What is organ donation Removing healthy organs or

What is organ donation • Removing healthy organs or tissues from a ‘live’ or ‘recently dead’ person to be used in another person

Need of the hour In India 1000000 and counting Are in need of organs

Commonly donated organs Skin and bones

Organ Donation • Somatic Death • Home - Eyes , Skin • Hospital - Eyes, skin, bone • Brain Death • Heart, Lung, Kidney, Liver, Pancreas • Live donors Blood, Liver, Kidney, Lung

Organ Donation Issues in India Community Problem No Awareness of “Brain Death” Concept, Misconcepts Hospital problem maintain Govt. Problem No efforts to identify & “Brain Dead” donors No Funding for programme No Interest

Organ Donation • Dealing with Community • Mass education by all possible medium • “ Nicholas Green Effect”

Organ Donation Community issues • • Relatives of donor – emotional stress Refuse to accept sudden event Pain of their loved ones death does not disappear Positive aspect : Comfort of loved ones gift gave other person second chance of life

Organ Donation Community issues • Encouraging people to donate organ 50% relatives will agree for donation of some organs – Rituals possible – No disfigurement of diseased – Encouraging community leaders and icons to speak about organ donation – Awareness through cinema theaters

Can an 85 year old person still be a donor? • YES! • the oldest organ donor on record was a 92 -year old woman whose liver was successfully transplanted by surgeons in London, ON • the age of the organ donor does not dictate who gets the organ – as long as the organ is healthy, it is offered to the patient next on the list • eye donation can occur in individuals up to 100 years of age ORGAN TRANSPLANT - INDIA 9

Can someone with diabetes still be a donor? • YES! • diabetes is not a barrier to donation although it may limit which organs can be donated • each organ is assessed separately and its suitability for donation determined • with diabetes, the kidneys and heart often are not suitable but this is not always the case ORGAN TRANSPLANT - INDIA 10

Can someone who wears glasses still be a donor? • YES! • not only can you donate your organs, you can still donate your eyes as well – wearing glasses does not mean your eyes are unsuitable for transplant! ORGAN TRANSPLANT - INDIA 11

Can someone who has had cancer still be a donor? • YES and NO • a benign, non-transmissible cancer is not considered a contra-indication to donation • a malignant cancer with the possibility of transmission to recipients is a contra-indication to donation ORGAN TRANSPLANT - INDIA 12

Can someone with HIV still be a donor? • NO! • when there is any risk of transmitting a fatal disease from a donor to transplanted recipients, the organs are NEVER used ORGAN TRANSPLANT - INDIA 13

Can someone who died under suspicious circumstances still be a donor? • YES! • if the cause of death is known • coroner’s consent is required and may be restricted to certain organs and tissues and may involve a time limit ORGAN TRANSPLANT - INDIA 14

Who can donate? • everyone who supports organ and tissue donation and transplantation is encouraged to express their intention to do so • at the time of death and following consent to donate, transplant teams will determine the suitability of the organs and tissues for transplant ORGAN TRANSPLANT - INDIA 15

How Do I Express My Intent to Donate? • varies between states • • The green most states – donor card ribbon is an international NGO – ILF, MKF, NKF , ZTCC, MF etc symbol of organ Motor Driving License and tissue in all cities, physicians will talk to donation. your next-of-kin at the time of death • talk to your family and let them know your wishes ORGAN TRANSPLANT - INDIA 16

Frequently Asked Questions • If donation occurs, is a funeral still possible? – Yes – the only way people will know that donation occurs is if the family chooses to tell them. • Are any religions against donation? – All of the major religions in India support donation. • If I have a signed donor card, will doctors bother to try to save my life after an accident? – YES -Definitely! – every effort will be made to first save your life – your well-being is the priority. • Is it true that the wealthy and influential get preferential treatment on transplant waiting lists? – Definitely NOT! – in India , all patients are treated equally while on the waiting list. • What if I’m not really dead when donation occurs? – Death is absolute and certain whether or not you become a donor. Donation can only occur if two physicians independent of the transplant team declare you dead. ORGAN TRANSPLANT - INDIA 17

Live Donation due to more people on the waiting list and a severe shortage of organs for transplant – more emphasis is being put on living donation • kidney – most common • living liver donation on the rise • living lung donation – not as common ORGAN TRANSPLANT - INDIA 18

Organ Donation Hospital issues • Hospital and Doctor Issues Underreporting of Brain Death patients Neurologist and Neurosurgeon have to take scientific and factual lead • In Tamilnadu – Declaration of Brain Death has been mandatory in medical colleges. – G. O. No 75 dated 03 -03 -2008

Organ Donation • For cadaveric donation “society remains a crucial aspect in a transplant programme” • Strategies to decrease refusal rates by families include efforts at education – the general population, – Religious heads & opinion leaders – health care workers individually – through the mass media

Promote Organ Donation Among Blood, Skin and Eye Donors • Design promotion programs to facilitate blood donors and families of skin and eye donors • Social appreciation of donors and their families

Organ Donation • Family members presence during Brain death testing • Helps near and dear ones to accept the truth digest the concept of brain death and promots the idea of donating organs and keeping the loved one’s legacy The presence of family during brain stem death testing. Doran M. Intensive Crit Care Nurs. 2004 Feb; 20(1): 32 -7

Organ Conversion Rate in India Current organ donation rate - India is 0. 05 per million population per year If in India - 1 per million donation rate we would have 1100 organ donors – 2200 kidneys, 1000 hearts, 1100 Livers, 2200 Eyes At 3 per million Donation rate we would have 3300 organ donors – 6600 kidneys, 3300 hearts, 3300 Livers, 6600 Eyes At 10 per million donation rate- 11, 000 organ donors 22, 000 kidneys, 11, 000 hearts, 11, 000 Livers, 22, 000 Eyes 20 per million donation rate - 22, 000 organ donors 44, 000 kidneys, 22, 000 hearts, 22, 000 Livers, 22, 400 Eyes Source: Indian Transplant Newsletter Issue no. 19 Feb 2006

Organ Donation • This can be performed only at centers approved for Transplant surgery. • Problem– Need to shift brain death person from one hospital to other. – Loss of organs from small center and peripheral centers.

Organ Donation Organ Shortage is a Crisis…. Ø Ø Ø Ø In india we need to Network and start thinking of sharing resources, expertise and organs Set up Collaborative projects Use Media for Promotion Get Religious heads to Participate Have Transparency in programme Set up regional Transplant co-ordinators Forums Social appreciation of donor family.