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By becoming an organ donor, one person can save the lives of up to eight people and improve the lives of dozens — mothers and daughters, fathers and sons, brothers and sisters — who are desperately in need of a transplant.  ~Barack Obama, 2016 April. World Organ Donation Day is observed on 6 of August annually throughout the world. August is marked as the Organ Donor Month. It is celebrated to encourage people to donate organs.   This article explains What is Organ Donation? Myths and Reality about Organ Donation,How to donate.

Need for Organ Donation

India is struggling with acute shortage of organs. The waiting list for kidneys in Mumbai stands at 3,100, a testimony of the despair every organ-failure patient must feel when told a transplant is the only hope. 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 is estimated that more than a million people suffer with end stage organ failure, but only a handful of 3,500 transplants are performed annually. At least 15 patients die every day waiting for organs and every 10 minutes a new name is added to this waiting list. Undoubtedly, the demand far outstrips the availability of organs. 

In India every year nearly:

  • 500,000 people die because of non-availability of organs
  • 200,000 people die of liver disease
  • 50,000 people die from heart disease
  • 150,000 people await a kidney transplant but only 5,000 get one
  • 1,000,000 lakh people suffer from corneal blindness and await transplant

Nationally, with a population of 1.2 billion people, the statistic stands at 0.08 persons as organ donors per million population (PMP). This is an incredibly small and insignificant number. Image below shows the number of donors in 2015 statewise.

Number of organ donors are very small

Number of organ donors are very small

Almost everyone can be an organ donor, during life and death, irrespective of age and disease (only the presence of active cancer, active HIV or active infection would rule out donation) . To understand the value of an organ donation, look at the recipient who makes a quick turnaround from being confined to a bed to normality. “Whoever imagined that a stranger from Mumbai would save my ailing daughter from Raipur. Such noble gestures, I believe, will make the world a beautiful place to live in,“ said Shruti’s father added. Shruti underwent a liver transplant.  Incidentally, the donor’s liver was split into two, saving the lives of two patients with end-stage liver disease.

What is Organ Donation?

Organ donation is the harvesting of an individual’s organs after he or she dies for the purpose of transplanting them into another person. The person who gives the organs is called a donor while a person who receives the organ is called a recipient.

All of us can be organ donors, irrespective of age, caste, religion, community, current or past medical condition. Children can also be organ donors after taking consent for organ donation from their parents.

However active cancer, active HIV, active infection (for example, sepsis) or Intravenous (IV) drug use are some of the contra-indications. 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.

What are the different types of organ donation?

  • Live Related Donation: Living donation takes place when a living person donates an organ (or part of an organ) for transplantation to another person. The living donor can be a family member, such as a parent, child, brother or sister, grandparent or grandchild (living related donation).
  • Live Unrelated Donation: Living donation can also come from someone who is emotionally related to the recipient, such as a good friend, a relative, a neighbour or an in-law (living unrelated donation).
  • Deceased/Cadaver Organ Donation: The patient has to register in a hospital that does transplants. The patient will be put on a waitlist. As and when the organ from an appropriate deceased donor (brain death) is available, the patient will be intimated.

Which organs can be donated and when?

Vital Organs like heart, liver, kidneys, intestines, lungs, and pancreas can be donated only in case of ‘brain death’. However other tissues like corneas, heart valves, skin, bones etc can be donated only in case of natural death.

When must organs be removed?

Organs must be removed as soon as possible after the determination of brain death, while circulation is being maintained artificially. Tissues may be removed within 12 to 24 hours.

In India why is the family so important in case of organ donation?

In many western countries an adult is asked to make a choice if he/she wants to be a donor. In India, this final choice is left to the family. In case of brain death of a person carrying a donor card, the family still needs to approve the donation of organs. Family consent is essential. The Transplantation of Human Organs Act states that it is mandatory that the next of kin (parents, spouse, etc.) should agree to donate the organs of a brain dead family member.

Following image gives an overview of Organ Donation

What is Organ Donation?

What is Organ Donation?

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 does organ donation help families of deceased donors to 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 wounds heal 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 is a national organ donor registry?

A national registry of potential donors is an enrollment procedure in which people who are willing to donate their organs after their death register themselves and this information will subsequently be used by hospitals on a later date to be able to utilize their organs. The enrollment can be done online on a common portal which is accessible to all the hospitals such that when every potential case of brain death or head trauma that is recorded, the authorities can look up if the given person has ever registered himself/herself as an organ donor.

What is brain death?

Brain death results from a severe, irreversible injury to the brain. All areas of brain are damaged and no longer function due to which a person cannot sustain his/her own life, but vital body functions may be maintained by an artificial support system. This maintains circulation to vital organs long enough to facilitate organ donation. People who experience brain death also donate tissues.

What is cardiac death?

Cardiac death results when the heart and breathing cease to function. All organs and tissues in the body suffer from lack of oxygen, circulation and die. People who have a cardiac death cannot be organ donors however they can donate tissues after death. But they can donate tissues.

Tissue donation after cardiac arrest

Tissue donation after cardiac arrest

What is the difference between brain death and coma?

Coma is a state of deep unconsciousness that occurs because the brain is injured in some way. The brain still functions and this can be seen in the tests that are performed. The person will be able to breathe on his own without the respirator. The brain can heal in state of coma. While brain death is an irreversible condition which results from a severe brain injury or hemorrhage which causes all the brain activity to stop. This can happen after a major road accident or bleeding in the brain due to stroke.

Who certifies that a patient is brain dead?

The Government has specified that a panel of doctors will certify brain death and not a single doctor. The panel consists of:

  1. Doctor in charge of the hospital (medical superintendent)
  2. Doctor nominated from a panel of Doctors appointed by the Appropriate authority
  3. Neurologist/neurosurgeon/intensivist nominated from a panel appointed by the appropriate authority
  4. Doctor treating the patient

Myths and Reality about Organ Donation

Myth No. 1. If I agree to donate my organs, my doctor or the emergency room staff won’t work as hard to save my life. They’ll remove my organs as soon as possible to save somebody else.

Reality. When you go to the hospital for treatment, doctors focus their priority of saving your life — not somebody else’s. The doctor in charge of your care has nothing to do with transplantation.Besides, Organ donation can only be considered after brain death occurs.

Myth No. 2. Maybe I won’t really be dead when they sign my death certificate. It’ll be too late for me if they’ve taken my organs for transplantation. I might have otherwise recovered.

Reality. Although it’s a popular topic in the tabloids, in reality, people don’t start to wiggle a toe after they’re declared dead. In fact, people who have agreed to organ donation are given more tests to determine that they are truly brain dead than are those who haven’t agreed to organ donation.

Myth No. 3. Organ donation is against my religion.

Reality.None of the religions object to organ donation and transplantation. On the contrary, religions endorse ‘giving’ and what bigger form of giving can there be than giving life. If you have any doubts you can consult your religious leader.  Saint Pope John Paul II believed that organ donation was a way of nurturing life when performed in an ethically acceptable way . Pope Benedict XVI who had pledged to donate his organs and even carried the donation card with him

Myth No. 4. I’m under age 18. I’m too young to make this decision.

Reality. That’s true, in a legal sense. But your parents can authorize this decision. You can express to your parents your wish to donate, and your parents can give their consent knowing that it’s what you wanted. Children, too, are in need of organ transplants, and they usually need organs smaller than those an adult can provide.

Myth No. 5. Organ and tissue donation will disfigure my body.

Reality. Organ and tissue donation doesn’t disfigure the body. Donated organs are removed surgically, which doesn’t disfigure the body. Also since the donor’s body is clothed for burial, so there are no visible signs of organ or tissue donation. (For eye donation, an artificial eye is inserted, the lids are closed, and no one can tell any difference – Don’t write this. For bone donation, a rod is inserted where bone is removed. With skin donation, a very thin layer of skin similar to a sunburn peel is taken from the donor’s back. Because the donor is clothed and lying on his or her back, no one can see any difference.

Myth No. 6. I’m too old to donate. Nobody would want my organs.

Reality. There’s no defined cutoff age for donating organs. Organs have been successfully transplanted from donors in their 70s and 80s. The decision to use your organs is based on strict medical criteria, not age. Don’t disqualify yourself prematurely. Let the doctors decide at your time of death whether your organs and tissues are suitable for transplantation.

Myth No. 7. I’m not in the greatest health, and my eyesight is poor. Nobody would want my organs or tissues.

Reality. Very few medical conditions automatically disqualify you from donating organs. The decision to use an organ is based on strict medical criteria. It may turn out that certain organs are not suitable for transplantation, but other organs and tissues may be fine. Don’t disqualify yourself prematurely. Only medical professionals at the time of your death can determine whether your organs are suitable for transplantation.

Myth No. 8. As a Hindu, if I donate organs, I will be born without them in my next birth.

Reality. When a Hindu is cremated, the entire body is consigned to flames and destroyed by fire. As per scriptures, the only element not destroyed is the soul. The physical body does not survive death anyway, so the organs hold no relevance in rebirth as they are destructible. It is the everlasting soul that is reborn.

Myth No. 9. Rich, famous and powerful people always seem to move to the front of the line when they need a donor organ. There’s no way to ensure that my organs will go to those who’ve waited the longest or are the neediest.

Reality. The rich and famous aren’t given priority when it comes to allocating organs. It may seem that way because of the amount of publicity generated when celebrities receive a transplant, but they are treated no differently from anyone else. In fact, what really counts is the severity of illness, time spent waiting, blood type and other important medical information. The organ allocation system is blind to wealth or social status. Factors such as race, gender, age, income, celebrity status are never considered when determining organ recipients.

Myth No. 10. My family will be charged if I donate my organs.

Reality. The organ donor’s family is never charged for donating. The family is charged for the cost of all final efforts to save your life, and those costs are sometimes misinterpreted as costs related to organ donation. Costs for organ removal go to the transplant recipient.

Myth No. 11.People can buy and sell organs

Reality. The ‘Transplant of Human Organs Act’ prohibits any commercial dealing in organs and makes it a punishable offence.

How to donate

Websites for Organ Donation

To be an organ donor, it is important to register by signing up for Organ Donation. Please visit the website mentioned below to register.

  • OrganDonationday.in, https://organdonationday.in/index.php/, an intiative by Kokilaben Dhirubhai Ambani Hospital & Medical Research Institute and Times of India. Kokilaben Hospital is the flagship social initiative of the Reliance Group headed by Anil Dhirubhai Ambani.
  • Mohan Foundation, http://mohanfoundation.org/ MOHAN (an acronym for Multi Organ Harvesting Aid Network) Foundation is an organisation with a very unique mandate. It was established in 1997 with a view to facilitate deceased organ donation and transplant program in India.
  • Shatayu, http://shatayu.org.in/  ‘Shatayu’ a non profit organization- is a public service initiative by Govindbhai C. Patel Foundation, which is supported by Ganesh Housing Corporation Limited. It was evolved with the twofold objective of increasing awareness about organ donation in India, and broadening the mindset of people towards the gift of life.
  • Gift Your organ, http://giftyourorgan.org/. Gift Your Organ Foundation (GYO) is a NGO setup in February 2011 with the primary objective of educating every citizen of our country about deceased organ donation
  • Gift a Life, http://giftalife.org// Gift A Life is a unique initiative supported by the Apollo Institute of Transplants to encourage people to pledge their organs and save countless lives in the process. This public awareness initiative was started in 2010 with the aim if bringing together information and awareness on the issue of organ donation and at the same time connect doctors, citizens, hospitals.
For any queries regarding organ donation, please call – 1800 4193737 (Toll free by MOHAN Foundation)

Process of registering for organ donation

I pledged my organs for donation . Process was simple. I visited  OrganDonationday.in and signed up as the donor by filling the form shown in image below. It was a simple form asking for Name, Age, Address details, Emergency Contact Number, and which organs I want to donate and clicking Submit. That’s it.
Sign up as a organ donor

Sign up as a organ donor

I got an email at my address, from National Registry <info@organdonationday.in>

Dear Kirti,

Thank you for signing up and showing intent to be an Organ Donor. A donor card will be sent to your address directly. You can also download an e-donor card here.

We request you to sign and carry the donor card with you at all times. Please discuss your wish to donate organs with your family and friends and inform them about the same because their consent will be required at the time of donation. We also request you to visit our websites www.organdonationday.in & www.kdah.com and understand the concept of ‘brain-death’ and when organs can be donated.

We would like you to help us in this cause by introducing Organ Donation Day’ to your family and friends and spreading the word about this critical cause. Simply forward this email or share the link below on your favorite forum, blog or social media site to invite your friends to be part of this social cause.

http://organdonationday.in/

Thanks & Regards,
Kokilaben Dhirubhai Ambani Hospital and The Times of India

I then downloaded my e-Donor card, which is shown in image below.
Organ Donor eCard

Organ Donor eCard

We understand it is difficult to think about organ donation when you have just lost a loved one; however organ donation is a generous and worthwhile decision that can save many lives. By donating, each person can save the lives of upto 7 individuals by way of organ donation and enhance the lives of over 50 people by way of tissue donation.

Refwww.organdonationday.in

Quoting Tina Ambani “We must create enough awareness to start a fresh dialogue on the need for organ transplants and the various ways we can fill this gap. Organ donation gives meaning and purpose to our lives -it is a testament that we do not just live for ourselves; we are part of a greater force of humanity . At KDAH, we say , `Every Life Matters.’ When you sign up as an organ donor, you make yours count. Indeed, we are all born with the ability to change someone’s life. Let’s not waste it

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