12 hospitals are active in identifying cadavers
  • In 2013: 20 Cadavers were identified (19 in private hospitals and 1 in public hospitals) .12 hospitals contributed to donations
  • In 2012: 26 Cadavers were identified (24 in private hospitals and 2 in public hospitals). 9 hospitals contributed to donations
  • In 2011: 9 Cadavers were identified (9 in private hospitals)
  • One deceased donor can save up to eight lives through organ donation and can save and enhance more than 100 lives through the lifesaving and healing gift of tissue donation.


Why should I become an organ donor?

In India, an estimated 200,000 people reach end-stage renal failure each year, 100,000 reach end-stage liver failure and around the same number for heart. In contrast, only 3,500 renal transplants are performed every year, about 400 liver transplants and only a handful of heart transplants.

The rest die waiting for a transplant in the absence of suitable matching organ. India currently has a deceased(cadaveric) donation rate of 0.16 per million people and lags far behind the US, where the cadaver donation rate has reached 26 per million people in 2012.Also Spain has the highest rate of organ donation from brain dead patients in the world at 35 per million population.

And each year, thousands of people die while waiting for a transplant, because no suitable donor can be found for them. The need for organ donors has never been greater. It can be hard to think about what's going to happen to your body after you die, let alone donating your organs and tissue. But being an organ donor is a generous and worthwhile decision that can be a lifesaver.

All people can be considered as being potential organ and tissue donors after death. However, the presence of active cancer, active HIV, active infection (for example, sepsis) or Intravenous (IV) drug use would absolutely rule out donation.

Patients who have Hepatitis C may still donate organs to a patient who also has Hepatitis C. The same is true for Hepatitis B — but this happens in very rare cases. Most cancer patients may donate corneas.

Who can be organ donors?

Every adult can be an organ donor. (during life and after death). Children can be organ donors (only after death and only with consent of the parents).

How does organ donation help patients with organ failure?

For organ recipients, a transplant often means a second chance at life. Vital organs such as the heart, pancreas, liver, kidneys and lungs can be transplanted to those whose organs are failing. It allows many recipients to return to a normal lifestyle. For others, a cornea or tissue transplant means the ability to see again or the recovery of mobility and freedom from pain.

How do families of deceased donors cope with their loss?

The act of organ donation has the ability to comfort grieving families. It is always difficult to lose a loved one. Many grieving families of organ donors draw comfort from the fact that their loss may help to save or improve the lives of others.

Studies carried out to understand how a family’s heals have shown that the support from family members helps a person to overcome grief. The support of friends and religious and cultural beliefs also help donor families. Most of the donor families agreed to donate organs because they felt that it was the only positive outcome from their loss.

What organs and tissues can be donated?

Organ recipients are selected based primarily on medical need, location and compatibility. Organs that can be donated after death are the heart, liver, kidneys, lungs, pancreas and small intestines. Tissues include corneas, skin, veins, heart valves, tendons, ligaments and bones. The cornea is the most commonly transplanted tissue. A healthy person can become a ‘living donor’ by donating a kidney, or a part of the liver, lung, intestine, blood or bone marrow.

Currently, the following ORGANS can be donated and transplanted:
Heart: A muscular organ that pumps blood through the body. Heart transplant is used to help those suffering from heart failure and babies born with heart defects.
Liver: A large organ that secretes bile and is active in the formation of certain blood proteins and in the metabolism of carbohydrates, fats, and proteins. Liver transplant is used to treat various conditions which cause liver failure, such as cirrhosis or liver cancer.
Kidneys: A pair of organs that maintain proper water and electrolyte balance, regulate acid-base concentration, and filter the blood of metabolic waste, which is excreted as urine. A kidney transplant may be recommended for those who have been diagnosed with end stage kidney disease.
Lungs: A pair of spongy organs that remove carbon dioxide from the blood and provide it with oxygen. Lung transplants are recommended for those with severe lung disease. Sometimes there is a combined heart and lung transplant.
Pancreas: A long, irregularly shaped gland which lies behind the stomach and aids in the digestion of proteins, carbohydrates, and fats. Pancreas transplant is indicated for those with insulin-dependent Type I diabetes.

TISSUES that can be donated are:
Cornea: The outer curved transparent tissue covering the iris and pupil on the outside of the eye. Corneal transplant is a common procedure used to restore vision for those with eye diseases and corneal infections.
Skin: A tissue which protects the body from infection and injury. Skin transplants, referred to as skin grafts, are used to treat severe burns, extensive wounds and skin loss due to infection.
Heart Valves: Tissues that prevent the back flow of blood into the heart. Heart valve transplants are used to treat malfunctioning heart valves caused by infections, birth defects and aging. When an entire heart is not usable, heart valves are removed from the heart and are used for transplants.
Bones: Connective tissues that are dense, semi rigid, porous, and calcified forming the major portion of the skeleton of most vertebrates. Bone transplantation is done for reconstruction related to trauma, tumours, disease and fractures and to fill defects. For the recipient, it restores mobility, decreases pain, prevents amputation and collapse of bone.
Tendons: Tissues which attach muscles to bones. Tendon transplants are recommended for patients who have lost muscle function due to nerve injury or damage to tendons. It improves the recipient’s life and makes it pain free.

How do I pledge to become a donor?

Either in the case of brain death, or when an individual suffers a cardiac arrest, individuals may share the gift of life with others through solid organ and tissue donation.

You may pledge to donate your organs by signing and carrying a Donor Card. These cards are available with our transplant coordinators on 2nd floor, Transplant Coordination Unit. It is also important to tell your family that you want to be a donor. Even if there is documentation that a person was a designated donor, the consent of the family is essential for the organs or tissues to be donated. Hospitals seek consent from the next of kin before taking any action.

If you are not an adult (less than 18 years old), then your parents’ consent is required for organ donation. So if you want to become a donor, it’s important to tell them that you wish to donate. Children too are in need of organ transplants, and they usually need organs smaller than those an adult can provide.

The Transplantation of Human Organs Act (1994) and its Amendment (2011) allows the donation of organ and tissues for therapeutic purpose only.

If the hospital knows that I have pledged my organs, will it adversely affect my treatment?

Doctors will only focus on saving your life — not somebody else's. You'll be seen by a doctor whose specialty most closely matches your illness. Whether you have pledged to donate your organs or not, there will be no difference in the medical treatment given to you. Organ donation can only occur after brain death has been declared by physicians who are not in any way connected with organ retrieval or the transplant teams. The doctor in charge of your care has nothing to do with transplantation.

Myths and Facts about Organ Donation

Myth: There are certain things that can keep me from being an organ donor such as age, illness or physical defects.
FACT: Each person’s medical condition is evaluated at the time of their death to determine what organs and tissues are viable for donation. People living with chronic diseases or those who have a history of cancer or other serious diseases are still encouraged to join the donor registry.
All people can be considered as being potential organ and tissue donors after death. However, the presence of active cancer, active HIV, active infection (for example, sepsis) or Intravenous (IV) drug use would absolutely rule out donation.
Patients who have Hepatitis C may still donate organs to a patient who also has Hepatitis C. The same is true for Hepatitis B — but this happens in very rare cases. Most cancer patients may donate corneas.

Myth: If doctors know that I am registered to be an organ or tissue donor, they won’t work as hard to save my life.
FACT:The first priority of a medical professional is to save lives when sick or injured people come to the hospital. Organ and tissue donation isn’t even considered or discussed until after death is declared. Typically, doctors and nurses involved in a person’s care before death are not involved in the recovery or transplantation of donated corneas, organs or tissues.

Myth: If you are rich or a celebrity, you can move up the waiting list more quickly.
FACT: Severity of illness, time spent waiting, blood type and match potential are the factors that determine your place on the waiting list. A patient’s income, race or social status is never taken into account in the allocation process.

Myth: After donating an organ or tissue, a closed casket funeral is the only option.
FACT: Organ procurement organizations treat each donor with the utmost respect and dignity, allowing a donor’s body to be viewed in an open casket funeral.

Myth: My religion doesn’t support organ and tissue donation.
FACT: Most major religions support organ and tissue donation. Typically, religions view organ and tissue donation as acts of charity and goodwill. Donor Alliance urges you to discuss organ and tissue donation with your spiritual advisor if you have concerns on this issue.

Myth: My family will be charged for donating my organs.
FACT: Costs associated with recovering and processing organs and tissues for transplant are never passed on to the donor family. The family may be expected to pay for medical expenses incurred before death is declared and for expenses involving funeral arrangements.

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