Organ Donation In India

Our healthy organs are amongst the most valuable auctions we can donate. For those who are not used to the term, we are speaking about donating our healthy organs when people die, not when they are alive. In this blog, I will try to give you a low down on what Organ Donation actually is; the reasons why you should sign up for it; the different body parts that can be donated; and how the process works in India along with the religious restrictions that are there.

 “After I die if I am buried, I will rot. If I am burnt, I will become ash but if my body is donated, I will live to give life and happiness to many.”

– Professor Amit Abraham

What is organ donation?

Organ donation, in layman’s terms, is the vital practice that allows people to give away their healthy organs after death to people in need, who are medically the right fit for receiving organ transplants. An organ transplant is a process involving replacing the patient’s dysfunctional organ or tissue with a healthy organ from a donor, thus ensuring that the organ can continue to do its job inside the human body. Transplants are a modern medicine marvel which has allowed people to add a few extra years to their lives. Some of the organs that are transplanted include the lungs, liver, heart, and kidneys. It seems like organ donation is a huge force for doing good in the world.

As of 2019, 153,863 organs are transplanted annually in the world and every hour almost 17 transplantations take place. Although impressive, this number is far from enough. As estimated by the World Health Organization, this number represents less than 10% of the global need. Despite endorsements from various celebrities like Selena Gomez (who is herself a recipient of a donation), Priyanka Chopra, and Amitabh Bachchan, there prevails a lack of awareness amongst the public.

Organs that can be donated

A single organ donor can donate up to twenty-five different organs and tissues for transplant. Cumulatively, these organs and tissues have the potential to save eight different lives! Kidneys, the liver, pancreas, lungs, and heart are the usual donatable organs. Donatable tissues include tissues of the eyes, skin, bone, bone marrow, nerves, brain, heart valves, eardrums, ear bones, and blood.

• Kidneys: Both kidneys can be donated by a deceased person. Even a living person can easily donate one kidney to someone and function well for the rest of their life. Of all the organs, the kidneys are the highest in demand and are also the most frequently donated organs. Kidneys can be stored outside the human body for up to 30 hours.

• Liver: A donated liver from a deceased person can further be split into two and transplanted into two different people to save their lives. The liver is the only organ that can grow cells and regenerate. Therefore, a living donor can have a portion of their liver removed to donate to someone, and the rest of the liver will regenerate to almost its full previous size. The liver can be stored outside the human body for up to 12 hours.

• Heart: The heart is one of the most important organs. However, after being retrieved from the donor, a heart can survive only for 4-6 hours.

• Lungs: Single or double-lung transplants can be performed from deceased donors. Moreover, a single lobe from the lungs can be donated by living donors. However, it will not regenerate. Like the heart, the lungs too can only survive for 4-6 hours outside the human body.

• Pancreas: Pancreas of a deceased donor can be transplanted into an ailing patient. Living donors can also donate a part of the pancreas while still retaining functionality. The pancreas can be stored for up to 6 hours outside the human body.

• Intestine: After death, a donor can donate their intestines. A living donor too can donate a part of their intestine, although this is very rare. Like the pancreas, the intestine too can only be stored for up to 6 hours outside the living human body.

HURDLES IN ORGAN DONATION

It is often incorrectly assumed that people do not donate for religious reasons. Religion is often cited as an excuse for the poor rate of organ donation in India. However, contrary to popular belief, religion, no matter which one you follow, does not stop you from donating your organs.

A crippling lack of awareness and a shroud of superstitions that are drawn over the Indian population is other major reasons for the unavailability of organs in the country. According to a National Organ Transplant and Tissue Organization, “There are myths and misconceptions among the general public regarding organ donation. Out of every 100 cases we counsel (counseling families of brain-dead patients), we receive success in only five of them. Most families do not give consent. Some have religious superstitions like in the next birth they won’t get the organ they donate.”

There is also a lack of trust between the patient’s family and the medical professionals. Families are often worried that if they give their consent for donating the organs of the patient, the doctors will not try as hard to save him/her. Needless to say, this is merely a myth and has no factual basis.

Despite such beliefs, no religion explicitly stops its followers from donating their organs. Here are some relevant excerpts from religious texts:

Hinduism: “…….it is said that the soul is invisible, knowing this you should not grieve for the body.” Daan is the act of selfless giving. -Bhagavad Gita, chapter 2:25.

Sikhism: “The dead sustain their bond with the living through virtuous deeds”. -Guru Nanak, Guru Granth Sahib, p 143.

Islam: “Whosoever saves the life of one person would be as if he saved the life of all mankind”. – Holy Quran, chapter 5:32.

Christianity: Sacrifice and helping others are consistent themes in Christianity, which teaches the principle of seeking for others what you hope others would do for you. Teaching of Jesus Christ:- “…. Freely you have received, freely give.”- Mathew, chapter 10:8.

In addition to such taboos, organ donation in India also suffers from infrastructural setbacks such as insufficient transport facilities, a lack of trained experts, high costs of the procedure, lack of transparency in organ allocations, apparent preferential allotment of organs to foreign nationals, and absence of a centralized regulatory organization. The government has taken up several initiatives to overcome these problems such as the establishment of NOTTO and the Green Corridor which has been set up for more efficient transportation. There is still a long way to go and the professional community, as well as the state and central governments, need to fulfill their responsibility to Indian citizens and set up better infrastructure for organ transplantation and donation in the country.

There is an ever-increasing need for organ donation in India which is evident in these alarming statistics: according to the World Health Organization, only about 0.01 % of people donate their organs after death in India (in Western countries these numbers reach 70-80 %). Approximately five lakh people die every year due to the unavailability of organs and the Organ Donation Rate in India is a very low 0.34. A perpetual shortage of organs has led to a huge supply-demand gap and the condition does not seem to be improving any time soon. It is therefore imperative that the people of the country realize the importance of donating their organs and give many a second lease on life.

The primary legislation in the country regarding organ donation and transplantation is the Transplantation of Human Organs and Tissues Act passed in 1994. It aims to regulate the removal, storage, and transfer of human organs as well as prevent organ trafficking. This act identifies brain death as death, allows the transplantation of organs and tissues from living persons and cadavers, and defines the constitution and functions of regulatory and advisory bodies for monitoring transplantation activities. It also lays down the rules and regulations for ethical practice.

How to register (& become) an organ donor in India

Eligibility: Anyone above the age of 18 years can register to be an organ donor in India. It is important to note that the medical condition of a registered donor is only evaluated at the time of transplant.

You can register yourself at the following websites:

#1 NOTTO

National Organ and Tissue Transplant Organization (NOTTO) is a national-level organization set up under the Directorate General of Health Services, Ministry of Health and Family Welfare, Government of India. Visit the official website here.

#2 ROTTO

Following is a list of Regional Organ and Tissue Transplant Organizations:

1. Seth GS medical college and KEM Hospital, Mumbai (Maharashtra). Visit the official website here.

2. Govt. Multispecialty Hospital, Omnadurar, Chennai (Tamil Nadu). Visit the official website here.

3. Institute of PG Medical Education and Research, Kolkata (West Bengal). Visit the official website here.

4. PGIMER Chandigarh (UT of Chandigarh). Visit the official website here.

5. Guwahati Medical College (Assam). Visit the official website here.

#3 NGOs

There are also various non-governmental and non-profit agencies where one can register themselves, these include:

1. MOHAN Foundation (Tamil Nadu). Visit the official website here.
2. Organ Receiving and Giving Awareness Network (ORGAN) India (Delhi). Visit the official website here.
3. Shatayu. Visit the official website here.

Deceased donation: On the occasion that a deceased person is not a registered organ donor, the family or lawful custodian of the individual will need to fill out a consent form at the hospital for organ donation.

Inform your family: Upon registration, you shall receive a donor card. Keep this card with you at all times to let your doctors and family know of your wishes. However, the card is not a legally binding document and your family will still need to give their legal consent. Therefore, it is important that you communicate your wishes with your family.

To be able to contribute to the well-being of others even after death is a great honor and it is our responsibility towards humanity to grab this opportunity, especially in such trying times. So, register yourself as soon as possible and urge your others to do the same!