Organ Donation Dr Rahul Pandit MD FCICM FJFICM

Organ Donation Dr. Rahul Pandit MD, FCICM, FJFICM, FCCP, DA Senior Consultant Intensive Care Fortis Hospital Visiting Consultant Gosford and Wagga base Hospital Australia

What is Death The Transplantation of Human Organs Act, 1994 (Central Act 42 of 1994), - 'Deceased person' means a person in whom permanent disappearance of all evidence of life occurs, 1. by reason of brain-stem death or 2. in a cardio-pulmonary sense at any time after live birth has taken place. 3. 'brain-stem death' means the stage at which all functions of the brain stem have permanently and irreversibly ceased.

Governed by law • Only Recognized hospitals • Recognized Doctors • Organ distribution managed by ZTCC/SOTTO/ROTTO/NOTTO • NO chance for any mischief as all governed by government

Why Organ Donation

Organ Failure Incidence in India • Around 150, 000 patients on RENAL waiting list 3000 transplants/year • Around 50, 000 heart transplant needed Less than 100/year • Around 100, 000 Liver needed Less than 1000/year

Why do people need transplants? § Inherited genetic condition – Cardiomyopathy (affects the heart) – Cystic fibrosis (affects the lungs) – Bilary atresia (affects the liver) § § § Disease or damage to eyes Congenital defects in young children Severe trauma from accidents leading to organ failure Rheumatic fever and other severe illness or disease Burns can require skin grafts

Anatomy

Causes of Brain Death Normal Cerebral Anoxia

Causes of Brain Death Normal Cerebral Hemorrhage

Causes of Brain Death Normal Subarachnoid Hemorrhage

Causes of Brain Death Normal Trauma

Did you know? § § § The majority of Individual are willing to become organ (78%) and tissue (75%) donors. One organ and tissue donor can transform the lives of 10 or more people. Even if you register as a donor, your next of kin will be asked to confirm your decision. In India the family will always be asked to confirm the donation decision of the deceased before donation for transplantation can proceed. Less than 20% of families give consent for organ and tissue donation to proceed.

• Organ donation rates in India were 0. 05 per million Now has increased to 0. 8 per million

International comparison Spain ~ 35 dpm- Opt out System Australia- 15 dpm- Opt in System

Who can become an organ and tissue donor? § Almost anyone can donate – Allowed 2 years upto 80 years § Don’t assume you are too old, too young or not healthy enough § People who cannot donate organs may still be able to donate tissue § Most religions support organ and tissue donation § Living donors can donate a kidney or partial liver

What can people donate? ORGANS TISSUE KIDNEYS CORNEAS LIVER HEART VALVES HEART PANCREAS ISLETS LUNGS SKIN PANCREAS BONE INTESTINE TENDONS LIGAMENTS

Ask and know your loved one’s donation decision § Ask your friends if they have discussed their donation decision with their next of kin. § Organise a speaking event in your community. § Use facebook, whatsapp etc to promote. . § Discuss with your workplace/sporting organisation about becoming a Gift A Life Friend.