Organ transplants, especially heart, liver and lungs, are not so common in India at present but the advantages of this treatment are steadily gaining ground in the country with more patients and donors- both live and deceased- coming in favour of this medical facility. People need not worry about organ failures in the future as surgeons could be able to replace it with new ones without much pain. Here, Future Medicine takes a look at the current status of this treatment and its possibilities in our society
By Dr Noble Gratious
Organs and tissue transplant can happen in three situations. First and foremost is live donation which means a healthy person can donate blood, bone marrow, one kidney and a portion of the liver. Other organs like heart, pancreas, lungs and eyes are taken from dead donors, more specifically brain dead. Cornea and skin can be taken even after death, but as early as possible. The tissues which can be stored and used later are cornea, heart valves, blood vessels etc. At present, there are no solid organ banks as many people think.
In brain death situations there is a hope for organ donation.Brain death usually results from a severe brain injury or brain haemorrhage. This can happen after a major road accident or a bleeding in the brain due to stroke. In brain death, there is no possibility of recovery and the patient is clinically and legally dead.
Four doctors should sign the legal certificate. They include the medical practitioner in charge of the hospital, a medical practitioner and a neurologist nominated by the hospital and approved by the appropriate government authority, and the medical practitioner treating the patient.
The first degree relatives of the brain dead patient have to give the consent for organ retrieval in the presence of two witnesses in the prescribed form. In India, we practise a system called ‘required request’. We have to ask for the consent of the relatives (legal possessor of the body) to retrieve organs for transplantation even if they have signed Form 5 (donor card).
The organs have to be retrieved soon after the second brain death declaration because after brain death, somatic death (cardiac arrest) can occur at any time making retrieval of organs impossible. The process may take between 3-9 hours. The hospital takes care of all the logistics and the transplant coordination team carries out the entire process till the relatives receive the body of the deceased. The 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 or changed.
One kidney and a portion of liver can be donated when the person is alive. The live related and live unrelated are the two options. Unrelated donations can happen only after the documents verification and approval by the authorisation committee nominated by the government. Organ donation is the most wonderful legacy you can leave behind.
For promoting deceased organ donation in Kerala, the government launched Mrithasanjeeavani which maintains a list of patients in need of organs and selects them according to the severity of their disease and availability of organs.
For proper maintenance of the waiting list and to ensure unbiased, equitable distribution of harvested organs, a web portal is launched.
Ph: 0471 2528386
(The writer is a Nodal Officer, Mrithasanjeeavani, Kerala Network for Organ Sharing, and Assistant Professor, Thiruvananthapuram Medical College)
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