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Organ Donation in India

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Organ Donation in India

What is organ donation?
In organ donation, a person pledges during her/his lifetime, that after death, organ/s from the body can be used for transplantation to help terminally ill patients get a new lease of life. A living will needs to be executed and the family needs to be taken into confidence and convinced for the same. The Family doctor and the nearby hospital also can be informed.

Types of Organ Donation

I. Cadaver/Deceased Donor Transplant:

This kind of transplant involves taking organs from a person who has just died. According to the law, the prerogative on the decision eventually rests with the next of kin of the deceased. The person’s family must first give consent if organs are to be used for transplantation. This type of donation is usually in case of brain dead/ coma patients who have no scope/ chance of recovery and are on ventilator/ artificial life support.

Legal position on organ donations:

Organ donations are legal by Indian law. The Indian government enacted the Transplantation of Human Organs Act (THOA), 1994, which allows organ donation, and legalized the concept of ‘brain death’.

 Brain death:

Brain death is the irreversible and permanent cessation of all brain functions. In situations of brain death, a person cannot sustain his own life, but vital body functions may be maintained in an ‘intensive care unit’ for a short period of time. Such persons are kept on artificial support to maintain oxygenation of organs so that the organs are in a healthy condition until they are removed. Organs of such patients can be transplanted to terminally ill patients.


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By executing a ”Living Will “the intention / decision can be specified that if ever the person executing the will, is in a state where he cannot give consent and is incapable of being revived, how long he/she can be kept on life support and after that if the doctors confirm that he/she cannot be revived, the organs can be donated by the family. In case of unmarried persons the parents are the legal custodians and can give consent. The siblings also may have to give consent if they are majors. In case of married persons the spouse is the key person and major children also need to give consent. A team of doctors usually declare and counsel the family.

Due to social pressures, cultural and religious beliefs the relatives may hesitate and decline, however if the person desirous of donating convinces the family, informs the friends, relatives, the family physician things would be possible without complications. The living will facilitates this. In India this is not very popular but in other countries like U.S. it is widely practiced.

Documents required:

The donor needs to fill a prescribed consent form, which can either be downloaded from the ministry of health and family welfare, government of India (http://mohfw.nic.in/) or accessed from the medical facility that is approached for organ removal. Mohan Foundation,

A written consent form is required from the lawful custodian of the body after the death of the patient in a prescribed application form.

The potential donor can also approach organ donation agencies for a donor card. Although not legally binding, the donor card is a means of expressing ones willingness to donate kidneys and make family more understanding towards the cause.

Points to remember:

A panel of four doctors needs to declare brain stem death twice in a time frame of six hours. These are: the medical administrator in charge of the hospital, an authorized specialist, a neurologist/neuro-surgeon and the medical officer treating patient.

Healthy organs should be transplanted as soon as possible from the donor to the recipient.

The authority to give consent for organ donation lies with the person lawfully in possession of the dead body.

There is neither charge nor payment made on account of organ donation.

 II. Living Donor Transplant

This type of transplant occurs when a living person wishes to donate organs to someone in need. Living donors are usually family members or spouses. All living donors must meet basic medical criteria and undergo a very thorough medical evaluation before being accepted as a suitable donor. The family members related by blood, also the spouse can donate. The risks are explained to the donor and consent is obtained in writing. Incase of mis- match of family member’s organs in case of emergency where the patient cannot wait due to life risk, reciprocity with another patient’s family member( exchange of organs –kidney of patient’s family members)  is permitted after obtaining the Authority/ Medical Board permission. In Hyderabad NIMS – JIVAN DAAN may be consulted for more information.

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What Organs Can Be Transplanted

 Different organs such as heart, liver, kidneys and tissues such as corneas and bone marrow can now be successfully transplanted into patients, who can then expect to survive for years or even decades. It is the treatment of choice for many diseases, but all too often, a suitable organ is not available to meet the ever-increasing demand for transplantation.


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Understanding Brain Death:

Brain death results from a severe, irreversible injury to the brain. All areas of the 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.
A cadaver donation occurs when the family of a patient who has been declared brain dead agrees to donate his or her organs (mainly kidneys and liver). Brain death usually results from a severe brain injury which causes all the brain activity to stop. This can happen after a major road accident or a bleed in the brain due to stroke.

Who is not suitable?

The organs of persons who died due to poisoning, suicide, cancer, chronic diabetic persons, organ failure, are not suitable. Only eyes may be suitable rare cases. Certain other serious medical complications infections, septicemia are not suitable. However the body can be donated to Medical Colleges for the benefit of research and training of Medico’s.

Time:

This is the most important aspect. The organs have to be harvested as soon as within few hours after the death (depending on the organs) otherwise the exercise will be futile. The persons in ICU in brain dead state are the most suitable for donation. The family members need to act really swiftly even though it’s a hard time for the family keeping in view the last wish of the Deceased and to honor the same otherwise the purpose is defeated. The family doctor, the nearest hospital needs to be informed. As the family will be in mental trauma, shock, due to bereavement the friends, neighbors need to play important role in such circumstances.

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III. Organ donation process:
  • Organ Retrieval Banking Organisation (ORBO) coordinates the process of cadaver organ donation i.e. organ donation after death and transplantation.
  • There are two ways to donate organs: –
    1. By pledging for organ donation when a person is alive
    2. By consent of family after death.
  • During lifetime, a person can pledge for organ donation by filling up a donor form in the presence of two witnesses, one of whom shall be a near relative.
  • The organ donor form could be obtained from ORBO either personally or through mail.  It could also be downloaded from our Website (www.orbo.org).
  • The donor form is absolutely free of cost.
  • As mentioned earlier, you need to fill up the donor form and get it signed by two witnesses one of whom shall be a near relative and send the same to ORBO.  
  • After receiving the filled in form, ORBO provides the donor with an organ donor card bearing registration number on it.
  • It is suggested to keep the donor card in your pocket and share your decision with your near and dear ones.
  • If a person expires without registration, the family members can donate his/her organs.  For this they need to sign a consent form, which is provided at that time.
  • Once, the relatives give a written consent, organs are harvested within a few hours.
  • The family of the donor does not face any difficulty or extra burden upon them.
  • The transplant coordination team carries out the entire process till the relatives receive the body of the deceased.
  • The deceased body is given back to the family in a dignified way.
  • There is no disfigurement.  The body can be viewed as in any case of death and funeral arrangements need not be delayed.

IV. Organizations/ NGO’s :  Some of the Organizations operating in this noble service facilitating the great cause are

1.     JIVANDAAN: Govt of Telangana has formulated a comprehensive scheme “Jeevandan” proposed by the Cadaver Transplantation Advisory Committee (CTAC) to encourage and regulate organ transplantation. NIMS, is the designated authority, the scheme, rules, guidelines are available on the website. They conduct programs to train volunteers to facilitate popularize, encourage organ donation. 9459 donors have registered till date. One can register on line in the website to be a registered donor.

 2.      Mohan’s Foundation: www.mohanfoundation.org.

MOHAN Foundation is a NGO that promotes organ donation and transplantation in India since 1997.

3.       Donate Life India: donatelifeindia.org.

4.       Organ India: www.organindia.org.

5.      NOTTO: notto.nic.in  working 24×7 Toll free: 1800114770 National Organ & Tissue Transplant Organization set up by Ministry of Health & Family Welfare.

6.      DOROSO: www.dorso.org.  To boost voluntary organ donation, the website, can now be accessed by Donors, Delhi registered hospitals encountering brain dead persons as a result of road traffic accidents. Voluntary donors will be able to register their names on a website that can now be accessed by Delhi registered hospitals encountering brain dead persons as a result of road traffic accidents.

Organ Donation is a Noble cause and a great act of courage and humanity. One can live after life by through this great act. It is gifting life to someone and helping a family.   They may be gifted with their bread winner, dear mother, precious only child, spouse etc. We cannot choose one’s own birth or death, but choose to donate organs and gift life extend a new lease of life to someone.

Disclaimer: The information provided here is to the best of my belief and reading, understanding of the relevant laws, policies, info available. I have compiled and summarized the information based on my research.  Nothing shall be treated as Advise/authenticated, it is to be followed or used as per individual choice, understanding and one’s own judgment.

Rajeswari Wunnava
Legal Consultant

Editor’s Note: On behalf of iDiya team, I sincerely thank Rajeswari Wunnava for this educating and inspiring article about ‘Organ Foundation’. Feel free to follow Rajeswari on her iDiya profile http://www.idiya.net/rajeswari/

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