Organ Donation

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Many people live longer or enjoy better quality of life as a result of an organs or tissue transplant. Organs that can be transplanted include the kidney, liver, heart, lung and pancreas.

The demand for organs keeps on growing. There are not as many organs and tissues available for transplantation as there are people who need them. Many people die while waiting for a suitably matched organ to become available. If you have discussed you views on organ donation with your family; or carry an organ donor card or written consent, then your organs are more likely to be donated.

Who can donate?

Anyone can choose to donate organs and tissues, after death, for transplantation. Age and medical history are always considered but you shouldn't assume that you are too old or not healthy enough to donate.
If you decide to register as a donor, you can choose which organs and tissues you will donate.
Not all people who die can be organ donors — in fact, only about 1% of people who die in hospital each year may become organ donors. This is because organs for transplantation need to be removed soon after brain death while the heart is still beating, eg in brain injury, road accidents, or stroke.

How do I register as a donor?

In India we do not have an organ donor registry. Anyone can be an organ donor. You can simply leave a statement expressing your wish to donate; and easier still, you can carry an organ donor card.
Talk to your family.
Peoples opinions about organ and tissue donation and transplantation are influenced by their cultural, ethical, spiritual and religious views. This makes it especially important for all citizens to make their own decision about donation. Discussion with your family and friends is a central part of this.
If you die in circumstances where organ and tissue donation are possible, your family will be contacted and asked to consider organ donation.

Everyone is encouraged to:

  • think about organ and tissue donation;
  • talk about it with family and friends;
  • make a decision; and.
  • carry an organ donor card.
  • And you could agree to donate the organs of your near and dear ones in the event of a possibility.

Would my donation be managed carefully without offending my family?

It can be hard to decide about organ and tissue donation if you don't know what would happen and how your family would be cared for during the process. Organ and tissue donation is based on the following ethical principles:

  • Organs and tissues are only removed once the person is dead.
  • Donation is intended to benefit others.
  • No reward or even acknowledgment by those who benefit is expected.
  • A person's wishes about donation are respected. Families are given time to consider and discuss their views.
  • If a close family member objects, donation will not go ahead.

Counseling can be provided at the time of donation or later if the family wishes. The person donating is always treated with respect and dignity. Organs and tissues are allocated fairly, following specific processes for each type of organ or tissue as well as criteria for matching the donation to the recipient.
Health professionals work within a code of ethics and follow professional guidelines. This means that there are standards directing what we do and how we do it.
The family will be supplied with all the information that they need. They will also have access to counseling and other types of support.

We and all hospitals make sure that:

  • accepted medical criteria have been used to confirm death;
  • the necessary consent has been given by the person's next of kin;
  • the process is carried out following standards for hospital practice and the law; and
  • the family has been informed and is supported.

Donation after loss of all brain function

Head injuries, stroke, infections or a long period of time without oxygen (E.g from drowning) may damage the brain so severely that it stops functioning. The person will need the support of a ventilator and other medical treatments while assessments take place.
If the doctors then believe that all brain function has been completely and permanently lost, a series of clinical tests is carried out to confirm what we call brain death. The tests are carried out twice, each time by an experienced doctor.

For a person to be declared dead after loss of all brain function, both doctors who performed the tests must be in agreement that there was no response to every one of the tests and that the loss of function extends to the brain stem, which is involved in vital reflexes (E.g breathing).
Donation may only be considered after the person has been declared dead. In all patients who are brain dead, the heart will stop functioning eventually, usually within 72 hours.

Special care is taken to make sure that the process of organ and tissue donation meets strict safety, ethical and legal requirements.
Family members will be asked:
whether there are circumstances that the person would have wanted taken into account; and
Whether the person may have had a change of mind since registering.
If there is no written or verbal objection to donation or the person had not registered, the family will be given information about the process and asked whether they agree to donation.
Donation will not go ahead without the family's agreement.
If the family agrees, the next of kin will be asked to give consent, which will be recorded. As part of the consent process, he or she will also be asked which organs and tissues may be removed for transplantation.
If the possibility of donation causes the family significant distress, no further discussion will take place.
The donor continues to receive all the care necessary to preserve organ function.

How do they know you are really dead?Organs are only removed for transplantation after a person has died. Death is confirmed by a doctor or doctors who are entirely independent of the transplant team.
Death is confirmed in exactly the same way for people who donate organs as for those who do not.
Most organ donors are patients who die as a result of a brain haemorrhage, severe head injury, or stroke and who are on a ventilator in a hospital intensive care unit. In these circumstances, death is diagnosed by brain stem tests. There are very clear and strict standards and procedures for doing these tests and they are always performed by two experienced doctors.

Can someone who is declared brain dead come back to life?

Brain death can be confusing, particularly for families who are confronted with the sudden death of someone they love because a brain dead person on a ventilator can feel warm to the touch and look 'alive'. The heart still beats and the ventilator is pushing oxygen and air into the lungs making the person's chest rise and fall.
When this happens, some families expect the person they love to be kept on the ventilator in the hope that their condition may improve.
However, to be brain dead is to be actually dead and no improvement or recovery is possible. There is no method to jump-start or revive a brain that has been deprived of blood and whose cells have died.
There is no clinically documented case where a patient who has been declared brain dead following proper procedures, is later restored to a normal life.

The two doctors who certify brain death are:

A not involved in the care or treatment of the patient being certified;
B not in the team of medical practitioners who will remove the organ from the body; and
C not involved in the care or treatment of the proposed recipient of the organ during his hospitalization for the transplant.

Will the medical care of potential organ donors be compromised to expedite the recovery of organs?

Medicine is an ethical profession. No doctor would risk one life to save another. We would like to reassure you that every patient is given full medical care and every chance at survival irrespective of suitability and acceptance of organ donation. Organ donation is only considered after death has been certified as above mentioned.

Would relatives of donors be made to pay for the costs of organ recovery?

The hospital bills for any organ removal-related procedures and tests are not charged to the donor's family. The costs of supporting the medical care of organ donors and any tests done will be borne by the hospital.

How are the organs and tissues removed?

The operation to remove organs and tissues is performed by experienced professionals, with the care and precision of any other operation. The person's body is treated with the same respect and dignity given to a living person, the wound is closed and the body is made to look as normal as possible.

What happens to the organs and tissues?If donated organs and tissues are medically suitable, they are allocated to recipients. Several people may receive organs and tissues from a single donor, depending on what the person wished to donate, their medical condition and the number of suitable recipients at the time.
Allocation is not made on the basis of caste, religion, gender, marital status, social status, disability or age.

What happens afterwards?

What happens after the donation process depends very much on what the family wants. Records of people who donate organs and tissues and who receive transplants are confidential. Hospital staff cannot provide information about the people involved. There is no obligation for the donor family to have any further contact with staff.
However, if the donor family requests it, the donor coordinator will send them information about which organs and tissues were transplanted and how the recipients are progressing.

Why Donate?

1 After death, you'd like to do something to help others in medical need.
2 Once you're dead, you don't need my organs and tissues any more so someone else might as well have them.
3 It may comfort family and friends to know that some good has come from your death.
4 You will continue to live in other people's bodies as their organs long after your death.
5 Waiting lists are long and there is a real need for more organ donors.
6 Transplantation is generally successful and can improve the quality or length of life.

Don't take your organs to heaven; God knows we need them here!

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