Urgent need to clear misconceptions and taboo about organ donation

Urgent need to clear misconceptions and taboo about organ donation

Number of organ donors is abysmally low in India

New Delhi, 03 December 2017: According to statistics, every single person can save up to 7 lives by donating organs. Apart from this, at any given point, there are about 8 to 10 potential donors in the ICUs of any major city. Despite this, the number of organ donors in India is abysmally low at about 0.34 persons per million of population. As per the IMA, these statistics indicate the urgent need for people to step in and start donating their organs.

Organ donation is the process of Retrieving or Procuring an organ from a live or deceased person known as a donor. The process of recovering organs is called harvesting. This organ is transplanted into the recipient who needs that organ. There are two types of organ donation: Live Donation and Deceased or Cadaver Donation.

Speaking about this, Padma Shri Awardee Dr K K Aggarwal, National President Indian Medical Association (IMA) and President Heart Care Foundation of India (HCFI) and Dr RN Tandon – Honorary Secretary General IMA in a joint statement, said, “Organ donation is still an unsolved problem in our country. However, there has been a recent amendment to the Organ Transplant Act 2014, according to which it is now compulsory for every doctor to follow mandatory required request for organ donation. Live Donation is from a healthy and living person. This can only be done in the case of a liver or a kidney. When we talk about pledging one’s organs or about organ donation, we talk about deceased organ donation or cadaver organ donation. This is organ donation from a person who has been declared brain dead by a team of authorized doctors at a hospital. A person is said to be brain dead when there is an irreversible loss of consciousness, absence of brain stem reflexes and no spontaneous respiration. Organ donation can even provide someone with a second chance at life. For many, this process is a way to go back to a normal lifestyle, ability to see, freedom from pain, or even the ability to become mobile again.”

The absence of brain stem function is documented by conducting the following five tests: absence of Pupillary reflex response to light; absence of Corneal reflexes; absence of vestibulo-ocular reflex; absence of cranial nerve response to pain; and absence of gag and cough reflexes.

Adding further, Dr Aggarwal, said, “We need to communicate to people that they can live even after death through organ donation. There is also a need to remove myths and misconceptions about organ donation and spread the message around. As per IMA’s policies, 100% IMA members should pledge their organs / tissues after cardiac or brain death.”

Here are some myths about organ donation, demystified.

·         Age is not a barrier for organ donation. Even people above the age of 80 have become organ and tissue donors.

·         There is no requirement to be in perfect health for donation. Even those who smoke, drink or don’t have a healthy diet can donate.

·         Organ and tissue donation do not disfigure the body in any way.

In case of an accident, the doctor will always try to save the life of the victim first. Organ donation is considered as an option only when the person dies due to certain circumstances.

Organ donation can save as many as 7 individuals

New Delhi, 03 September 2017: According to reports, about two lakh Indians require organ donation, but not even 10% get it.[1]While Spain has a donor rate of over 34 per million people, countries such as France, Italy, and the USA stand at 20 to 30 million people. It is sad to note that currently, the rate of organ donation from the brain dead in India stands at 0.08 per million people. As per the IMA, not many Indians have the courage to agree for donating the organs of a family member even once they are confirmed as brain dead or dead.

Organ donation is the harvesting of an individual's organs after he or she dies for transplanting them into another person. Every individual can be an organ donor irrespective of age, caste, religion, community, current, or past medical condition. Children can also become organ donors with consent from their parents. Some contraindications to donation include active cancer, HIV, and infection (such as sepsis) or intravenous drug use.

Speaking about this, Padma Shri Awardee Dr K K Aggarwal, National President Indian Medical Association (IMA) and President Heart Care Foundation of India (HCFI) and Dr RN Tandon – Honorary Secretary General IMA in a joint statement, said, “Organs such as the heart, liver, kidneys, intestines, lungs, and pancreas are donated only in cases of 'brain death' as these are vital organs. Upon natural death, tissues such as corneas, heart valves, skin, and bones can be donated. Organ donation can save the lives of upto 7 individuals and tissue donation can save the lives of another 50. Organ donation can even provide someone with a second chance at life. For many, this process is a way to go back to a normal lifestyle, ability to see, freedom from pain, or even the ability to become mobile again.”

Brain death happens due to a severe, irreversible injury to the brain. In this condition, all areas of the brain are damaged and do not function, as a result of which the person cannot sustain his/her life. However, it is possible to continue vital body functions through an artificial support system, which helps in maintaining circulation to vital organs, long enough to facilitate organ donation.

Adding further, Dr Aggarwal, said, “The need of the hour is to make people aware about the need for organ donation and spread the message around. This will also help in removing misconceptions about donating organs. As per IMA’s policies, 100% IMA members should pledge their organs / tissues after cardiac or brain death.”

Here are some points clearing myths about organ donation.

·  Age is not a barrier for donating. Even people above the age of 80 have become organ and tissue donors.

·  One does not have to be in perfect health to become a donor. Even those who smoke, drink or don’t have a healthy diet can donate.

·  Organ and tissue donation do not disfigure the body in any way.

·  In case of an accident, the doctor will always try to save the life of the victim first. Organ donation is considered as an option only when the person dies due to certain circumstances.

x

Required Request in Every Death: “Puchna mat Bhulo”

Required Request in Every Death: “Puchna mat Bhulo” Dr KK Aggarwal National President IMA IMA is committed to promoting eye and organ donation. To this end, IMA will launch a campaign at branch and state levels called “Puchna Mat Bhulo” to promote “mandatory required request’. All IMA members should, in case of routine death, request the relatives or legal heirs for donation of eyes (in case of death) and organs (in case of brain death). As per Transplantation of Human Organs and Tissues Rules, 2014 any doctor in ICU in a situation of brain stem death, in consultation with transplant coordinator (if available) shall ascertain from the next of kin or the legal heir of the body whether the dead person, while he was alive, had authorised for donation of his or her organs either by filling form 5 or in driving license. If yes, then the RMD is duty bound to request the next of the kin or the legal heir to submit the aforesaid authorisation and sign the declaration/authorisation. Also the doctor SHALL ascertain, after certification of brain stem death of the person in ICU from his or her adult near relative or, if near relative is not available, then, any other person related by blood or marriage, and in case of unclaimed body, from the person in lawful possession of the body the following (a) whether the person had, in the presence of two or more witnesses (at least one of who is a near relative of such person), unequivocally authorised before his or her death as specified in Form 7 or in documents like driving license, etc. wherein the provision for donation may be incorporated after notification of these rules, the removal of his or her organ(s) or tissue(s) including eye, after his or her death, for therapeutic purposes and there is no reason to believe that the person had subsequently revoked the aforesaid authorisation; (b) where the said authorisation was not made by the person to donate his or her organ(s) or tissue(s) after his or her death, then the registered medical practitioner in consultation with the transplant coordinator, if available, SHALL make the near relative or person in lawful possession of the body, aware of the option to authorise or decline the donation of such human organs or tissues or both (which can be used for therapeutic purposes) including eye or cornea of the deceased person and a declaration or authorisation to this effect shall be ascertained from the near relative or person in lawful possession of the body as per Form 8 to record the status of consent, and in case of an unclaimed body, authorisation shall be made in Form 9 by the authorised official as per sub-section (1) of section 5 of the Act; (c) after the near relative or person in lawful possession of the body authorises removal and gives consent for donation of human organ(s) or tissue(s) of the deceased person, the registered medical practitioner through the transplant coordinator shall inform the authorised registered Human Organ Retrieval Centre through authorised coordinating organisation by available documentable mode of communication, for removal, storage or transportation of organ(s) or tissue(s). • "Mandatory" or required request for donation of the organs of patients dying in hospitals is likely to increase the rate of organ harvest and will alleviate the critical shortage of transplantable organs. • “Required request” or “required referral” is defined as “that it shall be illegal, irresponsible and immoral to disconnect a ventilator from an individual who is declared dead following brain stem testing without first making proper enquiry as to the possibility of that individual's tissues and organs being used for the purposes of transplantation”. • IMA policy is that in every death, the doctor should explore about corneal donation. India needs 2 lakh donor eyes per year to take care of corneal blindness. One is able to collect only 25,000 donor eyes per year. For every 1000 population, 7.89 persons die every year. If request is made for eye donation at the time of death and even if 1% people of total deaths donate eyes, one will be able to cover the shortage. IMA Slogans #Puchna mat bhulo: IMA policy is that in every death, the doctor shall explore about corneal donation. #Puchna mat bhulo: India needs 2 lakh donor eyes per year and only collects 25,000 donor eyes. #Puchna mat bhulo: For every 1000 population 7.89 persons die every year. #Puchna mat bhulo: Required request, it is illegal, irresponsible & immoral to disconnect a ventilator from a patient declared brain dead without enquiring possibility of that patients tissues and organs donation #Puchna mat bhulo: IMA member SHALL make the near relative or person in lawful possession of the body, aware of the option to authorise or decline the donation of human organs or tissues or both #Puchna mat bhulo: All IMA members should, in case of routine death, request the near relations for corneal and whole body donation and in situations with brain stem death for organs donations. #Puchna mat bhulo: As per Transplantation of Human Organs and Tissues Rules, 2014: Required request is mandatory.

Organ Donation Awareness must start in Schools

Organ Donation Awareness must start in Schools
Dr Harsha Jauhari, Recipient of Dr BC Roy National Award in conversation with Dr KK Aggarwal How does it feel to be conferred with one of the most prestigious awards in the medical field? Many professionals have been working tirelessly and selflessly in the field of Transplantation. I can only humbly accept this award on their behalf.
Tell me about your journey so far.
After graduating from AFMC (Pune) in 1972, and completing my MS in General Surgery in 1976, from GSVM Medical College, Kanpur, I went to UK, where after FRCS, I underwent training, at the Institute of Urology, London, in Transplantation Surgery, which was still in a nascent stage. 
I came back to India in 1988 and set up Transplant Centers in three states, first at Sir Ganga Ram Hospital, New Delhi, followed by one at Noida Medicare Center, Noida, UP and then at Artemis Healthcare Institute, Gurgaon.
What has been your experience regarding kidney transplants.
I have been involved in almost 5000 kidney transplants and have pioneered transplant in diabetes, post-CABG, HBsAg-positive and hepatitis C patients. I have also been instrumental in a number of surgical innovations, which are now standard practice.
Academically, I have presented and authored over 100 National as well as International Lectures and Presentations. I started the Transplant Program at Dr Ram Manohar Lohia Hospital in New Delhi. I have also trained a number of Postgraduate students in Transplant Surgery, who have then started their own programs.
You were appointed by Hon’ble Delhi High Court to review the provisions of the Transplantation of Human Organ Act (THOA) 1994. Please illuminate.
Yes, I was appointed by the Hon’ble Delhi High Court to review the provisions of the Transplantation of Human Organ Act, (THOA) 1994. Many of the recommendations, including creation of National Organ Transplant Programme (NOTP), were accepted and are now being implemented. I was also a member of a large member of Expert Committees on Transplants & Nephrology at Union Ministry of Health & Family Welfare.
I am serving as a Technical Advisor (Organ Transplant) to Union Ministry of Health & Family Welfare, since August 2014 and helping to create, develop and operationalize the National Organ & Tissues Transplant Organization (NOTTO). I have been the President of the Delhi Nephrology Society and presently, I am President of Association of Surgeons of India (Delhi Chapter).
Tell me about your family.
My wife is a professor of English and I have two children, both of whom are lawyers.
If you had to give a message to the community, what would it be? My message to the community is very simple. It’s a one-line message: “Ang Daan Jeevan Daan / Donate Organs, Save Lives”.
Given a chance, what changes would you like to bring about in health policies?
I have been involved in many changes in organ transplant over the years. I would like to include a lecture or two, on Organ Donation in schools and colleges, to create awareness.