Organ Donation and Challenges Sanjay Dubey IAS Divisional

Organ Donation and Challenges Sanjay Dubey, IAS Divisional Commissioner, Indore http: //organdonationindore. org/ 1

Organ Need and Transplant Kidney – 2, 000 v/s 5000 Heart – 50, 000 v/s 100. Liver – 50, 000 v/s 750. Eyes – 50, 000 per year. Skin – no count http: //organdonationindore. org/ 2

Organ Donation Rate (India) 2015 (source: Indian transplant news letter) State/city No of donors ODR(pmp) Tamil Nadu 155 2. 1 Kerala 76 2. 3 Telangana &AP 98 1. 2 Maharashtra 60 0. 5 Karnatka 60 1. 0 Gujrat 45 0. 7 Chandigarh 33 37. 0 Delhi-NCR 14 Pudduchery 9 7. 2 Rajasthan 7 0. 1 Uttar Pradesh 4 MP 2 http: //organdonationindore. org/ 1 3

Southern- Western strip Screen Shot 2017 -07 -05 at 2. 32. 23 PM http: //organdonationindore. org/ 4

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Challenges a. Ethical. b. Moral. c. Financial. d. Administrative. http: //organdonationindore. org/ 14

Formation of Organ Donation Society 1. Registered Society in Feb 2014. 2. Govt officials as Ex officio members. 3. NGOs, Individuals & others. 4. Launched its website http: //organdonationindore. org/ 15

Organ Donation website -Aim 1. Awareness. 2. Registration of Donors & Recipients. 3. Matchmaking. 4. Transparency http: //organdonationindore. org/ 16

Dismantling of Bureacatic Barrier for Cadaver donation a. 24 x 7 body receipt b. Checklist for non acceptance c. Immediate Death certificate issuance d. No requirement of NOC http: //organdonationindore. org/ 17

Preparation for Organ Donation 1. Delegation of Power to Dean by state government. 2. Registration of Hospital by Appropriate Authority. 3. Registration of Doctors. 4. Recognition of BSD teams http: //organdonationindore. org/ 18

Training and awareness a. Counsellors. b. Institutions. c. NGO’s d. Physicians. e. IMA. f. Schools & Children. http: //organdonationindore. org/ 19

Minimising the Bureaucratic hurdles for organ donation 1. Multi deptt team onboard 2. PM in the private hospitals 3. Waiver of NOC from Police 4. Single table clearance 5. Creation of ‘Green Corridor’ http: //organdonationindore. org/ 20

Stakeholders-Green Corridors Donor Police Doctors Traffic Police Green Corridor CISF Hospital Airlines Recipient Airport Authority http: //organdonationindore. org/ 21

Race Against Time……. • First BS Declaration • Second BSD declaration • Consent of family members • Information to NOTTO and ROTTO • Confirmation of requirement http: //organdonationindore. org/ 22

Steps contd…. . • Organising the team of doctors to fly in • Scheduling their inward journey and return • Priortising the retrival • Family’s concern is also to be taken care • Coordination with authorities http: //organdonationindore. org/ 23

Achievements 1. Donating excess bodies to Medical colleges 2. Saved more than 130 lives 3. More than 10000 donation pledges 4. Facility for liver and heart transplant established 5. Cost of surgery is reduced and availability is increased http: //organdonationindore. org/ 24

Policy suggestions- state govt … 1. Organ donation topic is taught in MBBS prof II 2. Compulsory sharing of information about death in ICU 3. Policy of giving weightage based on the urgency be made transparent. 4. Centralised list of recipients amongst city hospitals 5. 5. Health insurance coverage to 2 family members http: //organdonationindore. org/ 25

Policy suggestions - central govt … 1. ‘Opt out’ option to citizens 2. Streamlining the system of unclaimed body donation 3. Government hospitals to be given priority in receiving organs 4. Swap transplantation to be encouraged. 5. Close relatives of donors to get priority over others http: //organdonationindore. org/ 26

Thanks……. . Created By: Indore Society for Organ Donation http: //organdonationindore. org/ 27

What Next ? 1. Bone Marrow Transplant 2. Thalesemic transplants 3. Transplants of Pancreas & Lung 4. Opening of chapters in different cities 5. Heart valve banking and bone banking http: //organdonationindore. org/ 28

Department of Anatomy, MGM Medical College, Indore Under the following Conditions the body will not be accepted for donation CRITERIA YES (1) Death due to infections/presence of the following diseases at the time of death : i. T B – Tuberculosis ii. HIV – AIDS iii. Hepatitis – B & Hepatitis – C iv. Septicemia (servere infection). (2) Post mortem body. (3) After donation of organ (Kidney, Liver, Heart). (4) Edema of body/ body parts(hands, feet, stomach). (5) Bed sore/ non healing ulcer/gangrene. (6) History of uncontrolled diabetes. (7) Death due to cirrhosis of liver. (8) Death due to cancer. (9) Death due to Medico legal case eg: Road trafiic accident, Burns, Suicide, Homicide, suspicious etc. (10) Death due to renal failure. (11) Any sign of petrefaction/decomposition a. Distension of abdomen after death b. Foul smell from body c. Discoloration of the Body. http: //organdonationindore. org/ 29 NO