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Organ donation Awareness is must - Dr. Vatsala Trivedi



As goes the famous quote of Sir Winston Churchill,

     WE MAKE A LIVING BY WHAT WE GET.. BUT WE MAKE A LIFE BY WHAT WE GIVE.


Dr. Vatsala Trivedi. (Urologist & kidney transplant surgeon)

          

                                             END STAGE ORGAN FILURE is a devastating condition, which commonly affects young adults, who are the bread winners of the family. This situation leaves the family physically, emotionally, & financially drained. If it affects the lady of the house, the family including the children, get totally disintegrated.

                                             The organ failure could affect the kidney, liver, heart, lungs etc. In India about 500,000 people die every year due to various organ failures. There are various reasons for the large numbers of organ failure like uncontrolled environmental pollution, unabated adulteration in food products, rapidly increasing population afflicted by LIFE STYLE disorders like diabetes, High blood pressure, alcoholism, work place stress etc. About 3,50,000 new patients are detected with kidney failure, about 200,000 people from  liver disease, & about  50,000 from heart failure every year.

WHAT IS THE TREATMENT?

                                                 The only treatment for the end stage disease of any organ leading to organ failure is to replace the affected organ so that body can function. The procedure of replacing the failed organ is known as ORGAN TRANSPLANTATION. The organ transplantation is the greatest achievements of the medical science wherein a patient with end stage organ failure gets a new lease of life. For kidney failure the treatment options are,

  1. Lifelong dialysis
  2. Transplantation of kidney.

It is proved scientifically beyond any doubt that quality of the life is much superior after kidney transplantation.

SOURCES OF ORGANS.

 For transplantation one has to procure the necessary organs. Since organs cannot be manufactured in factories or in laboratories etc. they have to be procured from the following sources only.

  1. Living donor
  2. Animal donor.
  3. Deceased donor.

LIVING DONOR

 A living person donating one of his /her paired organs like kidney, lung or a part of his organ like liver known as living organ donation. The living donor could be

  1. RELATED DONOR: (Near relatives as defined by the LAW   include parents, Grandparents siblings & off springs. The spouse is emotionally related). With these many options too there is common situation of non-availability of a single donor in the family as grandparents & the parents may not be alive or medically fit or may not be having compatible blood group. SIBLINGS again may not be present, may not be matching, may not be medically fit or may not be willing to donate. With regards to spouse apart from the medical condition, he or she may not be willing to donate as he or she will have to take the burden of the family.
  2. LIVING UNRELATED DONOR: This kind of donor is acceptable only after proving that the donation is purely with altruistic intensions & no monetary exchange or exploitations of the poorer strata of the society.
  3. ANIMAL DONOR---The organs from the pig is supposed to evoke minimal immunogenic response. This kind of animal to human transplant is known as XENO TRANSPLANTATION. This may not be practical in near future as it is still in experimental stage. Whatever may be the immunological response it will cause severe rejection. Also there will be fear of spreading animal specific diseases in human beings. Apart from these issues there is a worldwide debate and objections from various societies of animal protection
  4. Deceased donor organ transplantation.—the organs from the heart beating, brain dead donors who are found only in the INTENSIVE CARE UNITS.

WHAT IS BRAIN DEATH?

          Whenever there is an intra-cranial catastrophe (inside the skull) leading to injury and swelling of the brain, the vital centres are affected too. If they are irreversibly damaged the individual cannot remain conscious or breathe spontaneously. Such patients are treated in the intensive care units with mechanical ventilators & their pulse, blood pressure etc. controlled by the necessary drugs.  Though brain is irreversibly damaged & dead leading to the death of the patient, rest of the solid vital organs like heart, lungs, liver, kidneys etc. get the warm oxygenated blood & hence they are alive. This state can be maintained for few hours to few days in an ICU setup. It is during this window period the organs could be surgically retrieved with the permission of the next to kin of the deceased donor (as per law), preserved in appropriate fluid & transplanted in suitable recipient within stipulated time.

The brain death should not be confused with COMA or EUTHANASIA.

In 1994 Indian parliament enacted  the law—TRANSPLANTATION OF HUMAN ORGANS ACT 1994(THOA1994) which has  accepted brain death also as definition of death apart from cardiac death  which was already existing. The tissues like skin, cornea, bone, cartilage etc. can be retrieved after the heart stops & death occurs not only in hospital but also at home or anywhere within 6 to 12 hours.

     The deceased donor program is a feasible, economical, legal & ethical program. It will effectively reduce the ever increasing gap between the waiting recipient & the donor if properly understood & implemented.

       The commonest causes of brain death are head injuries due to road traffic accidents, fall from height, gunshot wounds, brain tumours, brain surgeries etc. After brain death is diagnosed in ICU the screening for any cancer, transmissible infections, functions & fitness of

 

The transplantable organs, age of the donor, any systemic disease like diabetes, hypertension etc. . Is carried out in a scientific manner as per protocol.

The relatives are counselled & a written permission is obtained from the authorised person before retrieving the organs. After retrieval the organs are allocated impartially to most deserving recipients by the regional allocating authority. The body of the donor is surgically reconstructed with full care to avoid any disfigurement & handed over to the relatives for the last rites.

Some of the FAQs (frequently asked questions).

  1. Who can become donor?

Any healthy adult above the age of 18 years can be considered for living donation. For Deceased donor transplantation, patients between the ages of 2 to 70 years are considered as less than 2 years the tissues, organs may be immature, & after the age 70 the organs may not be optimally functioning.

 

  1. Does the brain dead donor get the pain during organ retrieval.

No pain is felt as the brain dead donor is no more i.e. he is dead.

 

  1. Will my religion allow the organ donation?

All religions of the world support the organ donation.

 

  1. Whether the patient will get full care in ICU if the relatives agree for the donation.

There   is no conflict of interest as ICU & Transplant teams are two different independent teams of doctors, and irrespective of your decision the patient will be given the best and optimum care.

 

  1. Who will pay for the donor investigations & the surgery?

Once the relatives give the consent no payment has to be done by the donor family.

 

  1. What should I do to become an organ donor after my death?

You must sign a donor card and carry it in your pocket all the time & inform your relatives regarding your wish.

 

                              Giving your organs after death is not just about making a donation; it is about making a difference. Do not think that organ donation is giving up a part of you to keep a stranger alive.  It is actually a total stranger giving up a large part of them to just keep a part of you alive. In the end one must realise that each one of us is born with the unique ability to change someone’s life. We must not waste it.

                              

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