Why should I become an Organ Donor?
In India, there are over 150,000 people currently in need of kidney transplants. The wait-list for patients with heart and liver failure is growing all the time as well. And each year, thousands of people die while waiting for a transplant, because no suitable donor can be found for them. The need for organ donors has never been greater. It can be hard to think about what's going to happen to your body after you die, let alone donating your organs and tissue. But being an organ donor is a generous and worthwhile decision that can be a lifesaver.
All people can be considered as being potential organ and tissue donors after death. However, the presence of active cancer, active HIV, active infection (for example, sepsis) or Intravenous (IV) drug use would absolutely rule out donation. Patients who have Hepatitis C may still donate organs to a patient who also has Hepatitis C. The same is true for Hepatitis B — but this happens in very rare cases. Most cancer patients may donate corneas.
How does Organ Donation help patients with organ failure?
For organ recipients, a transplant often means a second chance at life. Vital organs such as the heart, pancreas, liver, kidneys and lungs can be transplanted to those whose organs are failing. It allows many recipients to return to a normal lifestyle. For others, a cornea or tissue transplant means the ability to see again or the recovery of mobility and freedom from pain.
How do families of deceased donors cope with their loss?
The act of organ donation has the ability to comfort grieving families. It is always difficult to lose a loved one. Many grieving families of organ donors draw comfort from the fact that their loss may help to save or improve the lives of others.
Studies carried out to understand how a family heals have shown that the support from family members helps a person to overcome grief. The support of friends and religious and cultural beliefs also help donor families. Most of the donor families agreed to donate organs because they felt that it was the only positive outcome from their loss.
What organs and tissues can be donated?
Currently, the following organs can be donated and transplanted:
Heart - A muscular organ that pumps blood through the body. Heart transplant is used to help those suffering from heart failure and babies born with heart defects.
Liver - A large organ that secretes bile and is active in the formation of certain blood proteins and in the metabolism of carbohydrates, fats, and proteins. Liver transplant is used to treat various conditions which cause liver failure, such as cirrhosis or liver cancer.
Kidneys - A pair of organs that maintain proper water and electrolyte balance, regulate acid-base concentration, and filter the blood of metabolic waste, which is excreted as urine. A kidney transplant may be recommended for those who have been diagnosed with end stage kidney disease.
Lungs - A pair of spongy organs that remove carbon dioxide from the blood and provide it with oxygen. Lung transplants are recommended for those with severe lung disease. Sometimes there is a combined heart and lung transplant.
Pancreas - A long, irregularly shaped gland which lies behind the stomach and aids in the digestion of proteins, carbohydrates, and fats. Pancreas transplant is indicated for those with insulin-dependent Type I diabetes.
Tissues that can be donated are:
Cornea - The outer curved transparent tissue covering the iris and pupil on the outside of the eye. Corneal transplant is a common procedure used to restore vision for those with eye diseases and corneal infections.
Skin - A tissue which protects the body from infection and injury. Skin transplants, referred to as skin grafts, are used to treat severe burns, extensive wounds and skin loss due to infection.
Heart Valves - Tissues that prevent the back flow of blood into the heart. Heart valve transplants are used to treat malfunctioning heart valves caused by infections, birth defects and aging. When an entire heart is not usable, heart valves are removed from the heart and are used for transplants.
Bones - Connective tissues that are dense, semi rigid, porous, and calcified forming the major portion of the skeleton of most vertebrates. Bone transplantation is done for reconstruction related to trauma, tumours, disease and fractures and to fill defects. For the recipient, it restores mobility, decreases pain, prevents amputation and collapse of bone.
Tendons - Tissues which attach muscles to bones. Tendon transplants are recommended for patients who have lost muscle function due to nerve injury or damage to tendons. It improves the recipient’s life and makes it pain free.
Who can become an organ donor?
Either in the case of brain death, or when an individual suffers a cardiac arrest, individuals may share the gift of life with others through solid organ and tissue donation. You may pledge to donate your organs by signing and carrying a Donor Card (available on MOHAN Foundation website). It's also important to tell your family that you want to be a donor. Even if there is documentation that a person was a designated donor, the consent of the family is essential for the organs or tissues to be donated. Hospitals seek consent from the next of kin before taking any action. If you are not an adult (less than 18 years old), then your parents’ consent is required for organ donation. So if you want to become a donor, it’s important to tell them that you wish to donate. Children too are in need of organ transplants, and they usually need organs smaller than those an adult can provide.
The Transplantation of Human Organs Act (1994) and its Amendment (2011) allows the donation of organ and tissues for therapeutic purpose only. The Form 5 of the THO Rules 1995 is the donor card. And Forms 6 and/or 9 are consent forms that the next of kin has to sign before organs/tissues can be retrieved.
What is the value of carrying a donor card when the decision to donate rests with the family after my death?
Donor card works as a bridge of communication.
Donor card serves as an emergency card in the wallet.
It makes you an advocate for the cause.
It is partly a legal document and if the doctor finds one in your purse - they will not hesitate in approaching the family.
Taking consent from next of kin is to ensure safety of the donor - more so with all the corruption sometimes you may have in the system.
If the hospital knows that I have pledged my organs, will it adversely affect my treatment?
Doctors will only focus on saving your life — not somebody else's. You'll be seen by a doctor whose specialty most closely matches your illness. Whether you have pledged to donate your organs or not, there will be no difference in the medical treatment given to you. Organ donation can only occur after brain death has been declared by physicians who are not in any way connected with organ retrieval or the transplant teams. The doctor in charge of your care has nothing to do with transplantation.
In India why is the family so important in case of organ donation?
In many western countries an adult is asked to make a choice if he/she wants to be a donor. In India, this final choice is left to the family. In case of brain death of a person carrying a donor card, the family still needs to approve the donation of organs. Family consent is essential.
Will my family have to pay for the donation?
No. The family of an organ or tissue donor is never responsible for costs related to donation. Your family will be only charged for the cost of all final efforts to save your life. A road traffic accident is the most common cause of brain death in India. The victim is taken to the emergency ward and then into ICU. The cost of the treatment during these crucial times is charged to the patient. Once brain death has been certified and the patient’s family has given consent for organ donation, the costs incurred towards organ retrieval do not go to the patient.
How does my age and health affect organ donation?
The decision to use organs is based on various medical criteria, not age alone. It may be that a few organs are suitable for donation, while others are not. The doctors will decide at the time of death whether a person’s organs and tissues are suitable for transplantation. A few guidelines with regard to age and organ donation:
Upto 100 years: Corneas
Upto 70 years: Kidneys, Liver and Skin
Upto 50 years – Heart and Lungs
Upto 40 years – Heart Valves
Why do I need to tell my family of my decision if I have already recorded my wish to become a donor?
The death of a loved one is a very traumatic time for a family, and knowing the wishes of the deceased makes it easier for them to decide about or accept organ donation. If your family is asked for consent, telling them about your decision to be a donor is the best way to ensure that your wishes are carried out.
The Transplantation of Human Organs Act (THOA), 1994, and its Amendment (2011) allow the donation of organ and tissues for therapeutic purpose only. The Act states that it is mandatory that the next of kin (parents, spouse etc) should agree to donate the organs of a brain dead family member. In order for a deceased organ donation to take place, specific forms are filled and signed. The Form 5 of the THOA Rules is the donor card. Forms 6 and 9 are consent forms that the next of kin has to sign before organs/tissues can be retrieved.
Can I sell my organs?
No. The Transplantation of Human Organs Act makes it ILLEGAL to buy or sell human organs and tissues. Violators are subject to fines and imprisonment. You may feel that selling an organ is your only option and that after selling your organ yours debts will be settled and you can start afresh. But studies have shown that those who have sold their organs in exchange of money to lessen their debt have not done well at all.
It is an offence under Section 19, if a person:
1. Makes or receives any payment for the supply of, or for an offer to supply, any human organ.
2. Seeks to find a person willing to supply for payment any human organ.
3. Offers to supply any human organ for payment.
4. Initiates or negotiates any arrangement of payment related to organ donation.
5. Any advertisement related to inviting persons to supply or offering to supply for payment of any human organ.
6. Preparation or submission of false documents related to organ donation.
Penalty under THOA 1994
Shall be punishable with imprisonment for a term which shall not be less than 2 years but which may extend to 7 years and fine amount of 10000 which may extend to 20000 rupees.
Enhanced Penanlty Under Amendment 2011
Shall be punishable with imprisonment for a term which shall not be less than five years but which may extend to ten years and shall be liable to fine which shall not be less than twenty lakh rupees but may extend to one crore rupees
What is the importance of a donor registry?
A registry is an essential part of understanding who and where potential donors are. A registry gives a planner enough information to devise strategies to get more public cooperation and commitment towards organ donation. Having a registry in place allows doctors and transplant coordinators to check if a brain dead person wished to donate and then approaching the family for consent becomes easier. It helps in saving crucial time in the process of organ donation.
Written by Snigdha Basu | Wednesday February 15, 2017 , Chennai
