CHENNAI: Organ transplantation is the only way for survival for people who are in last stages of organ failure. Every year, over 2.5 lakh deaths in India are attributed to organ failure. According to a study the organ donation rate is 0.26 donors per million population, compared to 30 donors per million in western countries. With World Organ Donation Day on August 13, we look at the organ donation scene in the city as well as the teamwork behind saving lives.
There are two types of organ donation — deceased and living donation. Deceased organ donation is when a person is declared brain dead by doctors and is eligible to donate his organs, with family consent. “In India, more than 1.6 lakh people die of road traffic accidents annually, of which 60% have head injury. Potentially, many can donate organs, provided the family agrees,” explains Dr Sunil Shroff, MOHAN (Multi-Organ Harvesting Aid Network) foundation, an NGO promoting organ donation since 1997. “Brain-dead patients can donate eight organs, thus saving eight lives,” he says.
When Sudhakar’s only son Raj unexpectedly met with an accident, he decided to donate his 20-year-old son’s organs. “Instead of going into the ground, my son’s organs will save lives. No parent can handle a child’s death. I agreed for organ donation so that other families don’t have to go through a loss,” he says.
Deceased donors
A vast network of people from various teams race against time to ensure an organ is donated and transplanted properly. Sujatha, programme manager, MOHAN foundation, walks us through the procedure. Once a patient is certified as brain-stem dead, according to the Transplantation of Human Organs Act, a confirmation test has to be repeated after six hours if they’re adults, and 12-24 hours in children. After the first test, doctors inform the family and the transplant coordinators counsel them.
“We need to give them time to grieve and digest the passing of a relative. We broach the subject of organ donation only after a while,” she explains. If the family refuses, they don’t approach again. If they agree, two things have to be coordinated at once — the medical team will confirm the patient is brain dead; the other team of transplant coordinators will inform the police and finalise legal formalities. A forensic doctor needs to confirm that he will not need the organs in question for further post-mortem study.
The co-coordinators inform the Transplant Authority Of Tamilnadu (TRANSTAN), about the potential donor, and according to the allocation policy, they will look into the priority list and inform the potential recipient’s hospital. A team from there, will arrive at the donor hospital, collect samples and do cross-matching. “I coordinate with the recipient team, about feasible retrieval times based on the time for each organs,” she says.
Once organs are retrieved, each organ has its own time — heart and lung four hours, kidneys 24 hours, liver 12 hours. A Green Corridor will be coordinated by the police, the recipient and donor team. “The police marks the easiest route and make way for the transport vehicle,” she says. After retrieval, the deceased will be sent to the mortuary, and handed over to the family.
Living donors
Living donation of certain organs such as the liver and kidney are also possible. Recently a city-based entrepreneur, Prasanna Gopinath, reached out to a friend, Puja, who had chronic liver disease for 17 years. He donated half his liver. “I don’t think there is anything more important in life than saving a life. I had no hesitation, and was very clear about the decision,” he says.
The operation was completed in July, and both Prasanna and Puja are recovering well. “As a society, we need to start thinking beyond our own family. Organ donation is absolutely fine; you will have to recover for a few months, post-surgery, but that’s about it,” he re-affirms, adding that his family was supportive, his mother also having donated a kidney earlier.
Over the years, there has been increased awareness of organ donation because of the work of the government and NGOs, who have broken myths and misconceptions that prevail around organ donation. “Tamil Nadu has 15 organ donors per million, which is on par with some countries abroad. More awareness and improvement in infrastructure will aid more,” says Dr KR Balakrishnan, chief cardiothoracic & transplant surgeon, Fortis Malar Hospital. With more people signing up for organ donation, there is hope that more lives will be saved for every loss.