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A second chance at life
A second chance at life.Organ donation and transplant provides a second chance at life for thousands of people each year.
There are a number of myths associated with organ donation, which need to be addressed to change the existing scenario
Organ donation and transplant provides a second chance at life for thousands of people each year. The growing disparity between the rich and poor, demand for human organs and availability of technology in the country makes the trading of organs a quick means to riches for some and a relief for others.
Invariably organ trade leads to exploitation of the poverty-stricken people by tempting them with financial gains to meet their immediate short-term financial needs.While 2.1 lakh Indians require kidney transplantation annually, only 3000-4000 kidney transplants are done. The situation is not very different in relation to heart transplants. While annually around 4,000–5,000 patients in India require a heart transplant, so far only 100 heart transplants have been conducted across the country. According to the National Programme for Control of Blindness (NPCB) 2012-13 report, only 4,417 corneas were available in 2012-13 against a whopping requirement of 80,000-1, 00,000 per year.
Finding a donor is the critical issue. Lack of awareness and improper infrastructure facilities are the main reasons behind the existing scenario. Administrative hurdles and conservative mindset further affect organ transplant scenario in India. There are number of myths associated with organ donation which need to be addressed to solve this problem. Most Indians generally believe that it is against nature and religion that body parts are mutilated. Some are suspicious that the hospital staff may not work hard to save their lives if they want organs.
The lack of a centralized registry for organ donation acts as another hurdle for people to donate organs or get data about donors. Further, there is a problem of certifying brain deaths as it becomes difficult to convince relatives of patients for organ donation, if they are unaware of it. The Government passed the Transplantation of Human Organ Act (THO) in 1994 which made unrelated transplants illegal and deceased donation a legal option with the acceptance of brain death. Overcoming organ shortage by tapping into the pool of brain-dead patients was expected to curb the unrelated transplant activity.
However, despite the THO Act, neither the commerce has stopped nor have the number of deceased donors increased to take care of organ shortage. The concept of brain death has never been promoted or widely publicized. Most unrelated transplants currently are being done with the approval from an Authorization committee.In 2011, the Government enacted the ‘Transplantation of Human Organs (Amendment) Act, which made provisions for simplifying the procedure for organ donation.
The potential for deceased donation is huge due to the high number of fatal road traffic accidents and this pool is yet to be tapped. At any given time, every major city would have 8–10 brain deaths in various ICUs. Some 4–6% of all hospital deaths are due to brain death. Annually, road accidents account for around 1.4 lakh deaths and of these almost 65% sustain severe head injuries as per a study carried out by AIIMS, Delhi. This means there are almost 90,000 patients who may be brain dead.
While it cannot be said that people don’t want to donate, a major problem is that there are no mechanisms in hospitals to identify and certify brain deaths. What should be done? Signing a donor card is the first step in making your wishes about donation known. While signing a donor card demonstrates one’s desire to donate organ after death, letting the family or friends know about the decision is very important. That is because family members will be asked to give consent for the donation. The decision will be considered final when they give consent.
Vital organs such as heart, liver, lungs, kidneys, pancreas and intestines, and tissues such as corneas, heart valves, skin, bones, ligaments, tendons, veins, etc can be donated in case of brain death. Enhanced awareness among people is needed to encourage people to donate organs.This requires involvement of the civil society, religious leaders and other stakeholders in creating awareness. A comprehensive campaign is indeed the need of the hour.
By H R Keshavamurthy
